“How These 31 Variables May Cause Your Anti-Breast Cancer Lifestyle To Fail You”

There’s a theme swirling around my social media and real-life worlds this week, with Twitter followers and in-person clients alike describing their pre-cancer lifestyles in the following fashion:

  • “But I ate organic!”
  • “But I did ALL the right things.”
  • “But I really took care of myself.”
  • “F*ck genetics! This is how I ate (and organic) for a decade or more before cancer diagnosis.”

With a diagnosis of breast (or any) cancer, some of the first and long-lingering questions are these:

WHY (did I get this). HOW (did I get this). WHEN (did I get this). WHAT (did I do to get this).

I know this with absolute certainty because I asked WHY, over and over and over and over again. Why did I, promoter of wellness, prevention and healthy living, walker-of-the-talk and champion of all things nutritious and giddily healthy, actually have the words “It is cancer.” directed at me?

What I now know, is that perhaps a better question to ask may have been “why not?”

New cancer rates are increasing; about half of all men and one-third of all women will develop cancer in their lifetimes.* The county I’ve lived in for the past 26 years has the 7th highest rate of breast cancer in the state of Illinois.

Why wouldn’t I get breast cancer?

Well, I wouldn’t of course, because I did “all the right stuff.”

Yet here’s the thing; I never thought that. I know there are no guarantees, that I was merely stacking the “healthy deck” in my favor, certainly not securing any absolutes from the universe. I mean, what arrogant thinking that would have been on my part, that simply because I’m an enthusiastic and of my own volition embracer of a healthy lifestyle (and an honest-to-God real dietitian for heaven’s sake) I would be kept safely out of cancer’s clutches.

As if there were even enough kale, lentils and running paths on the planet.

Breast cancer doesn’t care about my RD credentials any more than it cares about the substantial collection of running medals hanging in my closet.

But that thinking did come from some people. “WTF? Cathy Leman has breast cancer? I give up.” And I completely get it.

The desire for personal control is innate in each and every one of us, and hearing that someone who takes care of themselves is dealt a staggering health blow? That doesn’t at all help us feel in control.

In my experience, when people learn that someone living la vida healthy has a serious illness, they head to one of two camps.

Camp One: Person living healthy lifestyle is diagnosed with cancer. Person living “less than healthy” lifestyle determines that if healthy person gets cancer “the rest of us are doomed”, ergo, exercise and eating healthy doesn’t work, abandons all effort or thought of making slightest shift toward a healthier lifestyle; commences binge-watching t.v. accompanied for eternity by a steady diet of all things junky, processed, and artificial.


Camp Two: Person living healthy lifestyle is diagnosed with cancer. Person living “less than healthy” lifestyle determines that if healthy person gets cancer, yet comes through with minimal (or manageable) collateral damage, there must be something to that healthy lifestyle, commits to making small changes toward improving their own health; goes out for a walk, buys a bushel of broccoli and learns five different ways to prepare it, then actually eats it. Every day.


There’s no question that taking care of yourself builds physical resilience and positions you to get through ANY illness with increased odds of a better outcome. I see it in the research, in anecdotal reports from other survivors, and I experienced it firsthand myself.

But here’s the bottom line. Nothing, not one particular food or any specific type or amount of exercise has been 100% proven to prevent breast cancer, and with the exception of BRCA gene mutations and/or an otherwise strong genetic history, no one really knows WHY we get the cancer we get. Wait, that’s not entirely true. I clearly recall my nurse navigator saying, “Smokers are the only people who don’t ask “Why did I get this?”

No one does EVERYTHING perfectly for their whole, entire life. Cancer takes years to develop; can you honestly say that you’ve done EVERYTHING perfectly (assuming we even know what the exact “everything” we need to do should be) in the years leading up to right now?

And consider this. Perhaps you currently “cook and eat organic” at home, and aim to keep your toxin exposure to a bare minimum, but you’re also out there in the big old world living your life:

  • eating at restaurants, airports and other locations where you honestly don’t know what’s actually in the food
  • walking and running through neighborhoods where lawns are drenched in free-floating toxic chemicals in pursuit of suburban perfection
  • visiting glorious cities where you take in both the sights and the vehicle exhaust
  • staying in hotels (or other homes) where the cleaning products used are most certainly not toxin-free

Breast cancer is a complex web of biological, behavioral, social and physical conditions, all merging at exactly the right time to create the perfect storm.

Here’s an excellent visual representation of 31 different variables that are potential contributors to breast cancer. Be sure to click on the various boxes in each area (Domain, Strength, Data Quality) to view the connections (strong AND weak) outlined clearly: A Model of Breast Cancer Causes

See how complex and random it is?! But don’t get discouraged.

I encourage you to take the best care of yourself that you can, because there’s no question that it absolutely makes a difference, but also, to be kind, gentle and forgiving with yourself. You can’t “cause” breast cancer, any more than you can avoid the sheer randomness of it.

* Cancer Rates: http://theoncologist.alphamedpress.org/content/12/1/20.short

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“Three Reasons Why Strawberries Actually DON’T Cure Breast Cancer”

I get a little cranky when I see headlines like this: “Eating Strawberries Daily Can Help Prevent and Even Cure Breast Cancer”

I know I shouldn’t get cranky. This sort of headline primarily serves to increase readership and subscriptions, for heaven’s sake. I mean, why would an editor ever consider that these words could be a dagger to the heart for some of their readers?

Editors don’t think about those of us who’ve been through the ravages of REAL breast cancer (vs. in the laboratory FAKE breast cancer), feeling all vulnerable and open to trying most ANYTHING if it will cure the REAL breast cancer or keep the REAL breast cancer away or prevent it from returning forever, amen.

Not to mention, headlines like this confuse the heck out of breast cancer folks – they’re already unsure about what to eat or not – rickety science headlines do nothing to help.

In order to assuage my crankiness, let’s take this apart; first looking at this headline for what it is, and then seeing if we can find something good in it, shall we?


Let’s start with a question. What food (or foods), do you actually eat daily – 365 days/year?

I’d say, not many, probably.

For me personally, the ONLY thing I eat or drink every, single day, is coffee. Even my own anti-cancer, risk-reduction diet that I cling to like a life-raft can deviate (slightly) from day to day.

Without question, there are standard items that I aim to eat daily, but sometimes my food choices depend on whether I’m traveling, if I’ve been to the grocery store, or if my husband polished off the remaining (fill in food here) that I’d planned to eat.

So if, as the headline screams, the prevention and cure hinges on the frequency of strawberry eating, and you can’t (or won’t) sustain daily strawberry eating? You’re already doomed.


Next question. When was the last time you ate strawberry extract?

And not just any old strawberry extract. Extract from the “Alba” strawberry.

Right. Never.

In this study, the researchers used polyphenol-rich strawberry extract (PRSE) obtained from the “Alba” variety.

As it turns out, the “Alba” strawberry is an early ripening variety from Italy. A quick online search reveals that this particular variety is very difficult to get your hands on in the United States.

Believe me when I say, there is little I would like better than to be in Italy 365 days/year, eating early ripening strawberries, be they juiced, dried, whole, macerated, even extracted.

But that’s highly unlikely, so if I were looking for this strawberry cure or prevention RIGHT NOW? Vorrei, ma non posso.

If the prevention and cure hinges on the FORM (extract – read “concentrated”) and VARIETY (“Alba”, courtesy of beautiful Italy), once again, doomed.


This research was performed using “cell lines” of both mouse and human origin.

Cell lines are cell cultures developed from a single cell. In cancer research they’re used as fundamental models to study the biology of cancer and to test the beneficial effectiveness of anticancer agents, but cell lines have limitations, and aren’t perfect representations of actual human or cancer cells.

Also of note, this study looked at the effects of the PRSE on one particular cell line; the highly aggressive and invasive basal-like breast cancer cell line A17.

If I’ve learned anything since my own breast cancer diagnosis, it’s that there are many different types of breast cancer, so a beneficial treatment, even in food form, may perhaps not have the same outcome for everyone. Which begs the question; what impact, if any, would this strawberry extract variety have on different types of cancer cells?

We don’t know. And that can feel discouraging. Bleh.


But hey, let’s not write strawberries off yet! Here’s where we unearth the goodies from this story, and I get less cranky.

Berries (of ALL types) have a group of phytochemicals (anti-cancer compounds) called “polyphenols.” Two particularly active types of polyphenols that work together are anthocyanins, a class of flavonoids that gives berries their color, and ellagitannins, the source of ellagic acid, which may inhibit tumor cell production.

Berries also contain simple, yet powerful phenols such as quercetin and ferulic acid, and they’re loaded with vitamin C, manganese (a mineral) and fiber.

Strawberries in particular have high levels of antioxidants and phytochemicals, as well as a host of other bioactive compounds. Yet, as the researchers do point out (yay researchers!):

“The role of strawberry bioactive compounds on cancer prevention seems to involve different mechanisms, which have not yet been fully elucidated; therefore, further investigations are needed to clarify the roles of the different strawberries phytochemicals against cancer cells. Several studies on extracts of strawberries, raspberries, and other fruits and berries, did not find any correlations between the content of some phytochemicals and inhibition of cancer cell proliferation. Different studies indeed have shown that the complex mixtures of phytochemicals present in fruits and vegetables are more effective than their individual constituents in preventing cancer, through both additive and synergistic effects.”

So, here’s what you can do.

Eat the whole, entire, real fruit. Skip the berry extract supplements and powders and drinks. Buy yourself a pint of strawberries, and if you’re so inclined (and don’t have diabetes where you need to watch carb portions), eat the entire thing in one sitting. The calories are low(ish), fat non-existent, and the benefit completely outweighs eating an entire bag of potato chips (duh) – which people are inclined to do with nary a thought.

Each week, add 4-5, 1/2 cup servings of berries to smoothies, oatmeal and other cereal, salads and snacks, keeping in mind that there may be merit to eating a variety of berries (black, blue, straw, rasp).

They each bring something different to the anti-cancer party!

Source: Polyphenol-rich strawberry extract (PRSE) shows in vitro and in vivo biological activity against invasive breast cancer cells