The Progress Educational Trust's enlightening series of events on breast cancer came to a close on Thursday with 'Breast Cancer Risk: Facts, Fictions and the Future'.
At the beginning of this series the subject of the fourth and final meeting was a matter for speculation. It was put into the hands of the audience, who at the three prior events got to decide what they wanted to discuss. The topic was close to their hearts, which was apparent from the lively and engaging atmosphere in the lecture theatre.
The panel comprised a broad mix of interested parties. It included a patient, a researcher and the head of public heath at a charity. It also saw the return of Professor Gareth Evans, a consultant in medical genetics and cancer epidemiology, who was on the panel at the first event.
One of the evening's themes was facts and fiction about breast cancer, and the organisers used the opportunity to test their audience's knowledge with a quick quiz. It was encouragingly evident that everyone was well informed. The theatre remained still when asked if we thought underwired bras were a risk factor for breast cancer, but a forest of hands appeared when asked the same question about the contraceptive pill. Everyone had done their homework.
Armed with the knowledge that her audience hadn't succumbed to the many fictions about breast cancer risk factors, the talks were opened by Eluned Hughes. Eluned is head of public health at the charity Breakthrough Breast Cancer, and she spoke broadly about the risk factors involved in developing the disease. She highlighted the extensive misinformation available on the internet that can bamboozle people, and listed a few false risk factors such as power lines, caffeine and bizarrely, dogs.
She was followed by Fay Schopen, a journalist who previously had breast cancer. She gave a personal account, discussing how constant, often contradictory, articles about the latest 'risk factor' left her feeling confused. She described the media as scaremongering and expressed her frustration that these articles often leave survivors feeling as though they personally are at fault for developing the disease.
A change of direction came from Dr James Flanagan, a researcher investigating epigenetics in cancer. This was a challenging topic to address, as an understanding of epigenetics is often difficult to grasp, but Dr Flanagan confidently stated that in the not too distant future epigenetic signatures will help us better identify those individuals at real risk of developing breast cancer.
Professor Evans continued in this vein, but from a broader perspective. He spoke optimistically about the future of breast cancer risk assessment. He discussed better identification of 'at risk' people, the use of preventative medicine, and the possibility of personalised medicine, tailored specifically to a person's need.
The talks were kept brief, allowing plenty of time for a lively Q&A session, chaired by Dr Jess Buxton. There was a constant stream of wide-ranging questions from an eager audience that included doctors, patients, campaigners and people at risk of developing breast cancer.
Through the discussion the theme that emerged most clearly was on the tangle of information available in the media about what increases or reduces the risk of developing breast cancer. Many questions were asked along this line about specific factors, which in particular kept Professor Evans busy. Are antioxidants protective? Is having an abortion a risk factor? Does dairy increase your risk?
This all strongly echoed Fay Schopen's talk about the deluge of conflicting information out there, and there was a tangible sense of frustration from women in the audience about the confusion. Fay summarised the feeling well. She said when she was diagnosed her oncologist didn't give her advice about changing her lifestyle to reduce her risk of developing the cancer again. But women at high risk want to know what they can do to prevent cancer developing, as it gives them a feeling of control. But just how do you know what information is right?
In response Eluned discussed how the media might run a story about a risk factor based on a small study, intending to engage the general public who may not of even thought about their lifestyle or how it affected their risk of breast cancer. But those who know they are at risk often want more clear, proven information. Which is where charities like Breakthrough Breast Cancer come in, who can provide clear verified information. The panel emphasised the need for large and rigorous studies when looking at risk factors, and stressed the importance of evidence.
When the discussion was brought to an end the take home message from the panel was the need for rigorous evidence when looking at breast cancer risk factors. But they were optimistic that identification, prevention and the treatment of breast cancer were improving, and as Professor Evans said, 'the future is rosier'.