Newsletter #75–Jan./Feb. 2003
The Breast Cancer Personality:
How I Learned to Stop Worrying About Worrying
by Lauren John
One morning while driving in heavy traffic, I heard a National Public Radio interview with a cardiologist who talked about the link between Type A behavior and heart disease.
For the more relaxed among us who don’t know what Type A behavior is, I offer this explanation from Los Angeles Times writer Elaine Woo: “Type-A personality [is] shorthand for the sort of driven individual who feels oppressed by time. This is the person who honks and fumes in traffic, barks at sluggish salesclerks, and feels compelled to do several things at once—perhaps shave while paying bills and dialing a phone.”1
Cardiologists Meyer Friedman and Ray Rosenman discovered the link between Type A behavior and heart disease in the 1950s, in part because they kept having to reupholster the chairs in their San Francisco waiting room. They noticed the most wear and tear on the front edges of the seats and armrests, instead of the back areas, which usually wear out first. When the doctors tried to figure out why this was happening, they noticed that coronary patients tended to sit on the edge of the seat, drumming their fingers on the armrests and leaping up frequently, usually to ask how much longer they would have to wait.2
This made me wonder if there were certain personality traits linked to breast cancer risk. Is there such a thing as a breast cancer personality? Are we shredding the copies of Oprah magazine in the surgeon’s office? Are we chewing on the plastic breast self-examination shower cards offered to us in our gynecologist’s waiting room?
A lot of common sense and a lot of studies say that if you are stressed out or depressed a lot or if people don’t like hanging around with you, your immune system can be affected and you can become prone to all kinds of illnesses, including the common cold.
But are personality and breast cancer linked more directly, the way that personality and heart disease seem to be? It’s a hard thing to study scientifically—but folks are out there trying. One study by a team of Australian researchers looked at 2,224 women who completed questionnaires while waiting for the results of a routine mammogram in a breast cancer screening program. Among other things, these women were asked about their self-esteem and their levels of anxiety and depression. The study concluded that there was “no evidence to support an independent association between these personality measures and the development of breast carcinoma.”3
A smaller study by the same research team involved interviews with 514 women called in for biopsies after a routine mammogram. A little less than half of the women were found to have breast cancer, while a little more than half turned out to have benign breast disease. In this study, the women were asked about social support as well as their emotional states. The findings here were that “women experiencing a stressor objectively rated as highly threatening and who were without intimate emotional social support had a ninefold increase in risk of developing breast carcinoma.”4
Breast surgeon and author Susan Love says that this finding doesn’t mean that stress causes breast cancer. “We don’t really know what it means until more research is done,” she says. “Theoretically, it could mean that social support during stressful times is important because it reduces the effect stress has on the immune system, thereby slowing cancer growth. But we don’t know for sure.”5
Fools Rush In
Unfortunately, a lack of medical knowledge in the general population, coupled with fear, causes all kinds of self-proclaimed experts to rush in to try to fill the void. Here’s a dangerous one: James A. Arond-Thomas, founder of the Center for Contemporary Medicine in Ann Arbor, Michigan. Here are his credentials, according to his web sites: He received a master’s of science in autonomic psychopharmacology and an M.D. from Ohio State University in 1970, and he completed an internship in psychosomatic medicine and psychiatry at Bellevue Hospital and the New York University Medical Center in 1971.6,7
These credentials look impressive to me. I decide to read on.
“Lack of self-esteem, the need to people-please, frustrated self-expression, sexual repression, a conflicted mother-daughter relationship, and other traits all are part of the breast cancer personality,” he writes.8
Does this sound like you or anyone you know?
Luckily, Arond-Thomas offers a solution. “The wonderful news about Dr. Arond-Thomas’ system is that once the psychological risk is identified, the patient can work to make changes that will, in fact, alter her risk for breast cancer,” his site continues. “Without long-term therapy with a psychologist or psychiatrist, a woman at risk can take control of her health. With guidance and in partnership, she can learn to change behavior patterns and alter her psychological profile.”
Well, it beats the hell out of tamoxifen. I wonder which is more expensive.
Still, Arond-Thomas might be on to something here. Can you imagine a direct link between getting breast cancer and, say, being someone who resents the hell out of making Christmas dinner every year for the entire family but does it anyway?
How many of you have mothers (or daughters) who say, “If you keep aggravating me this way, you’re going to give me a heart attack!” Might we more accurately say, “Cut that out or I’m gonna get breast cancer”?
Susan Love has some thoughts on this. OK, maybe she has never worked at Bellevue as Dr. Arond-Thomas did. But I’ll bet she knows from crazy, having seen a whole lot of different breast cancer personalities in her career and a whole lot of coping styles. Asked if there is such a thing as a breast cancer personality, she says on her web site:
We know what cancer is—uncontrolled cell growth stemming from the genetic mistakes that can occur when cells reproduce. These mistakes may be inherited—as with the BRCA genes—or they may be caused by an array of other external factors. There is no evidence, however, that one of these external factors is how women express—or don’t express—their emotions or how they handle stress. Improving your mental health won’t reduce your breast cancer risk, but it can improve your overall well-being as well as your relationships with family members and friends.9
The Post-Breast-Cancer Personality
The one thing that I can tell you for sure about personality and breast cancer is that my personality changed after breast cancer. I think that’s probably true for a lot of women. There are so many ways to react (or not react) to this disease that I think that scientists would be hard put to chronicle them all.
So, even though nobody asked, I am going to help out.
Here are five personality traits that I have noticed in myself and in other women I know who have been diagnosed with breast cancer. I have no idea if they are good or bad traits to have in terms of prognosis, and I don’t think you’ll find these in the medical journals just yet. But you might recognize yourself here, and I’m told that having a sense of community is healthy. I know I felt better just writing them down.
We love to celebrate birthdays. Many women in their 30s and 40s and beyond simply dread having birthdays; to them, birthdays are a sign of lost youth. Not so for many women living with breast cancer. (I just turned 45 in December!) We throw great birthday parties with joyous toasts to another year of life. Granted, the dessert may be soy-based carrot cake. And sure, we’ll argue over whether or not to serve alcohol, for health or political reasons. But each year of life is a cause for celebration—and we are thrilled to be having arguments over what kind of food and drink to serve, rather than what kinds of chemo to choose.
We know the metric system—and the diameters of most common fruits. When I learned that I had a 1.4-centimeter tumor growing in my breast—“the size of a grape,” my surgeon said—I learned the metric system damned fast and ran to the grocery down the block to see how big a grape was. As long as tumors are measured in millimeters, centimeters, raisins, grapes, and kumquats, women are going to be very familiar with European measurements and small fruits.
We don’t sweat the small stuff—especially when it’s someone else’s small stuff. Yes, I still get stressed out in traffic. But when other people complain about traffic, I’m not very sympathetic. Ditto for stories about the hassles of toilet training your kids, your problems with home contractors, and complaints about your neighbors who use their leaf blower early on weekend mornings. After getting cold stares with my stock reply—”You call that a problem? I’m living with breast cancer. That’s a problem”—I’ve learned that nobody loves a martyr.
We’re there for the big stuff. Weddings, commitment ceremonies, anniversaries, christenings, memorial services, hospital stays—I’m there for as many of these milestones as possible. Part of it is very self-serving. If I die of breast cancer sooner than I should, at least I will be immortalized in everyone’s photo albums and guest books.
But the most important reason that I show up is because after cancer, spending good times and bad with people that you love becomes more important than ever.
I think I cry more and pray more than other people at these kinds of events—especially at the weddings. At weddings my tears are tears of joy for the couple and also tears of joy for me. I take great joy in that fact that after all that disfiguring breast cancer treatment, I have my health back and look so great in the new outfit and shoes that I have bought for the wedding.
I was a newlywed when I got breast cancer. At every wedding I go to, in between the tears, I pray, “Dear God, please always keep these people as happy and healthy as they are today.”
Some women say that they especially cry at milestone 30th, 40th, and 50th wedding anniversary parties out of both joy and sadness—they’re happy for the couple that is celebrating, but at the same time they’re sad because they wonder if they themselves will live to cherish that long a marriage or relationship.
We never ever want to see our daughters, our granddaughters, our nieces, our daughters-in-law, or anyone else go through what we did. ’Nuf said.
1 Woo, Elaine. (Obituary, Meyer Friedman.) Doctor identified “Type-A” behavior, Los Angeles Times, May 6, 2001.
2 Ibid.
3 Price, M.A.., et al. The role of psychosocial factors in the development of breast carcinoma: Part 1. The cancer prone personality, Cancer, February 15, 2001, vol. 91, no. 4, pp. 679–85.
4 Price, M.A., et al. The role of psychosocial factors in the development of breast carcinoma: Part 2. Life event stressors, social support, defense style, and emotional control and their interactions. Cancer, February 15, 2001, vol. 91, no. 4, pp. 686–97
5 www.susanlovemd.com/community/questions/question010525.htm
7 www.breastcancerstrategies.com/program/atrisk.html
8 Ibid
9 www.susanlovemd.com/community/questions/question010525.htm