Eleven months ago, Lankenau Medical Center oncologist Marisa Weiss was forging ahead with her latest project, a step-by-step guide to reducing the risk of breast cancer.
That's when a mammogram revealed her breast cancer.
The painful irony is not lost on her: "Here I am, a breast-cancer doctor, and I couldn't prevent it."
But adding "survivor" to her breast-cancer bona fides - clinician, author, speaker, and founder of breastcancer.org, arguably the world's leading online breast-health resource - has made her career-long crusade only more personal. Now she diligently practices what she preaches about making lifestyle changes.
"Getting a diagnosis is a wake-up call and a great motivator," said Weiss, 51.
The 32-page booklet, "Think Pink, Live Green," was introduced Saturday at Lankenau during a free half-day conference attended by nearly 250 people. Presenters included Harvard Medical School cell biologist Joan V. Ruderman, who helped with the scientific basis for the guide. A fully referenced version is now online at http://www.breastcancer.org/guide
Of course, self-help guides are nothing new. A search of Amazon.com for "breast cancer prevention" books turns up hundreds of tomes - including Weiss' own 1998 book, Living Beyond Breast Cancer, and the 2010 update, Living Well Beyond Breast Cancer, both written with her mother, Ellen Weiss.
And while risk reduction sounds great, Weiss is the first to admit it is complicated and fallible.
"There is no combination of steps to guarantee breast-cancer prevention," she said. "All we can do is try to reduce risk in a meaningful way."
Still, she sees a need for "Think Pink, Live Green," which she plans to promote through social and traditional media.
Despite all the talk of breast-cancer awareness, she has found that many females, especially young ones, know little about the biology of breasts. Nor are they aware that their body's own estrogen and chemicals that add or mimic estrogen - such as birth-control pills, menopausal hormone therapy, and alcohol - can promote breast cancer.
To change that, she began speaking in local schools five years ago. That spawned a Random House book, Taking Care of Your 'Girls,' A Breast Health Guide for Girls, Teens and Inbetweens.
"This has been Marisa's passion for quite some time," said Jennifer Sabol, medical director of Lankenau's breast-cancer program. "She's found kids have astronomical misconceptions about breast cancer. Thirty percent think they could develop it at 12 to 15 years old."
The booklet provides a lay-language overview of the biology, then cites modern trends, both good and bad, that have increased risk. Among these: earlier puberty, later (or no) childbearing, less breast-feeding, more obesity, and greater longevity.
Today, an American woman's lifetime chance of breast cancer is one in eight, compared with one in 10 in the 1970s. Death rates have fallen, but the disease will still claim an estimated 40,000 lives this year.
The booklet offers 31 "opportunities" for prevention.
Some recommendations, such as "stop smoking" and "limit alcohol use," involve well-established risk factors.
Others are more controversial. "Limit your use of canned foods and plastics," the booklet urges, on the theory that they release bisphenol A, a chemical that may be carcinogenic, into foods.
Jose Russo, director of the breast-cancer research lab at Fox Chase Cancer Center, says he believes the advice is prudent, even though evidence of harm comes from lab and animal studies, not humans.
"I think the booklet is well-balanced," he said.
Weiss herself has become a role model. Even though her own cancer was caught early and her treatment went well, she is not complacent.
She researched her family tree - another "Think Pink" recommendation - and found relatives besides her mother who had breast cancer. Now 15 pounds lighter, she buys organic fruit, filters her tap water, avoids meat and alcohol, takes Vitamin D supplements, and has found an exercise program she can stick to.
"I found exercise exceedingly boring. Then I discovered Zumba," she said of the dance-based fitness classes. "Now I exercise five to seven hours a week. That's a huge change."
Meanwhile, she is capitalizing on the fan base of breastcancer.org, which claims 10 million regular users worldwide. The Indian government has invited her for a visit to explore ways to promote risk reduction using mobile-phone applications.
"There hasn't yet been a cohesive movement aimed at breast-cancer prevention," she said. "It's partly because people don't realize how much is in their power."
Contact staff writer Marie McCullough at 215-854-2720 or firstname.lastname@example.org.