SAN FRANCISCO — By seventh grade we had been hearing that our bodies were going through a lot of fascinating changes. Hardly anyone I knew could tell, and everyone was thinking there was something wrong with them and this pretty much set the tone of the next six years.
--cartoonist Lynda Barry
Teen-age girls and their body-image traumas are standard fodder for lighthearted commentary. Seattle cartoonist Lynda Barry, for example, devoted an entire book to the theme of an adolescent's perception of the physical changes going on in her and her peers. "It seemed like nearly everyone was deformed without ever having a chance to be normal," she wrote.
In reality, this obsession with physical perfection is sometimes less than amusing--for instance, when young women starve themselves or alternately binge and purge in their lust to be thin. And now an associate researcher at the UC San Francisco School of Medicine has uncovered what she believes to be yet another grim outcome of young women's perennial dissatisfaction with their bodies.
In her book, "The Silent Wound: A Startling Report on Breast Cancer and Sexuality" (Addison-Wesley, $14.95), Peggy Boyd reports that women who harbor conflicts about their sexuality during adolescence are at least twice as likely as their untroubled counterparts to later develop breast cancer.
"I'm not saying that this (unresolved adolescent conflict) is the cause of breast cancer," said Boyd, 47, in an interview at her home near the UCSF campus. "The causes are multidimensional. You have to have a lot of things going on at the same time in order to get breast cancer."
Boyd, who holds a doctorate in public health from UC Berkeley, said her findings simply contribute one more item to the roster of known factors--among them age, heredity, reproductive history and diet--that determine who is likely to get the disease.
Most Common Form
According to new statistics issued by the American Cancer Society, breast cancer will strike one woman in 10 in her lifetime. It is the most common form of cancer in women.
The medical director of the Woman's Breast Center in Santa Monica, Dr. Saar Porrath, said that Boyd's report is not likely to be embraced by physicians. Much of what is published in psychological literature never makes it into the medical consciousness, he said. And doctors who do come across theories such as Boyd's, he noted, are often reluctant to accept psychological factors as contributing causes of cancer.
"I have difficulty (with Boyd's findings) on the basis of one study," Porrath said. "But it's an interesting thesis, and I would not discount it."
Body-image conflicts, he added, are not unique to women with breast cancer. "That's a tremendous problem among women in general," he said. "That's a universal."
Boyd was working as a nurse on an oncology ward in the Bay Area several years ago when she began to notice that breast cancer patients differed from patients with other diagnoses.
"They're the kind of people nurses like because they never complain about anything and always have a smile," she said. "I also began to notice (during evening visiting hours) that these patients behaved differently toward their husbands and their families," Boyd added. In the book she explains that the breast-cancer patients appeared to be "courteous and superficial" when interacting with their spouses.
She began researching theories of psychosomatic medicine, and discovered a school of thought that held that stress-triggered illnesses could be organ-specific. Rather than illness striking randomly when the body is under stress, the theory said, negative feelings toward an organ or body part could weaken the body's defenses in that region, leading to localized disease.
Boyd's theory took shape as she had long talks with two close friends who were diagnosed as having breast cancer. Both admitted to lifelong fears about dating and intimacy. The women tended to be remote from their husbands. True to Boyd's hypothesis that such women repress anger and conflict by always behaving in a good-natured manner, the victims shielded news of their impending surgery from their co-workers and families, so as not to disturb anyone.
Boyd tested her ideas on Dr. Nicholas Petrakis, chairman of the Department of Epidemiology and International Health at the UCSF School of Medicine. Boyd said she had been warned that Petrakis was notorious for rejecting proposals for psychologically based research.
He Cleared the Way
But when she suggested to Petrakis that women who develop breast cancer tend to be "physiologically mature, but psychologically immature," he said," 'I think you may be absolutely right,' " Boyd said. Petrakis cleared the way for her study to be funded.