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Six months ago, Liu Lichun didn’t know her breast could contain cancer. No one had taught the 40-year-old Chinese woman from Inner Mongolia what the disease was. She’d never heard of a 1)mammogram or 2)mastectomy. It had thus never occurred to her that she would lose her left breast to the mysterious illness nor that such a loss would probably save her life.
The lump that transformed Liu’s world was not much larger than a marble. A company physician found it in June during the routine checkup that her employer, a Swiss firm in Shanghai, encouraged its sales staff to undergo each year. Once a 3)biopsy proved the tumor was 4)m alignant, Liu believed that the diagnosis was a death sentence.
Breast cancer is the most 5)lethal form of cancer for women in the world. An estimated one million cases would be identified 2007, and about 500,000 new and existing patients would die from the disease. In the U.S., breast cancer are diagnosed in one in eight women.
But in China, as in most other emerging economies, breast cancer is a relatively new concern, something that both patients and doctors are only 6)haltingly learning how to treat. Previously a 7)malady that mostly afflicted white, affluent women in the industrial hubs of North America and Western Europe, breast cancer is everywhere. Asia, Africa, Eastern Europe and Latin America have all seen their 8)caseloads spike. By 2020, 70% of all breast-cancer cases worldwide will be in developing countries.
Worse, as the reach of the disease is expanding, the reach of detection and treatment isn’t. For a woman battling breast cancer in the industrialized West, new diagnosis and treatment options come along all the time. Not so elsewhere.In the U.S., an estimated $8.1 billion is spent to diagnose and treat breast cancer each year, and the ubiquity of
9)mammography machines, clinics and specialists shows what that money can buy. As for a desperately poor land like 10)Kenya? If you can’t travel overseas for treatment, says Mary Onyango, a resident of the country whose disease was diagnosed at age 40, “you just sit and wait for your death.” Says Nancy Brinker, founder of the 11)Komen group: “Poverty is a known 12)carcinogen.”
Some of this bad news is the result of very good news. Thanks to better sanitation, more food and improved 13)public health, the average life expectancy in low-and middle-income nations has risen from 50 in 1965 to 65 in 2005. Women are simply living long enough to reach the age at which they’re most 14)susceptible to breast cancer.
While the risk factors for a disease may cross borders freely, the cultural understanding it takes to treat it doesn’t. Americans may live in a world of pink ribbons, but in other parts of the globe, breast cancer is still a shameful secret. Every three minutes an Egyptian woman is informed that she has the illness, and one of her first fears is that her husband will leave her. Secrecy leads not only to misery but also to 15)misinformation. In India, women with breast cancer may be forced to use separate plates and spoons because of the widespread belief that the disease is contagious.
Western Ways, Western Woes
If the spread of U.S. and European lifestyles is indeed contributing to the breastcancer boom, the first and worst of all those new habits is almost surely diet. In a study released in July 2007, scientists traced the eating habits of 3,000 Chinese women, ranging in age from 25 to 64. Half of the group ate a “meat sweet” diet of Western cuisine, rich in red meat, shrimp, fish, candy, desserts, bread and milk. The others stuck to more traditional Asian fare of tofu, vegetables, sprouts, beans, fish and soy milk. 16)Postmenopausal women in the meat-sweet group showed a 60% greater risk of developing the most common kind of breast cancer.
Then, too, there’s lack of exercise—a growing problem in the Western world. People who work on farms and in factories may get a workout all day long. But the more a globalizing world shifts from fields to offices, the less moving we do.
Speaking Out
If the developed world does not always do a good job of keeping itself well, health-care leaders there do understand that to fix the diseases you’ve got, you first have to talk about them. That is often not remotely the case elsewhere.
But things may be changing.Nongovern-mental groups such as Komen for the Cure and the World Health Organization sponsor lectures, professional gatherings and promotional events to educate women and 17)caregivers about the disease. Grass-roots initiatives are sprouting up in places that never dared mention the disease before.
In Hungary, where every woman from 45 to 65 now gets a free annual mammogram—with even travel costs covered—breast cancer has dropped from first place to third as a cause of death among women. In China the country’s 18)anticancer association launched a nationwide drive in 2005 to provide a million women, ages 30 to 70, with a free mammogram within the next three years.
It’s too early to say if these efforts indeed mean a start toward ending the global breast-cancer crisis. In the rich world, a diagnosis of breast cancer
may bring terror, but a terror lightened by hope. Elsewhere that is still not the case. If the developed world can work to globalize wealth, then it should be similarly able to globalize the opportunities for health.
6个月前，刘丽春（音译）还不知道她的乳房会长瘤，也没有人告诉过这位来自内蒙古的40岁中国妇女什么是乳癌；她从未听说过“乳房X光照片”或“乳房切除术”等名词。因此，她也就从未想过这种神秘的疾病会让自己失去左边的乳房，也不了解只有切除乳房，才有可能保住她的生命。
这个改变了刘丽春一生的肿块不过一块弹子大小。刘丽春供职于上海的一家瑞士公司，这家公司鼓励其销售部员工每年进行一次体检。在6月的一次例行检查中，公司所雇的医师发现了刘丽春乳房内的肿瘤。当切片化验结果表明该肿瘤是恶性时，刘丽春立刻觉得诊断结果给自己判了死刑。
乳癌是全球女性的头号癌症杀手。据估计，2007年全球的乳癌患者已达100万人，约有50万新患者或之前已确诊病人将死于该疾病。在美国，8个女人中就有1个被确诊患有乳癌。
然而，在包括中国在内的其他许多经济迅速发展的国家中，乳癌是近年才出现的健康问题，病人和医生对于乳癌治疗的了解还比较少。过去，此种疾病的患者主要是北美和西欧工业发达地区的富裕的白人妇女。但现在，乳癌已经随处可见，亚洲、非洲、东欧和拉丁美洲地区的患病率均急剧上升。到2020年，发展中国家的乳癌病例将占到全球总数的70%。
更令人担忧的是，乳癌在向全球扩散，但乳癌防治的覆盖面却远远不足。在业已工业化的西方世界，患者受惠于不断出现的诊断和治疗乳癌的新方法。然而世界其他地区与此种疾病作斗争的女性就没那么幸运了。在美国，每年用于诊断和治疗乳癌的资金约为81亿美元，乳房X光摄影机、专科诊所和专家的普及显示了金钱的力量。但在像肯尼亚这样极度贫困的地区，情况又如何呢？肯尼亚的玛丽·安延戈在40岁那年被确诊患有乳癌，她说，如果你无法到国外去治疗，那么“你就只能坐着等死了”。科曼乳癌基金会的创始人南茜·布林克指出：“贫穷是众所周知的致癌物质。”
然而，在一定程度上，这种悲剧的产生是由其他一些令人振奋的好消息带来的：由于卫生环境、食物供应及公共卫生设施的改善，世界低收入及中等收入国家的人均寿命由1965年的50岁提高到了2005年的65岁。妇女的寿命延长了，更多人活到了一个最容易罹患乳癌的年龄。
疾病的诱因也许可以轻而易举地跨越国界，但人们却难以突破治疗疾病时面临的文化障碍。美国人生活在一个“粉红丝带”的世界（编者注：这里指美国社会对乳癌警惕性较高），然而在世界其他地方，乳癌依然是一种让人蒙羞的隐痛。在埃及，每3分钟就有一名妇女被确诊患有乳癌，她们的第一个担忧就是会遭丈夫抛弃。不正视乳癌，不但导致当事人痛苦，还使人们产生误解。在印度，患乳癌的妇女可能会被禁止与别人共用餐盘和餐勺，因为人们普遍认为乳癌会传染。
西式生活方式的悲剧
如果说乳癌发病率剧升确实是源于美国和欧洲生活方式的流行，那么罪魁祸首无疑是饮食习惯。2007年7月份公布的一项研究报告中，科学家追踪了年龄介于25岁到64岁之间的3000名中国妇女的饮食习惯。其中一半人“无肉不欢、甜食不断”，具有典型的西方饮食习惯，她们食用大量的红肉、虾、鱼、糖果、甜食、面包和牛奶；另外一半人的饮食则一贯是比较传统的亚洲型，以豆腐、蔬菜、芽苗、豆类、鱼和豆奶为主。有前一种饮食习惯的已绝经妇女患最常见的乳癌病的风险比后一种高60%以上。
其二，缺乏锻炼也是西方世界面临的一个日益严重的问题。在农场和工厂工作的人每天都有足够的活动量。但在日益全球化的今天，人们的工作环境已经从田间转移到办公室，我们的活动量也大为减少了。
大声说出来！
如果说发达国家的人有时会因生活优裕而患病，这些国家的医疗部门至少明白，控制疾病的前提是让人们敢于以平常心面对它。但在其他国家却远远做不到这样。
不过情况也许正在好转。科曼乳癌基金会等非政府组织以及世界卫生组织赞助了各种讲座、专家研讨会以及宣传活动，旨在向妇女和医务工作者传授乳癌疾病知识。在原先从不敢提及乳癌的地方，抗击乳癌的民间运动也开始萌芽。
在匈牙利，每位年龄介于45岁到65岁的妇女每年都免费接受乳房X光检查，连往返交通费都由政府支付。乳癌曾经是匈牙利妇女的第一杀手，现已下降到第三位。2005年，中国抗癌协会在全国范围内推行一项举措，在之后的三年里，100万名年届30至70岁的妇女每年都可以进行一次免费乳房X光检查。
现在来判断这些努力是否确实意味着遏制全球乳癌危机的一个开始还为时过早。在富裕的国家，乳癌的确诊可能会带来恐惧，但治愈的希望能减轻这种恐惧感。然而，在世界的其他地方却不是此种情况。只有发达国家协力促成财富的全球化，那么，他们才同样能使所有的国家都有平等的机会获得健康。
The lump that transformed Liu’s world was not much larger than a marble. A company physician found it in June during the routine checkup that her employer, a Swiss firm in Shanghai, encouraged its sales staff to undergo each year. Once a 3)biopsy proved the tumor was 4)m alignant, Liu believed that the diagnosis was a death sentence.
Breast cancer is the most 5)lethal form of cancer for women in the world. An estimated one million cases would be identified 2007, and about 500,000 new and existing patients would die from the disease. In the U.S., breast cancer are diagnosed in one in eight women.
But in China, as in most other emerging economies, breast cancer is a relatively new concern, something that both patients and doctors are only 6)haltingly learning how to treat. Previously a 7)malady that mostly afflicted white, affluent women in the industrial hubs of North America and Western Europe, breast cancer is everywhere. Asia, Africa, Eastern Europe and Latin America have all seen their 8)caseloads spike. By 2020, 70% of all breast-cancer cases worldwide will be in developing countries.
Worse, as the reach of the disease is expanding, the reach of detection and treatment isn’t. For a woman battling breast cancer in the industrialized West, new diagnosis and treatment options come along all the time. Not so elsewhere.In the U.S., an estimated $8.1 billion is spent to diagnose and treat breast cancer each year, and the ubiquity of
9)mammography machines, clinics and specialists shows what that money can buy. As for a desperately poor land like 10)Kenya? If you can’t travel overseas for treatment, says Mary Onyango, a resident of the country whose disease was diagnosed at age 40, “you just sit and wait for your death.” Says Nancy Brinker, founder of the 11)Komen group: “Poverty is a known 12)carcinogen.”
Some of this bad news is the result of very good news. Thanks to better sanitation, more food and improved 13)public health, the average life expectancy in low-and middle-income nations has risen from 50 in 1965 to 65 in 2005. Women are simply living long enough to reach the age at which they’re most 14)susceptible to breast cancer.
While the risk factors for a disease may cross borders freely, the cultural understanding it takes to treat it doesn’t. Americans may live in a world of pink ribbons, but in other parts of the globe, breast cancer is still a shameful secret. Every three minutes an Egyptian woman is informed that she has the illness, and one of her first fears is that her husband will leave her. Secrecy leads not only to misery but also to 15)misinformation. In India, women with breast cancer may be forced to use separate plates and spoons because of the widespread belief that the disease is contagious.
Western Ways, Western Woes
If the spread of U.S. and European lifestyles is indeed contributing to the breastcancer boom, the first and worst of all those new habits is almost surely diet. In a study released in July 2007, scientists traced the eating habits of 3,000 Chinese women, ranging in age from 25 to 64. Half of the group ate a “meat sweet” diet of Western cuisine, rich in red meat, shrimp, fish, candy, desserts, bread and milk. The others stuck to more traditional Asian fare of tofu, vegetables, sprouts, beans, fish and soy milk. 16)Postmenopausal women in the meat-sweet group showed a 60% greater risk of developing the most common kind of breast cancer.
Then, too, there’s lack of exercise—a growing problem in the Western world. People who work on farms and in factories may get a workout all day long. But the more a globalizing world shifts from fields to offices, the less moving we do.
Speaking Out
If the developed world does not always do a good job of keeping itself well, health-care leaders there do understand that to fix the diseases you’ve got, you first have to talk about them. That is often not remotely the case elsewhere.
But things may be changing.Nongovern-mental groups such as Komen for the Cure and the World Health Organization sponsor lectures, professional gatherings and promotional events to educate women and 17)caregivers about the disease. Grass-roots initiatives are sprouting up in places that never dared mention the disease before.
In Hungary, where every woman from 45 to 65 now gets a free annual mammogram—with even travel costs covered—breast cancer has dropped from first place to third as a cause of death among women. In China the country’s 18)anticancer association launched a nationwide drive in 2005 to provide a million women, ages 30 to 70, with a free mammogram within the next three years.
It’s too early to say if these efforts indeed mean a start toward ending the global breast-cancer crisis. In the rich world, a diagnosis of breast cancer
may bring terror, but a terror lightened by hope. Elsewhere that is still not the case. If the developed world can work to globalize wealth, then it should be similarly able to globalize the opportunities for health.
6个月前，刘丽春（音译）还不知道她的乳房会长瘤，也没有人告诉过这位来自内蒙古的40岁中国妇女什么是乳癌；她从未听说过“乳房X光照片”或“乳房切除术”等名词。因此，她也就从未想过这种神秘的疾病会让自己失去左边的乳房，也不了解只有切除乳房，才有可能保住她的生命。
这个改变了刘丽春一生的肿块不过一块弹子大小。刘丽春供职于上海的一家瑞士公司，这家公司鼓励其销售部员工每年进行一次体检。在6月的一次例行检查中，公司所雇的医师发现了刘丽春乳房内的肿瘤。当切片化验结果表明该肿瘤是恶性时，刘丽春立刻觉得诊断结果给自己判了死刑。
乳癌是全球女性的头号癌症杀手。据估计，2007年全球的乳癌患者已达100万人，约有50万新患者或之前已确诊病人将死于该疾病。在美国，8个女人中就有1个被确诊患有乳癌。
然而，在包括中国在内的其他许多经济迅速发展的国家中，乳癌是近年才出现的健康问题，病人和医生对于乳癌治疗的了解还比较少。过去，此种疾病的患者主要是北美和西欧工业发达地区的富裕的白人妇女。但现在，乳癌已经随处可见，亚洲、非洲、东欧和拉丁美洲地区的患病率均急剧上升。到2020年，发展中国家的乳癌病例将占到全球总数的70%。
更令人担忧的是，乳癌在向全球扩散，但乳癌防治的覆盖面却远远不足。在业已工业化的西方世界，患者受惠于不断出现的诊断和治疗乳癌的新方法。然而世界其他地区与此种疾病作斗争的女性就没那么幸运了。在美国，每年用于诊断和治疗乳癌的资金约为81亿美元，乳房X光摄影机、专科诊所和专家的普及显示了金钱的力量。但在像肯尼亚这样极度贫困的地区，情况又如何呢？肯尼亚的玛丽·安延戈在40岁那年被确诊患有乳癌，她说，如果你无法到国外去治疗，那么“你就只能坐着等死了”。科曼乳癌基金会的创始人南茜·布林克指出：“贫穷是众所周知的致癌物质。”
然而，在一定程度上，这种悲剧的产生是由其他一些令人振奋的好消息带来的：由于卫生环境、食物供应及公共卫生设施的改善，世界低收入及中等收入国家的人均寿命由1965年的50岁提高到了2005年的65岁。妇女的寿命延长了，更多人活到了一个最容易罹患乳癌的年龄。
疾病的诱因也许可以轻而易举地跨越国界，但人们却难以突破治疗疾病时面临的文化障碍。美国人生活在一个“粉红丝带”的世界（编者注：这里指美国社会对乳癌警惕性较高），然而在世界其他地方，乳癌依然是一种让人蒙羞的隐痛。在埃及，每3分钟就有一名妇女被确诊患有乳癌，她们的第一个担忧就是会遭丈夫抛弃。不正视乳癌，不但导致当事人痛苦，还使人们产生误解。在印度，患乳癌的妇女可能会被禁止与别人共用餐盘和餐勺，因为人们普遍认为乳癌会传染。
西式生活方式的悲剧
如果说乳癌发病率剧升确实是源于美国和欧洲生活方式的流行，那么罪魁祸首无疑是饮食习惯。2007年7月份公布的一项研究报告中，科学家追踪了年龄介于25岁到64岁之间的3000名中国妇女的饮食习惯。其中一半人“无肉不欢、甜食不断”，具有典型的西方饮食习惯，她们食用大量的红肉、虾、鱼、糖果、甜食、面包和牛奶；另外一半人的饮食则一贯是比较传统的亚洲型，以豆腐、蔬菜、芽苗、豆类、鱼和豆奶为主。有前一种饮食习惯的已绝经妇女患最常见的乳癌病的风险比后一种高60%以上。
其二，缺乏锻炼也是西方世界面临的一个日益严重的问题。在农场和工厂工作的人每天都有足够的活动量。但在日益全球化的今天，人们的工作环境已经从田间转移到办公室，我们的活动量也大为减少了。
大声说出来！
如果说发达国家的人有时会因生活优裕而患病，这些国家的医疗部门至少明白，控制疾病的前提是让人们敢于以平常心面对它。但在其他国家却远远做不到这样。
不过情况也许正在好转。科曼乳癌基金会等非政府组织以及世界卫生组织赞助了各种讲座、专家研讨会以及宣传活动，旨在向妇女和医务工作者传授乳癌疾病知识。在原先从不敢提及乳癌的地方，抗击乳癌的民间运动也开始萌芽。
在匈牙利，每位年龄介于45岁到65岁的妇女每年都免费接受乳房X光检查，连往返交通费都由政府支付。乳癌曾经是匈牙利妇女的第一杀手，现已下降到第三位。2005年，中国抗癌协会在全国范围内推行一项举措，在之后的三年里，100万名年届30至70岁的妇女每年都可以进行一次免费乳房X光检查。
现在来判断这些努力是否确实意味着遏制全球乳癌危机的一个开始还为时过早。在富裕的国家，乳癌的确诊可能会带来恐惧，但治愈的希望能减轻这种恐惧感。然而，在世界的其他地方却不是此种情况。只有发达国家协力促成财富的全球化，那么，他们才同样能使所有的国家都有平等的机会获得健康。