This post originally appeared in Yiddish at the Yiddish Forward; this translation appears with their permission. This blog is also sponsored by my new book, Making Sense of Medicine. Pick up your copy today!
Dear Dr. Berger,
I am a woman on the cusp of 30 and I am not married. Recently I have come to understand that I might miss the opportunity to have children biologically. Of course I have various thoughts about this, but maybe you can help me with one of them: I heard that women without children get cancer more often. Is this true (though I understand that this is no reason to have a child)? What do you think about the general topic of how “natural” it is to give birth (or not), and how this can affect the body?
Yours,
Would Rather Make Books Than Kids
Dear Books,
The argument is that the hormones produced by the ovaries till menopause can indeed increase the risk of cancer. Everything that increases the time of the body’s exposure to hormones can also elevate that risk (e.g., a girl who starts menstruating at a younger age, or later menopause), and everything which reduces the time of hormone production (for example, pregnancy) can reduce the risk.
That’s all in theory, of course. What do the scientific studies tell us, and should someone worry about the connection between not having biologic children and cancer? A systematic review published this year shows that the chance of breast cancer is elevated 1.5 times in women who don’t give birth to children. Before getting anxious, one should understand what that means. First, you should ask - 1.5 times *what*?
If your risk of breast cancer is not significantly greater than the population’s, a factor of one and a half may not appreciably change your future. Secondly, though breast cancer is certainly to be avoided, not every case of the disease is alike. Cancer can be treated, and even prevented in some cases with pills. All of this requires a detailed discussion with a reliable doctor or nurse who is informed about the data and your priorities.
The same is true, with certain changes, about ovarian and endometrial cancer, though the proportions, and the reliability of the relevant studies, is somewhat different. There are other cancers which might be related to giving birth though the evidence is even less clear in those cases.
Let’s consider this another way, though. Of course you’re right that the risk of cancer is not a sufficient reason in itself to have biologic children. If we were a patient and a doctor in a room together, I would ask you -- do you really think that 30 is the end of having kids? People have kids in their 30s, and even “old women” well into their 40s! (That’s not to mention other routes, of course, like adopting, surrogacy, etc.)
I would also ask what disturbs you in particular about cancer. Of course “that disease” (many of our ancestors hesitated even to call it by its name) is a source of terror to many, but it’s not the only disease in the world. Maybe your family history includes a cancer which concentrates your thoughts and colors your approach? Or perhaps the “cancer awareness” of our society has affected you? The pluses and minuses of having kids (biologically or otherwise) are a lot deeper than risk factors for disease.
In conclusion - I agree that books are just as important as kids. Both can bring joy and worry in equal measure.
Dear Dr. Berger,
I am a woman on the cusp of 30 and I am not married. Recently I have come to understand that I might miss the opportunity to have children biologically. Of course I have various thoughts about this, but maybe you can help me with one of them: I heard that women without children get cancer more often. Is this true (though I understand that this is no reason to have a child)? What do you think about the general topic of how “natural” it is to give birth (or not), and how this can affect the body?
Yours,
Would Rather Make Books Than Kids
Dear Books,
The argument is that the hormones produced by the ovaries till menopause can indeed increase the risk of cancer. Everything that increases the time of the body’s exposure to hormones can also elevate that risk (e.g., a girl who starts menstruating at a younger age, or later menopause), and everything which reduces the time of hormone production (for example, pregnancy) can reduce the risk.
That’s all in theory, of course. What do the scientific studies tell us, and should someone worry about the connection between not having biologic children and cancer? A systematic review published this year shows that the chance of breast cancer is elevated 1.5 times in women who don’t give birth to children. Before getting anxious, one should understand what that means. First, you should ask - 1.5 times *what*?
If your risk of breast cancer is not significantly greater than the population’s, a factor of one and a half may not appreciably change your future. Secondly, though breast cancer is certainly to be avoided, not every case of the disease is alike. Cancer can be treated, and even prevented in some cases with pills. All of this requires a detailed discussion with a reliable doctor or nurse who is informed about the data and your priorities.
The same is true, with certain changes, about ovarian and endometrial cancer, though the proportions, and the reliability of the relevant studies, is somewhat different. There are other cancers which might be related to giving birth though the evidence is even less clear in those cases.
Let’s consider this another way, though. Of course you’re right that the risk of cancer is not a sufficient reason in itself to have biologic children. If we were a patient and a doctor in a room together, I would ask you -- do you really think that 30 is the end of having kids? People have kids in their 30s, and even “old women” well into their 40s! (That’s not to mention other routes, of course, like adopting, surrogacy, etc.)
I would also ask what disturbs you in particular about cancer. Of course “that disease” (many of our ancestors hesitated even to call it by its name) is a source of terror to many, but it’s not the only disease in the world. Maybe your family history includes a cancer which concentrates your thoughts and colors your approach? Or perhaps the “cancer awareness” of our society has affected you? The pluses and minuses of having kids (biologically or otherwise) are a lot deeper than risk factors for disease.
In conclusion - I agree that books are just as important as kids. Both can bring joy and worry in equal measure.
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