Breast cancer survivor Nancy Evans is an activist, writer, editor, and filmmaker with a message.

By Teresa A. Nappier

Being diagnosed with breast cancer in 1991 changed Nancy Evans' life. Since then, she has been driven to change the world—the world we live in, work and play in, breathe, eat, drink, and sleep in.

To Evans, health issues have always been an integral part of life. For more than 35 years, she has been a writer and editor of medical texts, books, and articles. Receiving an English degree from the University in 1962, she has worked with Appleton & Lange, Addison-Wesley Publishing, and Mosby/Times Mirror Publishing, and as a health-science publishing consultant, free-lance writer, and editor. In the early '90s, however, her own health became the focus of her work.

After being diagnosed with breast cancer at age 53, Evans had a lumpectomy and underwent radiation. She says that she didn't get sick but that she got angry. Then she took action.

Leaving her publishing job at Appleton & Lange, Evans got involved in the grassroots breast cancer movement. "Everything I had done in my life up to that time prepared me for being an activist," she says.

Today she works with the Breast Cancer Fund, an advocacy group dedicated to increasing public awareness of breast cancer, to helping inform and care for those with the disease, and to helping eradicate its presence. "The Breast Cancer Fund has led the charge on trying to get more research started on the causes of breast cancer," Evans says.

Serendipity would happen again when Evans met Allie Light and Irving Saraf, Academy- and Emmy-award-winning documentary filmmakers. Light and Saraf's daughter was diagnosed with breast cancer at age 39. While the anxious parents were trying to learn about the disease—desperately searching for answers to their questions—they decided to take action as well. They teamed with Evans, as co-producer, to create a film that would ask "why" breast cancer happens to our mothers, daughters, sisters, partners, and friends.

The film, Rachel's Daughters: Searching for the Causes of Breast Cancer, which premiered on September 11, 1997, introduces eight women who are either survivors of breast cancer or are suffering from the disease. The affected women—with Evans, deemed a "statistical cure," among them—serve as the interviewers, asking tough questions of scientists and researchers, probing for possible causes and their probable links to the environment: the effects of exposure to ionizing radiation, electromagnetic fields, pesticides and other chemicals, hormones and lifestyle, and genetics. Several of the women succumb to the disease before filming is complete.

The poignant two-hour film was named in memory of Rachel Carson, who has been called "the mother of the modern environmental movement" and who warned of the adverse effects of pesticides in her book Silent Spring (1962). Ironically, in 1964, just two years after Carson alerted the world that pesticides were wreaking havoc on the environment—and, ultimately, on all species—she died of breast cancer.

"One of the things we wanted to do when we made the film was to change the focus of the dialogue, by asking what is causing so much breast cancer," Evans says. "The focus has always been on [the supposition that] women need to have more mammograms or that we need to find a cure for breast cancer. We certainly would love to have a cure, but we also have to keep from putting more cancers into the 'pipeline.'"

The Community Action and Resource Guide, which Evans compiled and edited to accompany Rachel's Daughters in 1997, details sobering statistics: "Over 2.6 million women have breast cancer, and only 1.6 million know it. In the United States, it is the leading cause of death for women between the ages of 35 and 54; this year 184,000 American women will be diagnosed with the disease, and 44,000 will die from it. The incidence among American women has more than doubled over the past 30 years."

Evans also writes in the resource guide: "… Breast cancer is part of a larger cancer epidemic. The lifetime risk of breast cancer is 1 in 8; the lifetime risk of all cancer is 1 in 3 for women and 1 in 2 for men.… Breast cancer has been called 'the canary in the coal mine,' a sentinel of our global public health crisis.…Breast cancer can become a wedge to open minds of the public and policy makers to the links between health and environment.…"

In other efforts to open minds, Evans served as co-chair of the Etiology Working Group of the National Action Plan on Breast Cancer and later as an Oncology Patient Fellow in a new FDA program that allows patients to observe drug development and approval processes. One result of her advocacy: A federally funded database of clinical trials for all cancers and other life-threatening diseases is now available online for patients' reference.

For her ongoing activism, Evans was recently honored with the Bella Abzug Advocacy Award from the Breast Cancer Fund. And of all the work Evans has done in the fight against breast cancer, she says she is most proud of Rachel's Daughters.

And she is not stopping with Rachel's Daughters, either. Evans has teamed with Light and Saraf on another film project: a three-part series that will focus on children's environmental health, particularly asthma, birth defects (including learning disabilities), and children's cancers.

"Children are most appealing to grownups, and by looking at what's happening in children's health, I think it is most revealing," Evans says. "The idea that children could have cancer, asthma, or some other terrible disease that could take their lives at an early age is unacceptable.

"Yet, the incidence of some childhood cancers has increased 1 percent a year over the last 27 years. The two most common cancers in children are brain tumors and the various leukemias," Evans says. "We have to look at these incidences versus what's happening in the environment: What are we eating? What's in the water? What's in the air? And what if it is related to what children were exposed to even before they were born? Studies have been done on amniotic fluid and on newborns' first feces, and in both of these, pesticides and PCBs have been found. There are more than 200 contaminants found in breast milk, including dioxins, pesticides, and PCBs.…

"As the grandmother of three, I am very interested in helping make the world a safer place for kids," Evans says.

"The public health approach has always been one of prevention of disease. Until we take that kind of approach with breast cancer and other cancers, we're not really going to make any progress."

And making progress is foremost on Evans' mind.

"One of the things that happened to me when I was diagnosed with breast cancer and became involved with the breast cancer community is that I realized I had lost my stage fright," she says. "All my life I had been afraid to speak in public: like many people, I had clammy hands and knocking knees. Suddenly, that was all gone. Now when I have a speaking engagement, I can hardly wait to do it.

"I realized I could speak about these issues, write about these issues, and that that was what I am supposed to be doing."

Teresa A. Nappier is the editor of this magazine.

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"One of the things we wanted to do when we made the film was to change the focus of the dialogue, by asking what is causing so much breast cancer," Evans says.