Breast Cancer Awareness Network

Ms. L. M. Human Needs Program Marin Community Foundation 17 E. Sir Francis Drake Blvd.; Suite 200 Larkspur, CA 94939 Dear Ms. M.: I am submitting this proposal as a follow-up to a meeting with M. B. earlier this year. The mission of Breast Cancer Awareness Network is to explore, identify, and reveal the reasons for Marin Countys extraordinarily high incidence of breast cancer, to work toward its eradication, and to create a healthier environment for ourselves, our children, and our grandchildren. I will act as contact person and can be reached at the following address: F. L. Breast Cancer Awareness Network 25 B. Blvd. San Rafael, CA 94901 Telephone and Fax: (415) 555-0000, (415) 555-0000 Sincerely, F.L.

ISSUE TO BE ADDRESSED M. G. was 31 when she discovered she had breast cancer and opted for a mastectomy. Eight years later the cancer returned. She formed a support group with four other women, and with their help survived to raise a child and become a charter member of the Breast Cancer Awareness Network. Her four friends have since died from metastatic breast cancer. When the catastrophe of breast cancer strikes, two very human questions are:

A NATIONAL CRISIS
Breast Cancer Cases per 100,000 Women 115 110 105 100

Why did this happen to me? and How can I protect my daughter?

This project seeks to help the women of Marin answer these questions.

Sadly, M.s story has become all too common. Breast cancer is the most frequently diagnosed cancer among 95 American women. In 1965, 62,000 90 cases were diagnosed. By 1995, the number had tripled to 182,000 although 85 population had increased by only 38%. 80 Rates in the United States are as much 75 as six times higher than other developed countries, and Marin County has the 70 dubious honor of being the leader in this national crisis. In any given year, about 200 women in Marin are diagnosed with breast cancer, so that today, over 1,000 source: Northern CA Cancer Center women in the county are living with or have survived the disease. Those who have survived are at high risk, and because of the genetic link to the disease, so are their daughters and other female relatives.
73 75 77 79 81 83 85 87 89

We do know some of the reasons for high rates of breast cancer in Marin. These risk factors include age, child-bearing history and heredity. However, these account for only 30% of the elevated rate. Recently, pioneering researchers have developed methods that promise to expand our knowledge of the unexplained 70%. Methods include in-depth surveys to identify not only personal risk factors but also environmental factors (such as exposure to pesticides and workplace toxins) computer mapping to correlate breast cancer cases with data on pesticide use, industrial and military waste dumping, water pollution, high intensity electromagnetic sources environmental investigation techniques that trace the circulation of toxins through a local ecosystem
A LOCAL CRISIS
J apan, Osaka Hong Kong Poland, Warsaw France, Doubs Canada, BC San Francisco Alam eda San M ateo Contra Costa M arin

19

91

50

100

150

Breast Cancer Cases per 100,000 Women

source: Northern CA Cancer Center and CDC

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With funding from state health departments and the federal government, these techniques were developed on the East Coast to investigate excessive cancer rates in Long Island, Cape Cod, and Newton (MA). However, they are not as well known or accepted in California.

PROJECT PURPOSE Therefore, BCAN proposes a one-year project that will keep the women of Marin up-to-date on cutting edge breast cancer research and encourage local investigation of breast cancer causes.

OUTCOMES Provide 1000 adults with intensive information about breast cancer causes and state-of-the-art research into possible causes. Provide 800 high school students with intensive information about breast cancer causes and state-ofthe-art research into possible causes. Provide 1200 families with ongoing follow-up information. Reach 80,000 people with general information on breast cancer causes and new research through mass media. Generate funding for the following projects 1. Studies of environmental causes of breast cancer 2. Computer mapping of breast cancer cases and suspected environmental carcinogens 3. Environmental investigation (Please note that funds from MCF will not be used to conduct research, but only to build local coalitions and develop proposals for research.)

PROJECT METHODS Adult Forums: We will conduct quarterly educational forums at Marin General Hospital and Corte Madera Community Center. Forums will generally be in a lecture format. Projected topics and invited speakers include: L. P. (president of the Long Island Breast Cancer Study Project) on results of current breast cancer research on Long Island S. S. (researcher for Silent Springs Institute) on results of the Newton and Cape Cod Studies P. R. (head of Environmental Epidemiology and Geographic Information Section, California Health Department) on new research in California on breast cancer links to organochlorines and electromagnetic radiation Dr. M. L. (founder and president of Commonweal and author of Alternative Choices) on alternative treatment options Dr. J. G. (author of Preventing Breast Cancer) on ionizing radiation as a cause of breast cancer D. M. (breast cancer survivor and grassroots activist) on activism, spirituality and breast cancer We estimate attendance of 1000 people over the course of the year. Evaluation: We will track attendance via sign-in sheet and compare against target attendance. In a written survey, audience members will comment on usefulness of content, suggest format changes, and recommend future speakers. High School Forums: We will conduct quarterly educational forums in Marin high schools. Some student forums will be conducted by guest speakers for the adult forums. Others will be conducted by a corps of 510 community educators (members of BCAN who have attended the adult forums and who have a personal experience of cancer). We estimate reaching 800 students over the course of the year. The forums will operate cooperatively with an environmental education program in the schools currently sponsored by the Pacific Environment and Resources Center. We are currently in discussion with H. C. of the Center to

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expand content and format to include links between the environment and health. Students will be taught how to review environmental records through hands-on experience as part of BCAN research projects. Evaluation: We will track attendance by head count and compare against target attendance. Students will be given a short test over content to evaluate effectiveness of forums. Quarterly Newsletter: With the volunteered time of R. C. (a professional journalist and BCAN volunteer), we will develop an 8-page quarterly newsletter to keep the community informed of recent developments in breast cancer research and grassroots organizing. The mailing list will be based on a 1000 name database including attendees at past adult forums. Sign-up forms will be made available at Marin General Hospital in the Breast Health Center and at private clinics throughout Marin County. Circulation is estimated at 1200. We will also develop a tri-fold pamphlet. These will be handed out at forums and will briefly describe BCANs mission and activities. Evaluation: We will compare targeted circulation and publication frequency to actual circulation and publication frequency. Further, in each newsletter we will invite reader response to content and format and provide a space for letters to the editor. Media Coverage: With the assistance of G. R. (public relations professional and BCAN volunteer), we will develop and place 10-15 articles and letters-to-the-editor in the Marin Independent Journal. Topics will include responses to current research, announcements of new BCAN grants and projects, updates on statistics, grassroots activities in the Bay Area, and personal stories of breast cancer survivors. Evaluation: We will track articles and letters placed and compare to targeted placements. We will also track media references to BCAN. Promotion of Research: Board members will work with a contracted grant writer to develop proposals supporting cutting edge research. As part of proposal development, we will fund travel by two board members to New York and Boston to study the research methods of the Silent Springs Institute and the Long Island Breast Cancer Research Project. Potential funders include: Breast Cancer Research Councils Causes of Breast Cancer Community Research Collaboration Program. In conjunction with the University of California system, the Council annually distributes about $16 30% Known Risk million gleaned from Californias tobacco Factors tax. The funds are targeted for breast Unknown Factors cancer research. We currently have a 70% $75,000 pilot award under this program, and will be preparing an application for a source: CA Dept. of Health Services full research award to cover a $500,000 three-year study of factors in adolescence that put women at risk for breast cancer later in life. We will also apply for a pilot project on environmental risk factors. California Endowment. The Endowment, a news ou rc e: C A D e p t. ofcreatedr vic es the privatization of Blue Cross foundation H ea lth S e by of California, is committed to funding health-related initiatives. The Endowment recently announced new guidelines for funding for projects that address persistent and/or emerging health challenges using a holistic, integrative, systems change approach. W. Alton Jones Foundation. The foundation funds research on the impact of toxins on the ecosystem. Evaluation: We will track grant proposals submitted and awards made. We intend to submit nine proposals and receive funding for at least three with an estimated total of $200,000 in new funding.

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PROJECT COST Total cost for the one-year project will be $100,021. We ask that Marin Community Foundation cover the operating expenses, a total of $27,221. The Marin Board of Supervisors has committed $5,000. In addition, Marin Supervisor H. B. is seeking additional funds to match the Foundations grant dollar-for-dollar. A letter of commitment/support from him is attached. The Breast Cancer Research Council has committed $13,000 for preparation of a research proposal on factors in adolescence that put women at risk for breast cancer later in life. Grants are pending at various foundations, as listed on the Funding Sources form in the attachments. In addition, we will continue donor solicitations and special events, estimated to raise $11,600, based on last years figures. ORGANIZATION BACKGROUND Breast Cancer Awareness Network was founded in 1995 and incorporated in 1996 by survivors of breast cancer. The Board of Directors includes eight members, seven of whom are cancer survivors and therefore have a strong commitment to the organizations mission. Several members of the medical community act as consultants to BCAN including Dr. F. H., radiation oncologist at Marin General Hospital; Dr. M. W. and Dr. M. L., both of the Epidemiology and Biostatistics Department at UCSF; Dr. G. F., a physician at the Marin Community Clinic; Dr. W. M., director of the Division of Pediatric Hematology Oncology at UCSF; Dr. D. E., epidemiologist at the San Francisco Department of Public Health. Over the past three years, we have striven to provide the most current but scientifically-supported information to the Marin community. As a result, we were recently awarded a $75,000 grant by the University of California system for a pilot study of factors in adolescence that later put women at risk for breast cancer. While research is important, most of our effort goes to community education. Since its inception, BCAN has sponsored monthly educational forums at Marin General Hospital, providing information on alternative health care, diet, and environmental issues relevant to breast cancer. Speakers have included M. M., M.D.; M. D., Ph.D.; D. O., M.D.; L. P., president of the Long Island Breast Cancer Study Project; and S. S., Ph.D. and author of Living Downstream. BCAN sponsored the screening of Rachaels Daughters (a documentary about breast cancer produced by two academy award winning film makers) at the 1997 Mill Valley Film Festival. The screening was sold out and raised $10,000 for the organization. Early in 1999, we will sponsor a screening of Exposure, an award-winning documentary that discusses links between environmental toxins and disease. In 1997, five board members attended the World Conference on Breast Cancer and later presented findings to the Marin community at an educational forum. The event was given front page coverage by the Marin Independent Journal. Earlier this year, board member R. M. was interviewed for an article on breast cancer published in the Pacific Sun. FIT WITH FOUNDATION GOALS We feel our project supports the goals of two of the Foundations grantmaking programs: Human Needs (Community Education) and Environment (Environmental Education). By using forums, a newsletter, and newspaper articles to reach the women of Marin with information about breast cancer and current research, we seek to involve the community in the promotion of womens health. By teaming with the local schools and the Pacific Environment and Resources Center, we seek to educate young people on linkages between health and the environment. And finally, by promoting further research on the causes of Marin Countys breast cancer rate, the highest in the world, we seek to create sound scientific knowledge that will inform public policy and allow a thoughtful approach to this health crisis. Thank you for your attention to our application. Please contact me if you need further information. Sincerely,

F. L. President