Mona Atwood sits in the doctor’s office, annoyed that the appointment is taking so much time. She has accounts to get to, sales to make--owning your own sales business is more than a full time job. Besides, her husband has been out work since the dot.com crash and finances are tough right now.

“I wish this doctor would hurry up with the results, I don’t have all day,” she thinks. The doctor enters the room, he is so serious she thinks. The only words she hears the doctor say are “You have cancer.” She knows he says more about treatment, about options, but all she thinks about is her family, her job and that she doesn’t have time for this. Outside the sun shines brightly, dominating a beautiful day in bountiful Marin County. Atwood has just become another statistic in the inexplicably high breast cancer rate in the affluent region north of San Francisco.

The Marin Cancer Project is sponsoring commercials lately that show Marinites ignoring dead bodies in supermarkets and on running trails. The commercials are supposed to symbolize that Marin county women are ignoring the high rate of death from cancer in their own picturesque backyards. Even after the Marin County Cancer Project aired these commercials a gathering of Marin county oncologists held a very public meeting in which the consensus was that the statistics are incorrect and that soon new statistics will show that the cancer rate is the same as the rest of the country’s.

Studies show that breast cancer is on the rise in Marin County. Incidence rates have risen 3.6 percent per year every year since 1990, six times more rapidly than in other areas. The most at-risk group are white women between the ages of 45 and 64. Although incidence rates have risen, the mortality rate has not changed significantly in comparison to other areas--meaning that many women are fighting cancer and many women are winning.

The radiologist points to a tiny circle on the x-ray hanging on the wall. Before he says anything Atwood knows what it is. “So that’s what a tumor looks like,” she thinks as she views her own mortality on a black and white transparency suspended on a radiologist wall.

Atwood has come to this meeting with her doctor without her husband. He has been out of work for many months now; he doesn’t even seem to be trying. Graphic designers are not in as high demand as the dot-com economy implodes. She remembers her first husband, when he lost his job back in Virginia, he too wallowed in self-pity. Her divorcing him is what prompted him to get his life back together. Here she is again, supporting herself, her husband, and now her precious daughter Hanna. She fears his neediness will overwhelm her, that she can’t help him in her moment of need.

The meeting with her doctor is over; she sits by herself in her car in the rooftop garage. Seeing Marin County beyond the steeple of the church next to the UCSF Medical Center, Mona cries. It is the first time she has cried all day. Eventually she calls her husband and he talks to her the on her cell phone. He talks to her for her entire trip back across the bridge to their three-bedroom suburban nest.

Atwood attacks her cancer with the same vigor that she attacks her sales job. It is through sheer hard work and networking that she built her business in office furniture sales. She is constantly on the go, on the phone, moving, selling, talking. These are the strengths that she uses to fight this new battle. She has little stomach for self-pity. When her alarm goes off at 6 a.m. the next morning she starts to work.

First she lines up the surgery. She checks around for the best oncologist she can find. She says she wants it “cut out of [her] body.” She goes into “seek and destroy mode.” She doesn’t delay. She lines up the radiation treatments. She toughs it out, the nausea comes in waves, the hair falls out in clumps.

“I remember realizing that this was a one-shot deal, if cancer comes back in the same place you cannot do radiation again, your body cannot handle it,” she says. “I’ve got to keep it from coming back,” she says matter-of-factly.

That is easier said than done. Doctors don’t really know what causes cancer, either in Marin nor anywhere else. The only known environmental cause of cancer is ionized radiation, the kind found in cell phones, nuclear reactors and X-rays. Cells that are subjected to X-rays become cancerous.

Atwood does her homework. She talks to experts, she explores alternative therapies. She changes the way she eats. She changes the way her daughter eats. An avid exerciser, Atwood becomes more focused. She tries to run frequently and ice skates with her daughter. One of the experts she seeks out is the mother of her daughter's best friend.

Holly Stanton has a runner’s body, not exactly the one that won races in high school track but not too badly beat up for 41. She is wearing a long sleeved T-shirt with the East Indian symbol for peace on the front as she stands in the aisle at a Whole Foods Market, surrounded on both sides by shelves of vitamins and herbs, which are in turn surrounded by shelves of organic foods and produce.

Stanton is a certified nutritionist and the head of the nutrition department at the market. Holly’s stance on cancer is quite militant. She is adamant in her opinions that cancer prevention is the key. “Don’t wait until you get it to do something,” says the athletic woman. In Marin’s declining economy, Whole Foods is experiencing an upsurge in sales over the previous two years. People, women like Atwood, are changing their habits. They are not waiting, they are taking charge, and diet changes are one of the steps they are taking.

The two little girls race from booth to booth. In the sweet pixie-like voices of pre-adolescence they ask the purveyors: “Is this sprayed? Are these conventional? Are you certified?” Holly and Mona follow behind smiling. Life lessons taught.

Conclusions in a report by the Northern California Cancer Center indicate that “incidence of invasive breast cancer has increased significantly in the affluent population of Marin County.” It seems that women with better access to health care actually have a higher susceptibility. The report goes on to include suspected risk factors as hormone replacement therapy and delayed child-bearing as potential factors. The report also indicates that higher risk to women with better socio-economic status is not isolated to Marin County. The report links higher risk of cancer to better education and higher income, among other factors. In an article in the North Bay Bohemian, Allie Gottlieb draws parallels in socio-economic risks of cancer between Marin County and affluent suburbs of Connecticut. There are also similar studies under way in affluent areas of Massachusetts.

Stanton has little faith in the established medical community. “Breast Cancer is big business to them,” she says. Stanton believes that breast cancer preventative treatment might actually cause some of the cancers. “You take mammograms [X-rays] and irradiate tissue that is highly sensitive to cancer, over and over again and voila you have cancer.” she says. Stanton believes that vigilance in diet, exercise and environment are the keys to fighting cancer.

Atwood disagrees with Stanton about mammograms. “If it hadn’t been for mammograms, my cancer probably would have gone undetected,” she says. Cancer is an unusual disease--carcinogenic cells come and go in the body all the time. Most are destroyed by the body’s own defenses. Very few form into what we know as cancer. The National Cancer Institute claimed as recently as 1995 that breast cancer was simply not a preventable disease.

Early detection is the key. But for some reason the only good early detection is mammography. Interestingly enough, once cancer is detected, a sonogram is employed to verify the X-rays findings. For some reason the less invasive and radiation free ultra-sound technology is utilized as a backup to the more risky and expensive x-ray technology. These seeming contradictions have given rise to many conspiracy theories. The Marin Cancer Project and many others consider hormone replacement treatment a possible risk factor. Western doctors are not omnipotent, they can and do make mistakes. Mistakes in diagnosis, and in treatment. One thing is clear, Western medicine is more concerned with treating cancer after you get it than preventing it in the first place.

Atwood breathes in and out slowly. She visualizes roots from her body extending down into the earth. Her eyes are closed, tightly at first, and as the roots extend the tension releases. She sees the roots touch a large glowing ball of energy, the roots pull the energy forth and bring it up through the ground into her feet. Then slowly through her entire body, washing her body clean, clean of cancer.

Visualization therapy is another method of alternative treatment that Atwood learned about in her woman’s cancer therapy group. Atwood says she utilizes visualization therapy in her work. “I do it when I’m sitting across the table from the CFO that I’m up against,” she says. “It helps with the stress.”

Briahn Kelly-Brennan paces back in forth in front of her SF State class in Chinese Medicine . She drives from her home in rural Sonoma County through Marin to her teaching job at SF State. She dedicates part of her curriculum to teaching about cancer prevention. The bespectacled woman extorts her class to take charge of their own health. “The chances of getting cancer would seem to be small because of all the things necessary to wrong. When I was a kid only old people got cancer,” she says wearily. “The age of cancer patients has dropped.”

Brennan tells her class that “A coagulation of stagnant chi hardens and becomes cancer,” that then exudes heat. Seemingly far-fetched until compared with western medicines Digital Infrared Thermography that detects breast cancer because of cancer's high heat signature. Although she doesn’t offer explanations for Marin’s seeming epidemic, she muses that stress could play a large part. In Chinese medicine, constant exposure to grief is seen as a major cause of cancer.

Atwood has had enough. The house payments are due and her husband doesn’t even seem to be looking for work. She wipes her bald head, gone are her blonde curly locks, at least it’s easier to take care of, she thinks. Her marriage is over-- she knows it now. Somewhere deep inside she knew it when she sat on that rooftop at the UCSF medical center all those months ago. The last months of working sixty-hour weeks while undergoing chemotherapy have sealed the deal. She cannot be the strength for two adults when one of them isn’t even trying. Things are tough, true, but he should at least try to get a job. She just doesn’t need the additional stress.

Stress figures highly into the Marin Cancer Projects Precautionary Principles. Their Web site offers 17 suggested lifestyle modifications. Limiting stress, not smoking or being around smokers, healthy eating is also succinctly listed as environmental factors to avoid. Others include limiting alcohol, avoiding pesticides, dry cleaning chemicals and cell phones.

Stanton prepares tea for herself and Atwood. Here in her home Stanton is surrounded by vitamin bottles. They line the shelves of her pantry and clutter the top of her refrigerator. Holly prepares the tea with filtered water, being careful to use only un-bleached tea bags. Atwood lifts the cup of chamomile tea to her lips, pauses, and says “I know that I’ve got to make more changes in my life. If I don’t lower the stress, the cancer will come back.” A thoughtful look passes over her face. “I’ve been thinking about being a political lobbyist for environmental causes, or maybe working on political campaigns.”

Stanton laughs and points out that both of those jobs have high levels of stress. Atwood laughs with her friend, “I guess I’m addicted to stress.” Atwood’s divorce is almost final. She has lost her home in San Rafael but she is upbeat. She is renting a home a short distance from the old one and Hanna is staying at the same school. Because of expenses she has let her older sister move in to help with the bills. Mona is getting concerned though, her sister has not been working and the bills are coming due.

Atwood often feels that she is the one to be relied upon. “I’m the one who is pulling the train along,” she says. She has been trying to ride the train a little more. She is working on trying to be more grounded, more "in the moment.” It is taking considerable effort on her part. The battles are many, undoing a lifetime of Type A behavior is not easy to do.

Little Hanna frolics by the pool. The nine-year-old jumps and screams, the summer sun beats down brightly on the little girl, bleaching her blonde hair. Atwood sits nearby, a wide-brimmed cap pulled down over the short downy new-growth of hair on her head. She still feels sick often, a lingering result of the chemotherapy, but her doctors are optimistic that she will recover.

Atwood will recover physically, but cancer has cost her her marriage and her home, gone in the divorce. She is determined not to let it take her family as well. She calls Hanna over, smearing liberally a 40 SPF sunblock over the squirming child’s skin. Atwood, after fighting a losing battle, lets little Hanna race back to the pool. She knows that because of her own cancer the statistics say that Hanna’s own odds of contacting cancer have more than tripled. By taking control she is determined to have Hanna beat the odds in Marin County, and save her precious daughter the fight she has fought.

Atwood believes the best protection for Hanna to teach her to fight, to never give up, and to fight each day’s battles as they come. Even with all the precautions it is the will to survive, to do whatever it takes, that will ultimately overcome the cancer. The shrill ring of Atwood’s cell phone interrupts the playful sounds of the children swimming. Work calling. “Damn, on my day off,” she thinks as she answers the phone.