Nancy Reagan was an American actress and First Lady From 1981 to 1989 as the wife of Ronald Reagan, the 40th President of the United States, She started the “Just Say No” campaign against drugs, that created 12,000 anti-drug youth clubs, and in October, 1988, she spoke to the United Nations General Assembly and called on the international community to enforce laws against recreational drug use.
In 1949, she received a contract to be an actress with MGM Studios. In 1951, During the McCarthy witch-hunting era, she was listed as an alleged communist sympathizer, but she was not a sympathizer. Another woman with the same name was also an actress. To clear her name, she requested a meeting with actor, Ronald Reagan, then president of the Screen Actors Guild. He had just divorced actress Jane Wyman. They fell in love, she became pregnant, and in 1952, they married.
In 1987 at age 66, she was diagnosed with breast cancer, had her entire breast removed, instead of the conventional lumpectomy at that time. Because she was the first lady, many women afflicted with breast cancer also opted to have their entire breasts removed, instead of the recommended much-less extensive lumpectomy.
She died of heart failure at age 94. Her many years of caring for her husband and his Alzheimer’s disease wore her out and she stopped her exercise program that could have strengthened her heart and helped protect her from heart failure
Early Years and Education
Anne Frances Robbins was born in 1921 in Queens, New York to a father who was a car salesman and a mother who was an aspiring actress. When she was six, her parents divorced and sent her to be raised by an aunt and uncle in Bethesda, Maryland. Her aunt frequently took her to New York to see her mother performing. Her mother married a famous Chicago neurosurgeon named Loyal Davis and in 1931, at age 10, she moved to Chicago to live with them. In 1935 she was formerly adopted by Dr. Davis and her new name became Nancy Davis. She went to the Girls Latin School in Chicago and to Smith College, where she majored in drama and earned her B.A. degree and in 1943, at age 22, .
Her Career and Causes
After college, she took odd jobs as a sales clerk in Marshall Fields Department in Chicago and as a nurse’s aide. In 1949, at age 28, she moved to Hollywood and signed with MGM Studios. She worked in a few films and then met and dated Ronald Reagan. After three years of dating, she became pregnant and they married on March 4, 1952. They starred together in her eleventh and final film, the 1956 World War II submarine movie Hellcats of the Navy.
When Ronald Reagan decided to seek political office, she became a strong helpful cog in all his campaigns. From 1967 to 1975 he was Governor of California, so she led a campaign to aid Vietnam veterans. When Reagan was elected President in 1980, she led a campaign to prevent drug abuse, particularly among young people. She also actively supported her husband in starting negotiations with the Soviet Union that lead to the end of the Cold War. In 1987, she hosted a state dinner for Mikhail and Raisa Gorbachev. After dinner, pianist Van Cliburn played “Moscow Nights” and both Mikhail and Raisa sang joyously along. She hosted 56 state dinners over eight years, compared to six by George and Laura Bush. “For eight years, I was sleeping with the president, and if that doesn’t give you special access, I don’t know what does,”
Just Say No
In 1982, a schoolgirl asked her what she should do if someone offered her drugs. Nancy Reagan responded “Just say no.” To promote drug abstinence, she traveled more than 250,000 miles, visited drug abuse prevention programs and drug rehabilitation centers, appeared on television shows, recorded public service announcements, and even wrote guest articles.
Her Breast Cancer
In 1987, she was diagnosed with breast cancer and chose mastectomy, major surgery to have her entire breast removed, rather than the simpler lumpectomy. I have not seen her medical records but I found several news reports stating that she had a type of breast cancer called Disseminated Carcinoma In Situ (DCIS) which we now learn is probably a pre-cancer and may not even be a cancer. Her cancer was only seven millimeters in diameter, about the smallest doctors can detect on a mammogram.
Because of her, many women became more aware of breast cancer and went out and had mammograms. In the three months following the removal her breast, there was a 25 percent increase in women opting to have their entire breasts removed for this condition (DCIS). Four months later, the percentage of women opting to have their entire breasts removed returned to the normal lower percentage (JAMA. 1998;279(10):762-766). See my report on DCISbelow.
Ronald Reagan’s Alzheimer’s Disease
Upon leaving the White House, the couple returned to California, where they purchased a home in the East Gate Old Bel Air neighborhood of Los Angeles. In 1994, her husband was diagnosed with Alzheimer’s disease. She became his primary caregiver and cared for him until his death in 2004 at age 93. During this period she worked actively with the National Alzheimer’s Association and the Ronald and Nancy Reagan Research Institute in Chicago, Illinois, searching for better treatments for Alzheimer’s disease and raising pubic awareness. This was her final and perhaps most important cause. The Reagan’s close friend, Charlton Heston, called their marriage “the greatest love affair in the history of the American Presidency.”
Final Years and Death
In 2008 at age 87, she fell and was hospitalized for two days. In 2012 she fell and broke several ribs. On March 6, 2016, she died of congestive heart failure at her home in Bel Air. At 94, she was the second-longest-lived First Lady of the United States, after Bess Truman (97). Ronald Reagan was the second-longest-lived President, after Gerald Ford; they were both 93 but Ford lived five-and-a-half weeks longer than Reagan.
Congestive Heart Failure
Heart failure is the most common cause of death in elderly people who have no other diseases or health problems. Nancy Reagan had no obvious risk factors for heart disease; she had stayed slim and active throughout her life. However, being the primary caregiver for a loved person with dementia wore her out and slowed her down. Aging weakens all muscles in the body, including the heart muscle.
Congestive heart failure means that the heart is not strong enough to pump the blood that returns to it, so the blood backs up, filling the lungs with fluid to make the person short of breath, and filling the legs and feet with fluid which causes swelling and pain.
The primary stimulus for blood to circulate through your body comes from your skeletal muscles, not your heart. When you move your muscles, primarily the large muscles in your legs, they squeeze the veins near them which increases the amount of blood that returns to your heart. Then the leg muscles relax and the veins near them fill with blood. Your heart is a big muscular balloon. The extra blood pumped by the leg muscles fills the heart causing the heart to beat faster and with more force. This helps to explain why strong skeletal muscles are so important for heart health.
Unfortunately, congestive heart failure is a vicious circle because the weaker your heart gets, the less you move around so the skeletal muscles continue to get even weaker. Discomfort and pain sap your energy so you lose interest in your daily activities and move even less. The American Heart Association recommends that all older people have a heart disease prevention program that includes safe exercise and treatment of depression, social isolation and other psychosocial issues (Circulation. 2002; 105: 1735-1743). However, it takes energy and determination to keep moving. Sometimes the person just decides that enough is enough.
Nancy Davis Reagan
July 6, 1921 – March 6, 2016
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Ductal Carcinoma in Situ (DCIS)
Ductal Carcinoma In Situ (DCIS) is a non-invasive cancer in the end ducts of the breast. Each year 64,000 American women are diagnosed with DCIS, amounting to 30 percent of women diagnosed with breast cancer. Almost always it shows up as tiny calcium spots on a mammogram in women with no lumps and no symptoms. It is not an immediately life-threatening cancer, and some experts question whether it should be called a cancer.
The 10-year overall survival rate is nearly 100 percent, but it is associated with increased risk of invasive breast cancer later on. “Is it possible that some DCIS could be left alone or treated with a chemo preventive agent (one that prevents or delays invasive progression) instead of surgery? Given that the goal of cancer screening is to identify early treatable cancers, it is difficult to propose doing nothing when such cancers are found and difficult to mount clinical trials in which women would forego a known curative treatment.” (M.D. Anderson Hospital OncoLog, January 2010;55(1):).
Some DCIS lesions will progress to invasive cancer, and some will remain harmless. Therefore today, doctors prefer to over-treat a woman with DCIS, rather than to do nothing and have the cancer spread. Women with DCIS almost always have surgery because nobody knows which DCIS will spread and which will not. So doctors treat it as if it is an invasive carcinoma by removing the entire breast or breast-conserving lumpectomy with or without radiation therapy.
Women treated with lumpectomy have higher recurrence rates than those treated with mastectomy, and women treated with lumpectomy alone have higher recurrence rates than those who receive lumpectomy with radiation. At present doctors do not recommend radiation treatment following removal of the whole breast, but they often recommend radiation after removing just a lump. Radiation increases risk for heart attacks and heart failure years later on.
Some doctors now treat some cases of this condition with “watchful waiting” and close follow up.
Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com
