October 3, 2012
Sober thoughts about breast cancer awareness month
Dr. Len Lichtenfeld of the American Cancer Society writes on his blog, “During Breast Cancer Awareness Month We Must Not Only Celebrate Our Success But Also Understand Our Limitations.” Excerpts:
“I fear that at times we have oversold our magic. I fear that despite all the progress and all the understanding about the disease, we still have too many women who either can’t get access to quality mammography, who can’t afford treatment, or who go bankrupt in the process. I fear that we have set expectations too high, while we are learning that our science is not as perfect as we would like it to be. I fear that we have too many tests chasing too few women for whose benefit some of the prescribed “solutions” are far from proven. I fear we have overpromised and sometimes underdelivered.
… I understand the anger of women with advanced breast cancer who say, “What about me?” Among these women are those who did everything “right” when it came to early detection and treatment. And among these are women who couldn’t do everything “right” because they couldn’t access the system or couldn’t find someone to treat them in a proper and timely fashion. These are women who pray for a breakthrough, who pray for a cure and wonder whether those who have not been diagnosed with breast cancer or who don’t have advanced disease really understand.”
That is a message that will resonate with many women with breast cancer.
Katherine O’Brien, who writes the ihatebreastcancer blog, tweeted:
“God Bless You, Dr Len!!! I have Stage IV BC (I am 46). My mom died from inflammatory breast cancer in 1983. Not partying…”
Related note: journalist Christie Aschwanden posts, “The false narratives of pink ribbon month, redux” on the Pink Ribbon Blues blog.
Comments (14)
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Michael Mirochna, MD
October 3, 2012 at 4:07 pmso is the overpromise that mammograms/early detection cures all? Is it not explaining that mammograms only reduce the risk of death from breast cancer by 15-30%? Is it not explaining fully the benefits of expensive chemo therapy?
Gary Schwitzer
October 3, 2012 at 4:16 pmDr. Mirochna,
You are apparently reacting to the writing of Dr. Len Lichtenfeld of the American Cancer Society. Perhaps you want to address your question to him directly. I thought he specified what he meant by overpromise very clearly.
Greg Pawelski
October 4, 2012 at 9:39 amJohn Crewdson wrote an article in the November 2009 issue of The Atlantic about The Lancet publication of the Swedish meta-analysis on mammography studies, and Dr. Otis Brawley, the cancer society’s chief medical officer, quote in the New York Times admitting “that American medicine has overpromised when it comes to screening…The advantages to screening have been exaggerated.”
Crewdson said, “There are multiple reasons women are ill-informed about breast cancer. The fault lies primarily with their physicians, the cancer establishment, and the news media – especially the news media. Until coverage of breast cancer rises above the level of scary warnings mixed with heartwarming stories of cancer survivors, women are likely to go on being perplexed.”
Gary Schwitzer
October 4, 2012 at 11:22 amGreg,
Thanks for your note.
I used that Crewdson quote in almost all of my talks.
Greg Pawelski
October 4, 2012 at 9:39 amJohn Crewdson wrote an article in the November 2009 issue of The Atlantic about The Lancet publication of the Swedish meta-analysis on mammography studies, and Dr. Otis Brawley, the cancer society’s chief medical officer, quote in the New York Times admitting “that American medicine has overpromised when it comes to screening…The advantages to screening have been exaggerated.”
Crewdson said, “There are multiple reasons women are ill-informed about breast cancer. The fault lies primarily with their physicians, the cancer establishment, and the news media – especially the news media. Until coverage of breast cancer rises above the level of scary warnings mixed with heartwarming stories of cancer survivors, women are likely to go on being perplexed.”
Liz Scherer
October 8, 2012 at 9:26 amWhat a fascinating post by LIchtenfeld. It’s heartening when the medical community actually admits its flaws and limitations, something that one rarely sees or hears. Western medicine has long overpromised and our society has become accustomed to quick fixes, tests and cure-alls. I never consider any of the [fill in the blank] days, weeks or years to be anything but a means to raise awareness. But awareness is only half the equation if the solutions are limited. Hopefully, the recent discovery of the NF gene will open new screening and treatment strategies. Of note; breast cancer may not be an equal opportunity disease but it is also not a disease that affects women only.
Carol Countryman
October 8, 2012 at 4:39 pmLiz Scherer’s note that breast cancer is not a woman-only disease brought back memories of my tenure teaching in an upstate NY prison. The majority of the inmates were young black men convicted of drug crimes in the NYC area. I was doing a health unit and told my students that the greatest gift they could give the women in their life was to make them get a mammogram. I added, almost as an afterthought, that men could get breast cancer, too. Stunned disbelief followed this revelation and I’ll never forget the furtive BSEs that were going on as the men marched back to their barracks.
Carol Countryman
October 8, 2012 at 2:14 pmI was recently discharged from the hospital following surgery for Stage 1 breast cancer. This was my second such experience, both arising from radiation therapy back in 1972 for Hodgkin’s disease. My first mastectomy was in 1985 and, thinking that I was no longer at risk, I stopped getting mammograms about 10 years ago. Until this spring my internist, the same one I’ve had for 15 years, never mentioned getting a mammogram. No one ever said, nor did I ever read, that patients who’d had radiation therapy to the chest area were at higher risk for breast cancer. I take responsibility for skipping the mammograms, but I’d never have lapsed had anyone reminded me it was important. My pathology was perfect, so the oncologist has me on 1 mg of Arimidex per day.
My hospital, Rochester (NY) General Hospital, is the only one in upstate NY to have a certified breast cancer clinical patient navigator on staff. Fortunate are the patients referred to this office. I have to believe that the staff is doing infinitely more good than the pink trailer hitches, one bearing the message, “Save The Girls,” that I ran across recently.
Carol Countryman
October 8, 2012 at 2:14 pmI was recently discharged from the hospital following surgery for Stage 1 breast cancer. This was my second such experience, both arising from radiation therapy back in 1972 for Hodgkin’s disease. My first mastectomy was in 1985 and, thinking that I was no longer at risk, I stopped getting mammograms about 10 years ago. Until this spring my internist, the same one I’ve had for 15 years, never mentioned getting a mammogram. No one ever said, nor did I ever read, that patients who’d had radiation therapy to the chest area were at higher risk for breast cancer. I take responsibility for skipping the mammograms, but I’d never have lapsed had anyone reminded me it was important. My pathology was perfect, so the oncologist has me on 1 mg of Arimidex per day.
My hospital, Rochester (NY) General Hospital, is the only one in upstate NY to have a certified breast cancer clinical patient navigator on staff. Fortunate are the patients referred to this office. I have to believe that the staff is doing infinitely more good than the pink trailer hitches, one bearing the message, “Save The Girls,” that I ran across recently.
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