Chapter 22
Changing the Conversation
This
morning, I “Googled” for statistics on breast cancer, with the intent to share
information with our readers, which they may not already have. As you can imagine, there is considerable information
available, should we take time to Google.
The title
of one article caught my immediate attention . . .
After reading the article, I contacted Susan Perry, the author, to
request her permission to reprint her article on my Blog. My request was forwarded to Susan Albright, the Co-Managing Editor of MinnPost, who approved my request as long as
I published it as it appears on MinnPost, credit the author, Susan Perry, and MinnPost.
MINNPOST
A sobering report
about breast cancer
By Susan Perry
| 08/15/12
Despite years of campaigns to raise
awareness, ever expanding screening programs, increased fundraising efforts and
more research, there has been little impact on the important outcomes in breast
cancer.
The National Breast Cancer Coalition released its annual
breast-cancer progress report on Monday. It’s a very sobering document.
It’s also an honest document. The 62-page report doesn’t
hide the truth about breast-cancer survival behind misleading statistics. Nor
does it oversell the benefits of mammogram screening.
“By any standard,” the report bluntly
states, “we have not made adequate progress. Despite years of campaigns to
raise awareness, ever expanding screening programs, increased fundraising
efforts and more research, there has been little impact on the important
outcomes in breast cancer. Breast cancer incidence and mortality have not
changed significantly.”
Unacceptable
losses
As the report points out, an estimated
290,000 women and 2,190 men will be diagnosed in the United States with breast
cancer in 2012. And an estimated 39,510 women and 410 men will die of the
disease — about one every 14 minutes.
“US breast cancer mortality has been
declining but only slightly,” the report says. “In 1991, in the United States,
119 women died of breast cancer every day. This year, that number is estimated
to be 108. If we continue making progress at the current rate, it could take a
few centuries to end breast cancer. These are not merely statistics, they
represent millions of lives. These losses are unacceptable.”
The public has many “myths and
misunderstandings” about breast cancer, the report adds. But “in order to make
real progress toward saving lives and ending breast cancer, we need to better
understand its reality at all levels. The reality is troubling.”
Here, from the report, are a few of those
troubling realities:
Regarding early
detection:
A great deal of attention and resources
have focused on the area of early detection. A mantra that has been drummed
into our consciousness over the past forty years is that early detection saves
lives. The reality is otherwise. About 70% of women in this country over age 40
have had a mammogram in the last two years. Unfortunately, randomized
controlled trials for mammography have shown, at best, a marginal benefit.
Breast self-exam (BSE) has also been a key women’s health mantra. But research
has demonstrated that routine BSE does not lead to a decrease in mortality from
breast cancer nor does it find breast cancer at an earlier stage.
Yet many resources are devoted to giving
the message of early detection and promoting breast self-exam and mammography
screening for younger and younger populations. Attempts to apply evidence to
the message of early detection are often met with anger and derision, as
evidenced by the response to the revised screening guidelines issued by the
United States Preventive Services Task Force in 2009. These are matters of
science.
Regarding
survival statistics:
While we want to believe we have made significant
progress in saving lives, that is not the case. The incidence of women
diagnosed with advanced breast cancer has not changed. Rates of diagnosis of
truly lethal disease have remained stable since 1975. …
Survival statistics do not reflect the real
experience of people with breast cancer. The [National Cancer Institute]
reports that five-year breast cancer survival is 98% for localized disease.
Survival rates are skewed by screening: the more you screen, the more you find
and thus more women will be alive at five years. But they were not going to die
of breast cancer in that time frame even if they had not been screened. And
these numbers do not take recurrence into account. While many mistakenly point
to five-year survival statistics as proof of progress, an estimated 20% to 30%
of women diagnosed with invasive breast cancer will have a recurrence of their
disease and may go on to die of the disease, yet they are included as survivors
in the five-year survival statistics.
Regarding breast
cancer treatment:
The cost of treating breast cancer
continues to rise without accompanying significant decreases in breast cancer
mortality. The national cost of cancer care in 2010 was estimated to be $124.6
billion, with female breast cancer care leading all cancer sites at an
estimated $16.5 billion. Despite that investment, a person with a new diagnosis
of cancer has approximately a one in five chance of failing to receive elements
of cancer care that are evidence-based and consistent with practice standards.
And millions of Americans have no insurance, which not surprisingly has an
impact on the quality of their health care.
Regarding the
media and the realities of the disease:
[A]n analysis of breast cancer coverage
during 2011 National Breast Cancer Awareness Month [found that] more than half
of the articles included one or more personal stories. Among 24 personal
stories that shared the age of diagnosis, merely three of the women were over
60 years of age at diagnosis. This does not reflect reality: 50% of breast
cancer occurs in women aged 62 and older. It comes as no surprise that young
women who read these ‘news’ reports throughout the month believe they have a
much higher risk of the disease than they actually do. Furthermore, the
majority of personal accounts were primary, early stage, breast cancer
diagnoses. Often times, a picture was painted of survivors who are disease-free
and overcame the disease. Only about 1 in 9 articles portrayed women battling
metastatic disease.
“Breast cancer continues to take a toll in
the US and globally despite significant attention and resources directed at the
disease,” the report concludes. “Billions of dollars have been invested in
breast cancer research, and many organizations and public health officials
continue to focus attention on early detection and awareness campaigns as the
primary approach to addressing breast cancer. Given the attention and resources
directed to breast cancer, the public understandably believes that we have made
significant progress, [but] that is not the case.”
We need to do better. And we need more
honest assessments like this one.
The National Breast
Cancer Coalition has released two breast-cancer
reports since 2011. The first
published in 2011 with its baseline information and the second
in 2012 as to progress made.
On page 40 | Breast
Cancer Deadline 2020® 2012
Progress Report |
Media Analysis
[Too often, many in the media gravitate
toward stories that are extremely hopeful. However, there was a handful that
told the story of women with everyone’s biggest fear—metastatic disease. Four
articles portrayed one or more women battling this deadly diagnosis. NBCC
President Fran Visco was quoted in a USA
Today article sharing the reality of Stage IV
disease:
“In October, and year-round, we paint
breast cancer as very pink and pretty, and we don’t talk about the fact that we
haven’t made much progress against Stage 4 disease 24
.“ ]
24. Szabo L: When there’s no cure,
there’s little support; Women with metastatic breast cancers live every day
fighting a
disease they can’t beat. In: USA Today.
Gannett Company, Inc.; October 20, 2011.
Please take a moment read the
two reports from the National BreastCancer Coalition, should you not have time right now, you can read, now, NBCC’s
Blueprint which is only 5 pages. On page 4 of NBCC’s Blueprint information
is provided as to how we all can “change the conversation”.
After posting this chapter, I
will be going online to
I
encourage you to do the same, and share this chapter with your friends and
family.
Post Script: Thank you, again, Susan Albright and MinnPost
for permission to share Susan Perry’s article “A sobering report about breast cancer” 08/15/12 Published in the MinnPost
Til’
we chat again, Floyd & Joe
TOGETHER WE CAN
FIND A CURE . . .
By . . .
“Changing the
Conversation”
If you have a moment, you are invited to visit my website;
www.visualartbyjoseph.com
If you have a moment, you are invited to visit my website;
www.visualartbyjoseph.com
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