Medicine
"I used to believe that a mammogram saved my life," begins breast cancer survivor Peggy Orenstein in a revelatory New York Times Magazine story that every woman (and man) should read before making personal decisions about screening for cancer. Although the ubiquitous spectacle of pink ribbons for "cancer awareness" has certainly raised breast cancer's profile as disease, Orenstein raises serious concerns about whether these campaigns have been good for patients:
Before the pink ribbon, awareness as an end in itself was not the default goal for health-related causes. Now you’d be hard-pressed to find a major illness without a logo, a wearable ornament and a roster of consumer-product tie-ins. Heart disease has its red dress, testicular cancer its yellow bracelet. During “Movember” — a portmanteau of “mustache” and “November” — men are urged to grow their facial hair to “spark conversation and raise awareness” of prostate cancer (another illness for which early detection has led to large-scale overtreatment) and testicular cancer.
- More On Mammography: Just Because You Don't Like The Results Doesn't Make Research Junk Science
A recent study published in the New England Journal of Medicine, “Effect of three decades of screening mammography on breast-cancer incidence”, by Archie Bleyer and H. Gilbert Welch[1], has generated enormous controversy. This has been caused by...
- Some Common Sense On Breast Cancer Screening
Yesterday, the American Cancer Society updated its guidelines on screening mammography for women at average risk, moving closer to the U.S. Preventive Services Task Force guidelines by recommending that most women start screening at age 45 (rather...
- Breast Cancer And The Angelina Jolie Effect
There is nothing like a celebrity to call attention to a preventable disease, especially if that disease is cancer. In March 2000, then-Today Show host Katie Couric, whose husband Jay Monahan died of colorectal cancer in 1998, underwent a live colonoscopy...
- A Different Perspective On Screening For Breast Cancer
A nurse practitioner and writer living in Washington, DC, Veneta Masson contributed a guest post to Common Sense Family Doctor earlier this year. This month, she published a thought-provoking piece in the journal Health Affairs, titled "Why I Don't...
- The Dark Side Of "cancer Awareness"
The American Cancer Society has designated this weekend "Suits and Sneakers Awareness Weekend," as part of the annual Coaches vs. Cancer program that will feature well-dressed basketball coaches wearing "sneakers instead of dress shoes with their usual...
Medicine
Pink ribbons don't cure breast cancer
"I used to believe that a mammogram saved my life," begins breast cancer survivor Peggy Orenstein in a revelatory New York Times Magazine story that every woman (and man) should read before making personal decisions about screening for cancer. Although the ubiquitous spectacle of pink ribbons for "cancer awareness" has certainly raised breast cancer's profile as disease, Orenstein raises serious concerns about whether these campaigns have been good for patients:
Before the pink ribbon, awareness as an end in itself was not the default goal for health-related causes. Now you’d be hard-pressed to find a major illness without a logo, a wearable ornament and a roster of consumer-product tie-ins. Heart disease has its red dress, testicular cancer its yellow bracelet. During “Movember” — a portmanteau of “mustache” and “November” — men are urged to grow their facial hair to “spark conversation and raise awareness” of prostate cancer (another illness for which early detection has led to large-scale overtreatment) and testicular cancer.
“These campaigns all have a similar superficiality in terms of the response they require from the public,” said Samantha King, associate professor of kinesiology and health at Queen’s University in Ontario and author of "Pink Ribbons, Inc.” “They’re divorced from any critique of health care policy or the politics of funding biomedical research. They reinforce a single-issue competitive model of fund-raising. And they whitewash illness: we’re made ‘aware’ of a disease yet totally removed from the challenging and often devastating realities of its sufferers.”
As I've blogged before, there are no easy victories in cancer screening and prevention. Physicians, researchers, politicians, and health advocates who exaggerate the benefits and minimize the harms of early detection of cancer with mammograms and other tests ultimately do patients a disservice. Orenstein makes this case on the personal and public health levels:
The idea that there could be one solution to breast cancer — screening, early detection, some universal cure — is certainly appealing. All of us — those who fear the disease, those who live with it, our friends and families, the corporations who swathe themselves in pink — wish it were true. Wearing a bracelet, sporting a ribbon, running a race or buying a pink blender expresses our hopes, and that feels good, even virtuous. But making a difference is more complicated than that.
It has been four decades since the former first lady Betty Ford went public with her breast-cancer diagnosis, shattering the stigma of the disease. It has been three decades since the founding of Komen. Two decades since the introduction of the pink ribbon. Yet all that well-meaning awareness has ultimately made women less conscious of the facts: obscuring the limits of screening, conflating risk with disease, compromising our decisions about health care, celebrating “cancer survivors” who may have never required treating. And ultimately, it has come at the expense of those whose lives are most at risk.
As I've blogged before, there are no easy victories in cancer screening and prevention. Physicians, researchers, politicians, and health advocates who exaggerate the benefits and minimize the harms of early detection of cancer with mammograms and other tests ultimately do patients a disservice. Orenstein makes this case on the personal and public health levels:
The idea that there could be one solution to breast cancer — screening, early detection, some universal cure — is certainly appealing. All of us — those who fear the disease, those who live with it, our friends and families, the corporations who swathe themselves in pink — wish it were true. Wearing a bracelet, sporting a ribbon, running a race or buying a pink blender expresses our hopes, and that feels good, even virtuous. But making a difference is more complicated than that.
It has been four decades since the former first lady Betty Ford went public with her breast-cancer diagnosis, shattering the stigma of the disease. It has been three decades since the founding of Komen. Two decades since the introduction of the pink ribbon. Yet all that well-meaning awareness has ultimately made women less conscious of the facts: obscuring the limits of screening, conflating risk with disease, compromising our decisions about health care, celebrating “cancer survivors” who may have never required treating. And ultimately, it has come at the expense of those whose lives are most at risk.
Read the full text of "Our Feel-Good War on Breast Cancer" here.
- More On Mammography: Just Because You Don't Like The Results Doesn't Make Research Junk Science
A recent study published in the New England Journal of Medicine, “Effect of three decades of screening mammography on breast-cancer incidence”, by Archie Bleyer and H. Gilbert Welch[1], has generated enormous controversy. This has been caused by...
- Some Common Sense On Breast Cancer Screening
Yesterday, the American Cancer Society updated its guidelines on screening mammography for women at average risk, moving closer to the U.S. Preventive Services Task Force guidelines by recommending that most women start screening at age 45 (rather...
- Breast Cancer And The Angelina Jolie Effect
There is nothing like a celebrity to call attention to a preventable disease, especially if that disease is cancer. In March 2000, then-Today Show host Katie Couric, whose husband Jay Monahan died of colorectal cancer in 1998, underwent a live colonoscopy...
- A Different Perspective On Screening For Breast Cancer
A nurse practitioner and writer living in Washington, DC, Veneta Masson contributed a guest post to Common Sense Family Doctor earlier this year. This month, she published a thought-provoking piece in the journal Health Affairs, titled "Why I Don't...
- The Dark Side Of "cancer Awareness"
The American Cancer Society has designated this weekend "Suits and Sneakers Awareness Weekend," as part of the annual Coaches vs. Cancer program that will feature well-dressed basketball coaches wearing "sneakers instead of dress shoes with their usual...