Counting the Years and a New Blog

Four years and about a couple of months — 1508 days in all. That’s how long it’s been since I finished chemotherapy treatment for triple-negative breast cancer. At this point — fingers (and toes) crossed — everything looks good for me health-wise, and I am almost able to think that my experience is really, truly part of my past. That it might be OK to think that I am OK (though of course there are never any guarantees).

I watch the news reports about cancer from a different perspective now, as part of the larger picture of health and health care in the U.S. and around the globe. The recent bad (but not surprising) news from the World Health Organization is that the incidence of cancer will continue to increase, more rapidly especially in developing countries in part from infections and in part from the adopting of more affluent lifestyles. The good news from India, where one fifth of new breast cancer cases occur each year, is that treatment for people with HER-2 positive breast cancer will become more affordable. The now-regular reports about research for triple-negative breast cancer are heartening. And an article sent today by a friend describes the humane-ness of cancer treatment in France.

I was very fortunate in my own cancer journey to have good insurance coverage, and good medical care at a center that treated patients well. But much has shifted in American health care in just these 4 years. For example, in the constant efforts for hospitals to secure their income streams in the face of legislative changes, cancer treatment has become a marketing chip, with even renowned centers vying for patients by publishing their survival rates. These changes prompt me to think about what constitutes not just health care but good health care, and how likely it is for the average patient to get that good care despite the smoke and mirrors that dominate the discussions.

Patients and physicians are at the very center of the debate of about healthcare reform, but unfortunately, that reform has been hijacked by government politics and corporate interests. As is clear from the healthcare exchanges, like so many other areas of American life, health care is fast becoming a do-it-yourself proposition. So it’s increasingly up to us as patients, as patients’ families, and as healthcare providers to work to keep medical care in the hands of those at its core — the patients and the care providers.

With this in mind, I am starting a new blog, The Educated Patient, as a forum for discussion of the many influences at work in health care and its reform. I hope it helps patients understand what goes on behind the scenes of their care and helps both patients and providers secure the connection between them.

I will continue writing for The Popsicle Report as before. But please join me in enlarging the discussion at The Educated Patient.

 

May I Help You?

May I help you?

It’s a question we often hear – and perhaps recite – without a second thought, especially at this time of year when we try to focus on those in need. After all, what could be bad about offering help?

But oh, what a loaded question it can be. As innocuous as it seems, help is, after all, a four-letter word.

Consider the Beatles, for whom the word was a request. Or the novel, The Help, by Kathryn Stockett, in which the word is a derogatory euphemism for people.

I never thought much about what constitutes help until my cancer diagnosis. And then I thought about it a lot, because people asked that question. And so I had to figure out if I needed help, and what that help might look like.

I can’t speak for others wrestling with a similar need for help – whether it’s because of a serious illness or even a joyous event like the birth of a child. And that’s the first thing to remember about help: it is a totally individual definition and its definition is as broad and varied as the people who ask for or offer it.

As I wrestled with the changes my diagnosis brought, here’s what I found most helpful:

  • The phone call from my internist the evening after she gave me the biopsy results. She had pushed hard to get quick results (because making a patient wait 2 weeks for a confirmed diagnosis is just cruel), and was checking to see how I was doing. Her voice that night was a lifeline in the stormy sea I’d just been thrown into.
  • The guidance of the surgeon and oncologist, who led my spouse and me through the steps to decide on treatment and paced that decision so we had time to figure out the right path. They explained not just the factual medical information (most critically that breast tumors can show up almost overnight between mammograms, so I could quit feeling guilty about missing one), but also the emotional and psychological impact on both of us.
  • My spouse, who investigated the medical information, checking with colleagues for second and even third opinions. Although I try to educate myself and be self-sufficient, the brain fog created by the diagnosis kept me from being able to process what I needed to know to make good decisions. For those facing trouble, it is essential to have such support on the path, someone who can keep you moving through the necessary steps, who can check and double-check details, even down to reading dosages on the bag of chemo drugs when it’s hung at your side in the infusion center.
  • The nurses in the infusion center, whose demeanor helped keep me on an even keel.  They know the seriousness of such a diagnosis, and some wonderful tricks to alleviate side effects, but they don’t reflect sadness or despair when working among the patients. In fact, they regularly reinforced the idea that the situation was manageable.
  • Capable and reliable household help, whether a sister, a friend, or even a hired college student. The critical point is that this help must be independent enough to manage the various duties – laundry, driving kids to events, even cleaning out roof gutters – without constant direction or oversight, but not so imposing as to make you feel like you’ve been sidelined from your own life. It is difficult to find that balance, but SO helpful when it’s there. And that includes those who volunteer to bring in food.
  • The cards and notes from friends and relatives. Hokey as it may seem for the ones who send them, they are the tangible sign that I am loved and supported. I still keep my basket of cards on a table where I can see them as a reminder of this network of support. And the chains of 1000 colorful origami cranes have an honored place on the walls of our home.
  • Conversations with others further down the road of the cancer journey, for they knew what was possible and served as beacons of hope. The yoga gang in particular continues to be a network of support, but I also recall the encounters with anonymous people I met randomly while out on errands, people who recognized the telltale headscarf and compassionately spoke to me.
  • The opportunity to continue to be as productive as I could in my professional life. Though I decreased my workload, my supervisor, who had wrestled with cancer himself, encouraged me to continue working at a level that would keep me engaged so that I was still a person rather than a diagnosis.

And here’s what was NOT helpful:

  • Hearing cancer referred to as “the big C,” which only perpetuates the fear that surrounds the diagnosis. Cancer is not Voldemort (He-Who-Must-Not-Be-Named). Saying the word does not bring on the disease or make it worse.
  • Being spoken to in a pathetic tone of voice (especially with the head cocked at a sympathetic angle). Concern is acceptable, compassion essential. Pity, however, has no place in the armamentarium of help.
  • Being told stories about relatives or friends who had a dire prognosis or died of cancer. Or, on the other hand, being told superficially, “Oh, you’ll be fine!” Cancer is the word used for a wide range of illnesses related to cell dysfunction, with an equally wide range of symptoms and prognoses, and no one ever knows how the story will turn out. It’s essential to help the person maintain her spirits and energy, but neither unrealistic hope nor descriptions of worst-case scenarios is helpful.

A tangent to those stories is telling the person how YOU are feeling about the situation. Someone who is blindsided by a life-altering event does not have any spare energy to help you figure out how you feel about the illness. A good guideline to prevent such a scenario is to follow the Ring Theory of kvetching, described by Susan Silk and Barry Goldman in their article in the Los Angeles Times. As they put it, “The first rule is comfort in, dump out.”

What is least helpful is any sort of help that is about your need to be helpful, rather than what the person really needs. This is not the time to prove to yourself or anyone else that you’re a good helper. If you’re someone who can offer help, be sure it’s the kind of help the person really needs, which is not necessarily the kind of help you might want to give. Help is a gift  — and gift, too, is a four-letter word. Like any gift, it should be about the person receiving it, not the one giving it.

If you’re someone who really needs to help or wants to organize help for a friend, there are several websites that can help you help someone else. Lotsa Helping Hands is just one of them.

And now, to lighten the mood, the musical closing.  Sing along if you like.

Guest Post: Sloppy Reporting Affects Too Much Cancer Writing

This month, I am re-posting an excellent blog post by Patricia Prijatel, the E.T. Meredith Distinguished Professor of Journalism Emeritus at Drake University in Des Moines, Iowa.  She is the author of Surviving Triple-Negative Breast Cancer, an investigation into the causes and treatments of triple-negative breast cancer (TNBC), the type of breast cancer that we both had. The book was published in 2012 and can be found here.

This article was originally posted on Patricia’s blog, Positives About Negative, on September 8, 2013. In it, she describes how it is that media reporters misinform the public about triple-negative breast cancer and the effects of that misinformation on the public’s understanding of the disease. Although she focuses specifically on TNBC, the situation she describes is rampant in the media when it comes to health and other topics, and she calls on reporters to be precise in their reporting, to represent their topic accurately, and take responsibility for their words and the effect those words have on the audience.

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Sloppy Reporting Affects Too Much Cancer Writing

By Patricia Prijatel

Reporters: Precision is especially important in health writing.  

Patients: Read carefully and learn to spot misinformation and dangerous generalizations.

I have been a journalist for 46 years, 30 of that teaching at some level. My son is a journalist, as are most of my close friends. Yet one of my biggest frustrations since my cancer diagnosis is with my own profession.

Most journalists have more of a job than they can handle right now, so I offer a few rules for them about breast cancer reporting, skewed toward information about triple-negative breast cancer (TNBC), which gets especially distorted in the media. What tripped my trigger today was a story in KGW.com, a station in Portland, Oregon, but it has been an issue with The New York Times, medical journals, blogs, and just about every form of medical or health information.

1. No one type of breast cancer is THE most aggressive. Not TNBC, not Her-2 positive, not inflammatory, all of which are repeatedly given that description in outlets large and small.

Which is THE most aggressive? Plenty of all types. Even early-stage hormone-positive breast cancer can be aggressive with the wrong mix of genetics (the BRCA genetic mutation and others that researchers are still uncovering), family history, and numerous environmental, health, and lifestyle issues (insulin resistance, weight, alcohol abuse, and so on.)

Some forms of TNBC are more lethal than some forms of hormone-positive, and less lethal than other forms. And so it is with all types and subtypes.

2.  There are successful treatments for most forms of TNBC. Yet journalists easily say things such as, in the KGW.com piece, “Women with triple negative breast cancer don’t usually respond to most traditional therapies.” I honestly appreciate that qualifier, “usually.” Neverthless, the statement is inaccurate. It is true that TNBC tumors are not responsive to estrogen-altering drugs such as tamoxifen and Arimidex because the disease is not fueled by estrogen.

But TNBC responds well to typical chemotherapy—better than other forms of cancer respond, in fact. So women with TNBC usually get their drugs in the form of chemo, either before or right after surgery, rather than in five-year doses, as is the case with patients with estrogen-positive disease.

Treatment for metastatic TNBC—stage IV—remains difficult, and it is true that many of those patients do not respond to current therapies. But fewer than 10 percent of patients with TNBC have stage IV, which means that 90 percent may respond well to treatment.

So the helpful qualifier in that statement would be “Metastatic TNBC does not usually respond well to most traditional therapies.”

3. Readers internalize your words. Last week I talked to a woman who had been given an excellent prognosis from her doctor, yet still thought her outlook was grim because she read a news release saying TNBC was lethal. Communications research demonstrates this phenomenon—we’re more likely to consider media reality as the real deal instead of our own lives. Everybody lives in cool apartments and houses on TV, so you believe that to be true in real life, despite the fact that most of your friends have standard-issue digs with furnishings from WalMart. Same way with health issues. Ominous news in the media feels more accurate than your doc’s more measured approach.

4. The generalizations you use can loop around to negatively affect your readers’ and listeners’ health. I recently talked to a highly educated woman with a medical background who thought that it did not matter that her TNBC was stage 1. “Stage doesn’t matter with this disease, does it?” she asked. She was ready to give up. Of course stage matters. Stage 1 TNBC is much less aggressive than stage 4 of anything else. The great majority of women with stage 1 TNBC survive—as many as 90 percent in some studies.

Still, because she thought TNBC was automatically aggressive, she was giving up, and few battles in health or otherwise are won by giving up.

So do your research and don’t lump early stage with late stage disease. The research reported on by KGW.com was on the drug PLX2297, which may be effective against TNBC. I cannot find the research the reporter alludes to, but I did find a clinical trial for PLX3397 in connection with Eribulin for metastatic TNBC.  Metastatic is late stage. Metastatic is a much different disease from non-metastatic. Know the difference and include it in your story. It actually only takes a word.

5. Remember your vocabulary. Lethal means deadly. So if you tell me my disease is lethal, you are telling me it will kill me. Yet most women with breast cancer, including TNBC, live happy lives long after diagnosis. I have talked to a great many of them. They compete in triathlons, have babies, tend their grandchildren, get remarried, buy cottages by the ocean.

6. Get your stats straight or don’t use them. Just as all breast cancers are different, so are their prognoses. Saying that TNBC patients have “another five to eight years to live,” as KGW.com reported, is outrageous. There is no research to back this up. Most recurrences of TNBC come in the first three years, but a host of studies show that the majority of women with the disease make that marker easily and live disease-free for decades. I have interviewed countless women who are 20 years past this diagnosis. And, sadly, I have lost friends before the three-year mark. There is no one prognosis, but the reality is that most women survive beyond “five to eight” years. Don’t tell readers they’ll likely be dead in five years. Really, I have to say that?

7.  Never settle for a one-source story. This is pretty basic and is true of all journalism, but especially for health. That source could be wrong, inarticulate, promoting an agenda, or speaking in medical shorthand that the writer’s colleagues might comprehend but which may confuse or frighten their patients. Researchers naturally want to show the importance of their findings and, in so doing, could mischaracterize the seriousness of a disease. This information is too important to let one individual set the tone. At least link to organizations with a broader perspective. Numerous sites exist for accurate breast cancer information, including breastcancer.org, the Triple-Negative Breast Cancer Foundation, Living Beyond Breast Cancer, and of course, this blog.

Read more about TNBC in the book, Surviving Triple-Negative Breast Cancer.

The News of the Day is Not All Bad

 

 

October 1 — and the news of the day is not encouraging:

The U.S. government is shut down because our Congress can’t seem to get along.

The websites to sign up for the new healthcare exchanges have crashed.

And our celebrities are so lazy, they can’t walk at a tourist attraction.

But, in honor of the pink month, there is some encouraging news:

  • Deaths from breast cancer in the U.S. in 1991:  43,583
  • Estimated deaths from breast cancer in the U.S. in 2013: 40,030

It may not look like much of a difference, but it’s a big deal for those 3553 people who remain alive.  Let’s celebrate what we can.

And if you’re tired of the today’s bad news and need a good laugh, check out the new story at my other blog.

Test Anxiety: The August Installment

This week’s mail brought two folded papers full of numbers.

These numbers are the results from last week’s visit with my internist for my annual check-up. Height, the same. Weight, the same. Cholesterol, TSH, vitamin D levels – all normal. The phlebotomist was so good I barely felt the needle stick in my arm — the right arm, ALWAYS the right arm, because it was the left side that was traumatized by the surgery and radiation. I still have to remind myself to tell the doctor’s assistant to use the right arm for the blood pressure cuff or needle. It’s not yet habit for me to remember this myself, and I don’t need to tempt another onset of lymphedema.

I didn’t expect to see anything scary on the report from my internist.  After all, I am in quite good health (oh, except for that bout with cancer).

The previous week, I anxiously awaited the results of the annual mammogram and MRI scan. The current guidelines for mammograms vary depending on whom you ask. Anyone who’s interested in or affected by these guidelines likely knows the ongoing controversy around the usefulness and timing of the test. Agencies and physicians change their minds frequently about what’s appropriate.

Given that mammograms are less reliable in people like me who have dense breast tissue, I am extremely reluctant to put my faith in them, especially since they did not show the tumor that caused me so much grief. Still, my oncologist insists I have one each year, and my radiologist says that, though it isn’t perfect, it’s the best test we have. (To which I say, it’s about time we come up with something better.)

So, every year around this time, I trek to the radiology center to undergo the test. Four years past my diagnosis, my anxiety about the test now only kicks in as I don the cape in the dressing room, not several days beforehand. And because the same radiologist has been viewing my images and so knows me (or at least my breast tissue) pretty well, he makes a point of coming to tell me the results before I can even leave the building.

They say your diagnosis is only as good as the radiologist reading the images. I’d also say, regardless of the diagnosis, the effect of the results on the patient is only as good as how (and how soon) the radiologist delivers them. The longer the wait, the higher the anxiety spikes.  A face-to-face conversation or a phone call the same day trumps a form letter a week later, even when the news is good.

People sometimes wonder why someone would not go to see a doctor if there is something wrong. It comes down to this – if you ask a question, you’ll usually get an answer. Anxiety is what tells you the answer might not be what you hope for. If you never ask the question, you never have to hear the answer, and so some people never ask.

Immediately after Dr. P came to report the results to me (“Everything looks OK”), I was taken to the other side of the building for an MRI, something I’ve asked for each year since the end of treatment. It’s not customary to have an MRI unless the doctor suspects there’s something to find, and the MRI has some inherent problems as well, but I have asked for it precisely because the mammogram is unreliable for me. And my oncologist has readily agreed. This is no small agreement as the test costs about 2 thousand dollars (which alone spikes the anxiety level) and, as my oncologist reported to me last time I saw him, he’s starting to see insurance companies refuse to cover the MRI unless the patient has current signs or symptoms needing attention. I can understand insurance companies wanting to cut unnecessary costs, but peace of mind is always necessary. With the results of the mammogram coupled with the MRI, I can be reasonably sure that we’ve got a good picture of what is (or isn’t) going on.

Lucky for me, our current insurance approved the test — at least for this year — and Dr. P reported, when he called the next day, that “All looks good this year.”

This year.

With this good news, and the normal numbers from the internist this week, my anxiety has dropped from stratospheric to just atmospheric, where it should stay till my check-up with the oncologist in November.

Seeing the Thestrals

Thestral

Thestral (Photo credit: Jon_Tucker)

In a conversation not long ago, a friend who has been reading this blog periodically observed that, this far out from my treatment for cancer, I “wouldn’t have so much to write about anymore.” The comment was intended to be reassuring, but it stuck with me in the way such comments do for people whose perspective has been changed by a life-threatening event.

I would love to be the first to affirm my friend’s observation. Would that it were true. But the impact of such an event never disappears, though it may fade a bit into the distance.  Cancer is too big a part of the overall picture of health care, not just in this country but around the world. There will always be more to be said because, once it invades your life, you can never be entirely free of its shadow.

And that shadow takes the shape of a thestral.

Fans of the Harry Potter books will quickly recall that, in the fifth book, Harry Potter and the Order of the Phoenix, Harry for the first time is able to see the thestrals, the invisible creatures that have been pulling the carriages from the train station at Hogsmeade up to Hogwarts castle when students arrive for the new school year. It takes awhile for him to find out why he can now see the thestrals, with their dark, skeletal, horse-like bodies and leathery wings. It’s his friend and teacher Hagrid who tells him that thestrals can be seen only by those who have seen death. Harry inadvertently earned the ability to see them by witnessing the death of a classmate at the hands of the evil Voldemort at the end of the fourth book. Once Harry sees the thestrals, he can’t pretend they don’t exist.

Things once seen cannot be unseen. We can only pretend not to see them.

Unlike Harry Potter, I haven’t quite “earned” the ability to see thestrals (were they to exist) because I have not yet witnessed death directly, only after it has occurred. But having had a serious go-round with cancer, I can see the faint, ghostly outlines of the creatures in the far-off distance at the edge of the woods.

To descend into symbolism (forgive my English major’s approach), we can talk about what the thestrals represent.  Are they death itself, or only reminders of it? In the book, the thestrals turn out to be helpful when they transport Harry and his friends to London in the misguided attempt to save Sirius, Harry’s godfather, from the hands of Voldemort. So they do not represent death, taking part as they do in an effort to prevent one. They are simply reminders that, after catching sight of our mortality, whether through serious illness or accident, we can expect to see the world differently — notice things that we did not notice before, and look at the world with new awareness.

This is the best explanation I’ve found for how the world looks to me now, several years after the encounter with cancer. The thestrals are dark, disturbing creatures, not ones we like to look at as we would, say, giraffes. But they serve to remind us that recognizing our mortality changes our view, and they can perhaps do for us what they do for Harry and his friends – move us to take actions that we might not have managed otherwise. They remind me, specifically, to keep my attention on what really matters:

  • The shower water in the hotel room isn’t as hot as I’d like?  So what.
  • My son wants a green streak painted in his hair?  No big deal.
  • Two friends disagree on what is the “correct” interpretation of Biblical scripture?  Not worth the argument.

The thestrals remind me to see only what really matters, and use that sight when I might actually be able to change things:

  • Make sure a friend’s voice is heard when the crowd isn’t listening? Indeed.
  • Call out a student who has been cheating her way through classes? You bet.
  • Write about my experience with a life-threatening illness, for those facing the same situation? Absolutely.

The thestrals are there for all of us. You don’t have to see them to know they exist. But if (when) you acknowledge their presence, you have to change the way you see the world.

Melissa versus Angelina: What’s Wrong With This Picture?



When I first heard about Angelina Jolie’s breast surgery (how could you not hear about it?  The news seeped in everywhere, even if you never read a newspaper or watch TV), I thought, “Really?  An op-ed in the New York Times? National and international headlines??  Really?!”

Never mind the fact that, when discussing the news, the announcer on the Yahoo channel mispronounced two rather important terms: preventive (not preventative) and mastectomy (not massectomy).

Never mind the fact that it seemed the New York Times has skewed priorities for its opinion pages. (I wonder what our soldiers in Afghanistan had to say about their lives on that particular day).

And never mind that every time people look at Ms. Jolie now, they will see not just the luscious lips, the dark eyes, and her skeletal figure. Even more so than before, their eyes will move to her breasts, with judgment, and they will whisper to their friends, “You know they’re not real.”  (Stay tuned to see if Jolie’s career takes a hit as Hollywood may now see her as “damaged goods.”)

The ripples from Jolie’s announcement continue to work their way toward shore.

Some say Jolie was brave to put herself out there and describe rather intimate details of her life. Her decision is one grounded in the anguish that arises when a woman learns she has one of the genetic mutations (BRCA 1 and BRCA 2) that can lead to breast and ovarian cancer. But this is a decision thousands of unknown women have had to make in their own quiet, desperate ways, without the advantages (or pressures) of the spotlight.

The myriad comments by readers and viewers worldwide show that Jolie’s choice resonates with many people, and that’s good. But it does raise the repeated problem of a celebrity becoming the intact, smiling, healthy-looking poster child for a particular illness:

  • Think Christopher Reeve recovering from his spinal cord injury
  • Think Michael J. Fox wrestling with a body ravaged by Parkinson’s disease
  • Think Robin Roberts after her recent bone marrow transplant

Their integrity is remarkable. But so is that of the average person whose struggle with illness is never so much as commented on in the local newspaper.  Even Christina Applegate, an actress who went through a similar procedure several years ago, didn’t rate above-the-fold headlines in the national newspapers.

Maybe the celebrities give us hope. Maybe they’re also guilty of putting a pretty face on conditions that are devastating for most of us on a daily basis, making it all seem so easy, so manageable.

The latest opinion – once again reported in headlines — comes from Melissa Etheridge, who is no stranger to the topic of breast cancer, having been called equally brave for appearing bald onstage at the Grammy awards in 2005 while undergoing treatment for breast cancer. I don’t agree with much of what she says in her confusing response to Jolie’s situation (which was even more confusing once she tried to clarify her comments), but I do agree with her opinion that Jolie is not brave.

As has been reported widely, Jolie has a strong family history of breast cancer and carries a defective gene that could lead her down the same path as her mother and her aunt. Her choice to remove and rebuild her breasts decreases the likelihood of her developing breast cancer by as much as 85% or more. To seal the deal of prevention, she will also need to undergo an oophorectomy to remove her ovaries.

Jolie has six children who count on her presence in their lives. And though science still has a long way to go on the topic, it has at least presented people like Jolie with some options before cancer develops. What she did was not the brave thing. It is not “brave” to do the thing that can save your life. It is simply the thing you must do.

But Jolie’s is not the experience of most women who face breast cancer. Genetic mutations account for only about 10% of breast cancer cases. The other 90% of us have no warning, no predictors, no scientific data to arm us for the enemy when it comes. We’re simply blindsided and left to figure out what to do in response.

I’ve been waiting for the press to report what I anticipated would happen after Jolie’s announcement:  the spike in fear from women everywhere as we are all once again terrified by the threat of this disease, and the spike in demand for a genetic test that is extremely expensive and not covered by insurance, unless you can demonstrate a medical necessity for the test. (Fortunately, the good news from the Supreme Court recently that Myriad Genetics cannot patent the breast cancer genes should force that company to relinquish their monopoly, and their huge profits, on the genetic test.)

Finally, an article by Kevin O’Reilly in the American Medical News, a newsletter published weekly by the American Medical Association brought these ripples to light:

  • The confusion the story created for women everywhere, who fear they will be one of the more than 200,000 women diagnosed with breast cancer every year
  • The flood of phone calls to doctor’s offices by these frightened women
  • The onerous task of already overburdened physicians and nurses trying to separate facts from the fears for the patients who call.

The article summarizes the point well:  “[S]ome medical experts are voicing the concern that the Oscar-winning actress’s story could lead to inappropriate use of genetic testing and prompt women without hereditary cancer risk to demand prophylactic contralateral mastectomy when less invasive treatment options are as available.”

Jolie has been, and will remain, in the spotlight for a long time to come. Maybe she can now turn that light not on “the choice,” not on “the cure” but on the real problems:

  • Our continued reliance on mammography as the “gold standard” tool, when it clearly fails many women, either by missing the cancer or implying it’s there when it’s not. We need something better.
  • Our continued heavy emphasis on finding “the cure” to the exclusion of finding the causes. A cure is necessary, but the greater miracle would be finding – and stopping – the causes, including the causes of genetic mutations.

Jolie’s article in the Times, instead of focusing on the real problems women (as part of ALL humanity) face, focuses on breasts, and not the breasts of the average woman. Jolie herself distracts attention from these real problems by talking about “empowerment.” The comments supporting Jolie show that we are much too willing as a society to accept that cutting off breasts to prevent cancer is acceptable, even normal, which contributes to the idea of breast cancer as just another rite of passage for women, like marriage or childbirth.

If you want to really empower women, put more of them in the House and Senate, put more on boards of the major corporations, those very corporations guilty of the pollution that harms all of us. Statistics show that women tend to be very concerned about health and safety issues, especially those that affect their families. TRUE power (not the passive type that only reacts to an event) is the ability to make decisions to stop harming our citizens for profit, which our government and businesses should be doing. Telling women to get mammograms (and haggling over who should, who shouldn’t, and when) isn’t going to get it done. Having people like Jolie “come out” about her actions also isn’t going to get it done.

Angelina – you have the spotlight. Be the actress – act, and turn that spotlight where it should be.

And Melissa – keep those great tunes coming.

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