How hard is it to tell the truth?

Not too long ago, a commercial for a local healthcare system in Western Pennsylvania caught my attention for the “statistic” it features at the very beginning.  The commercial is for the healthcare system’s 3D mammography services.

As soon as I read that “99 percent of women will survive breast cancer if detected early,” I shouted, “YOU’RE LYING.”  Unsurprisingly, the source of this so-called statistic is the Susan G. Komen foundation, though I have no doubt that Excela took the statistic out of context to suit its own purposes.  Excela Health wants to get as many women into the doors for its Walk in Wednesdays, and what better way than to keep perpetuating the myth that mammogram saves lives or early detection saves lives.  Who cares if it completely disregards facts, science or context, right?

Let me count the ways in which the commercial is as wrong as Donald Trump as president (seriously, dude is a clown).

1.) Those diagnosed with early stage breast cancer may go on to become metastatic, though the exact number is unknown. 

The Metastatic Breast Cancer Network estimates that 20 to 30 percent of those diagnosed with early stage breast cancer go on to become metastatic.  (Source)  We don’t know this statistic for certain because of this problem, as stated in Laurie Becklund’s op-ed “As I lay dying”:

I say “estimated” because no one is required to report a metastatic diagnosis. Death certificates normally report symptoms such as “respiratory failure,” not the actual disease. We are literally uncounted.

We now know that breast cancer is not one disease. What works for one person might not for another: There is no one “cure.” We are each, in effect, one-person clinical trials. Yet the knowledge generated from those trials will die with us because there is no comprehensive database of metastatic breast cancer patients, their characteristics and what treatments did and didn’t help them [emphasis mine].

 

How can any healthcare network make the assertion that 99 percent of women will survive if their breast cancer is diagnosed given the lack of information?  They can’t, and they should not.  It’s irresponsible for any health care provider to even give the impression that 99 percent of women will survive breast cancer if diagnosed early, especially without giving a time frame (context!).   Ms. Becklund died of metastatic breast cancer (source).

2.)  Excela Health is perpetuating the myth that mammograms save lives.   For years, there has been so much controversy regarding the effectiveness of mammograms.  Do they save lives, or have they contributed to the over-diagnosis of breast cancer?

Back in 2009,  the U.S. Preventative Services Task Force recommended that mammograms should begin at 50, instead of 50, and should occur every two years, instead of every year.

September 23, 2013 CBSNews.com article reported: 

A new study shows that women between the ages of 50 to 74 that get mammography screenings every two years may be at no more risk for advanced-stage breast cancer and at a lower risk for false positives, than those who get tested annually.

The results, which were published on March 18 in JAMA Internal Medicine, follow the 2009 recommendation by the U.S. Preventive Services Task Force that advocated for biennial mammography for women in this age group instead of the previous suggestion of getting screened every one to two years.

However, the study authors pointed out that the original recommendations only looked at age as a factor for influencing breast cancer risk. This new study factored in age, breast density and postmenopausal use of hormone therapy (HT).

According to a February 12, 2014 CBSNews.com item:

A controversial new study has found that annual mammograms may not help reduce breast cancer deaths and may increase the number of women unnecessarily getting treated for breast cancer.  The Canadian study tracked almost 90,000 women for 25 years, and found that having an annual mammogram between the ages of 40 to 59 did not lower the chance of dying from breast cancer more than having a physical examination.

The study, which was published in BMJ on Feb. 11, disconcertingly showed that 22 percent of invasive breast cancers were overdiagnosed by mammography, meaning the tumors would usually have been too small to cause symptoms or become life-threatening.

If different task forces and non-profit agencies cannot even come to the same conclusion regarding mammography, that speaks volumes.    Some might argue that, “Well, hey, the mortality rate is declining, so of course mammograms save lives?”  Well, are mammograms saving lives or is targeted therapies and better treatment contributing to this (source)?

3.) Without context, the 99 percent statistic is just misleading.

The American Cancer Society’s 2013-2014 Breast Cancer Facts & Figures (found here) states:

Based on the most recent data, relative survival rates [i.e., an estimate of the percentage of patients who will survive for a given period of time after a cancer diagnosis] for women diagnosed with breast cancer are: • 89% at 5 years after diagnosis • 83% after 10 years • 78% after 15 years

Relative survival rates should be interpreted with caution. First, they do not predict individual prognosis because many patient and tumor characteristics that influence breast cancer survival are not taken into account. Second, long-term survival rates are based on the experience of women treated many years ago and do not reflect the most recent improvements in early detection or treatment.

The same Facts & Figures document also states that five-year relative survival is also lower among women diagnosed with breast cancer before the age of 40 (yay…. me).   “This may be due to tumors diagnosed at younger ages being more aggressive and/or less responsive to treatment.”  You can’t make a blanket statement about a disease that is so complex.  Cancer doesn’t work that way, and breast cancer certainly does not work that way.  Breast cancer is not just one disease – it’s many.

4.) How dare anyone, especially a healthcare system provider, imply, insinuate or just outright state that those with metastatic disease weren’t proactive in their health or didn’t do all that they can to prevent a metastatic breast cancer diagnosis.   

An estimated 6% to 10% are diagnosed stage IV as their initial diagnosis (source).  What does that mean?  The remaining percentage were diagnosed with breast cancer (stage 0 through III) at some point prior to a metastatic recurrence.  Believe me, they were getting routine screenings (such as mammograms, MRIs and/or PET scans) from their oncologists or other healthcare provider.   After their initial diagnosis, those with estrogen (ER) + breast cancer take some form of hormone suppression medication (such as Tamoxifen, Arimidex and Zoladex).

Lisa B. Adams, who died in March 2015 from metastatic breast cancer, did absolutely everything to reduce her risk of a breast cancer recurrence after she was diagnosed with stage II breast cancer in December 2006.  She wrote on her website she had the following done: double mastectomy, chemotherapy (4 rounds of Adriamycin and Cytoxan two weeks apart followed by 4 rounds of Taxol two weeks apart), Zoladex injections to combat her ER+, PR+ breast cancer and later had a salpingo-oophorectomy (removal of my Fallopian tubes and ovaries) in December 2008.   She received a metastatic breast cancer diagnosis in 2012.

She caught it early!  She.  Caught.  It.  Early.   Many women (and men, of course) caught their breast cancer early, and later died of the disease, and that number is not 1 percent.

Just because someone has been diagnosed with stage IV breast cancer, it certainly does not mean that they did not do everything to prevent such a diagnosis.  Some tumors are more aggressive than others, and can be fast-growing.  Inflammatory breast cancer does not present with a lump.  It is quite possible to have a clean mammogram and then three months later, have a later stage breast cancer diagnosis.  To say otherwise, is downright offensive to those with stage IV breast cancer.

—————

Excela Health isn’t alone in this ever-present pink-washing cycle, perpetuating myth after myth.  However, given that they are an actual healthcare system, then they should be held to a higher standard.  I would love to think that the hospital I’m going to for my healthcare isn’t producing commercials with such garbage like this.  Breast cancer is horrible enough without adding myths and falsehoods on top of it.  How hard is it to tell the truth?

 

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Does abortion cause breast cancer?

A friend recently posted on her Facebook profile that she saw the bumper sticker, “Abortion causes breast cancer,” and wanted to know if there was any truth in that statement. I, of course, chimed in that no, that statement is not true. Then I wondered, “Who the hell puts a bumper sticker like that on their car?” I put on my investigating hat, and I found this Zazzle store where you can buy as many “abortion causes breast cancer” stickers as you want.

You know where else you can buy this bumper sticker? Well, the Abortion Breast Cancer Coalition also sells them.  Yep, there’s actually a coalition devoted to selling the myth that abortion causes cancer. Here is an example of some of their “facts”: “A first trimester miscarriage is quite a different situation from induced abortion of a normal pregnancy in its effect on the woman’s breasts. The longer a woman is pregnant before an induced abortion, the higher her risk of breast cancer. This is because high estrogen levels of the 1st and 2nd trimesters cause breast growth of type 1 & 2 lobules. When her pregnancy is terminated before the breast cells reach full maturity, she is left with more immature type 1 & 2 breast lobules than before her pregnancy started, and therefore is at increased risk. Her breasts never mature to type 3 & 4 lobules, which would have occurred in the 3rd trimester and would have lowered her risk.”

Uh, say what?

You’ll notice a couple of items missing from ABC’s link, such as hyperlinks to studies or just generally, facts and science. If you click on something purporting to be scientific and it doesn’t list a single source, run, not walk, away from that website.

I also really want to know why these folks elected breast cancer as the disease you supposedly get from having an abortion. Why not ovarian or uterine cancer – the lady parts involved in getting pregnant? Why breast? Is it because in the last 20 years, all the pink-washing campaigns have made this particular cancer the tour de force of cancers, and they want to hitch this theory on the cancer with the most household recognition?

From the ABC coalition website: “One of the difficulties with anti-cancer organizations is that radical feminists took up the breast cancer cause in the 1980’s. They saw this as a means of championing women’s rights, so it must have come as a surprise to them when they learned that their dominant concern — abortion — caused breast cancer. Once it became apparent that they had a conflict between abortion ideology and protecting women’s health, abortion won hands down!”

Ah, feminism is to blame for breast cancer. Gotcha.

I wonder if those who believe abortion causes breast cancer enough to put a bumper sticker on their vehicle actually know that breast cancer isn’t just one disease either? I want to ask them, “Abortion causes what type of breast cancer?” Invasive ductal carcinoma? Invasive lobular carcinoma? Metaplastic breast cancer? Inflammatory breast cancer? Estrogen-positive, Her2-positive or triple-negative cancer?”   I guess there isn’t enough room on a bumper sticker for things like facts and science, huh?

I understand that pro-life people are quite fond of their provocative bumper stickers and in-your-face posters (although, to be fair, pro-choice folks are also fans of the bumper stickers and posters). This particular bumper sticker is just so inaccurate and offensive that I’m really shocked that anyone would put this on their car.  Women are the ones who have elective abortions, and women (mostly) get breast cancer, so therefore, abortion causes breast cancer? Come on, let’s be better than this – correlation does not equal causation.  I mean, men have vasectomies. Men develop testicular cancer. Does that mean vasectomies cause testicular cancer? (No.)

Let’s go back to the question at hand: does abortion cause breast cancer? Does this bumper sticker mean all abortions, including spontaneous abortions (aka miscarriages) or stillborn births? When I was 28, I had a miscarriage/spontaneous abortion. Two years later, I was diagnosed with early stage breast cancer. Which means, according to the “abortion causes breast cancer” line of thinking, my miscarriage caused me to have breast cancer?

Nope. No. Just no.

I would wager a bet that every single person who slapped that “abortion causes breast cancer” bumper sticker on their vehicle wanted to shame any woman who had an elective abortion (not a spontaneous abortion/miscarriage). If they had an abortion, “Well, you’re going to get breast cancer and probably die,” and if they had an abortion and later developed breast cancer, “Well, that’s what you get for being a slut.”  If that’s the case, though, there is just so much wrong with believing that women who have had elective abortions get breast cancer as punishment, especially when the fact-based science (rather than the pseudoscience of seeking out data to prove one’s ideological beliefs) dismisses any link between the two.

According to the National Cancer Institute’s website, “the Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists concluded that ‘more rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.’”

The website also gives the following as other findings from the recent studies:

  • Women who have had an induced abortion have the same risk of breast cancer as other women.
  • Women who have had a spontaneous abortion (miscarriage) have the same risk of breast cancer as other women [emphasis mine].
  • Cancers other than breast cancer also appear to be unrelated to a history of induced or spontaneous abortion.

Here is another study: “Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study.” The conclusion of the study, which included women ages 29 to 46 years old: “Among this predominantly premenopausal population, neither induced nor spontaneous abortion was associated with the incidence of breast cancer.”

Oh look, another study (from June 2008): “Incomplete pregnancy is not associated with breast cancer risk: the California Teachers Study.” The authors provide some background on the study: “Early studies of incomplete pregnancy and development of breast cancer suggested that induced abortion might increase risk. Several large prospective studies, which eliminate recall bias [i.e., a ‘systematic error caused by differences in the accuracy or completeness of the recollections retrieved by study participants regarding events or experiences from the past’], did not detect associations, but this relationship continues to be debated.” The study concluded that “These results provide strong evidence that there is no relationship between incomplete pregnancy and breast cancer risk.”

You know what can increase your risk of developing breast cancer? Per Breastcancer.org, not having children can increase your risk (not cause – big difference): “Women who haven’t had a full-term pregnancy or have their first child after age 30 have a higher risk of breast cancer compared to women who gave birth before age 30.”  That does not mean having an abortion (spontaneous or elective) causes breast cancer.

Breast cancer doesn’t discriminate and it certainly doesn’t care if you have had a spontaneous or elective abortion. Breast cancer doesn’t just happen to “bad people,” because I certainly know a lot of wonderful, loving women who have had cancer and many among those who have died from it.  Your morals don’t shield you from ever having breast cancer.

Using breast cancer, a very deadly disease that approximately 40,000 people will die from in 2014, in the pro-life vs. pro-choice debate is disgusting and offensive. Women (mostly) are losing their lives, and you want to add shame (based in bias and anti-science) to their struggles? Shame on every single person who has put that bumper sticker on their car. You are not a virtuous person. You are horrible.  Women undergoing breast cancer treatment need your support, not your vitriol and blame.

Race for the Agenda

(Originally posted on Get Up Swinging on February 2, 2012.)

I have spent the last two days really thinking about the decision of Komen to cut off funding to Planned Parenthood. It’s taken me that long to really think about what I want to say to the Komen foundation, and here it goes:

Shame on you. You have let me down, and you have forever lost me as a supporter for your organization.

I had been participating in Race for the Cure races since 2000 in honor of my mother. Several of those years, I walked in the Race by myself because it didn’t matter that I was alone. I was racing in memory of my mother. Mother’s Day used to be painful for me because my mom was gone. Race for the Cure helped me feel close to her on a day that used to bring me pain. I go to sleep in nights in Race for the Cure T-shirts. All those years, I believed that I was doing good and something that mattered. My mom was a social worker and worked for the United Way before she died. My mom cared about others and wanted to help. I don’t know much about the woman, but I know that.When I participated in last year’s Race for the Cure, I felt a sense of community and pride. I looked around and took in all the other pink shirts. I saw the various signs proclaiming SURVIVOR. I loved it. I felt that one word they say a lot to cancer patients: “Hope.” I felt it and believed it. I saw women who were decades-long survivor and it gave me faith that I’m not going to die in the near future.

Komen made a cowardly decision by using a lame excuse, “Oh well, we’re not going to fund organizations that are under investigation.” I think I would actually respect their decision more if they just outright said, “We no longer want to be associated with an organization that provides abortions. This is our stance.” Okay then. Fair enough. Don’t hide behind a lame excuse – own up to it. However, my first question: why partner up with Planned Parenthood in the first place? It’s not like they all of a sudden became a place for women to go to for abortion. If it wasn’t political when the partnership started, then why make it political now?

I’ve spent way too much time on Komen’s Facebook page and have engaged with some lovely trolls, who had horrible literacy skills and scientific know-how. In the last two days, I have learned the following:

1.) Abortions cause cancer

Apparently there’s a website called abortionbreastcancer.com which, shocker, tells folks that abortion causes breast cancer. Yeah, that website seems really unbiased. Was the domain “BullshitMumboJumbo.com” not available?

I’m going to go out on a limb and say that ACS’ website is devoted to helping fight cancer, not some political agenda.

The topic of abortion and breast cancer highlights many of the most challenging aspects of studies of people and how those studies do or do not translate into public health guidelines. The issue of abortion generates passionate viewpoints in many people. Breast cancer is the most common cancer, and it is the second leading cancer killer in women. Still, the public is not well-served by false alarms. At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer or any other type of cancer.

2.) Birth control causes cancer

Let me refer you to the National Cancer Institute’s take on that.
3.) Women with no health insurance should just research harder for help if they are sick.

4.) By cutting ties with Planned Parenthood and taking away funding for screening, Komen now supports a pro-life agenda.

So by cutting off women’s access to cancer screenings and possibly delaying a cancer diagnosis…. that’s pro life? Whose life are we for here?


5) Poor women wanting free mammograms have this sense of entitlement.

Komen and Planned Parenthood are both charities. They are not the government. Implying that these people are trying to take advantage of the system is inaccurate and offensive. When folks give to charity, that implies they want to help others. When people in need go to charity for help, there should not be strings attached to that help.
6.) Breast cancer is a side effect of birth control.

Breast cancer is a disease. It’s not a side effect. It’s not punishment for being a slutty mcslut who sluts around. It’s a disease. It’s a disease that does not discriminate. It likes young women, old women, Democrats, Republicans, junk-food lovers, vegans, skinny women, overweight women. When you are a bald, sick individual fighting for your life, cancer does not care whether or not you donated to Planned Parenthood or stood outside its clinic showing pictures of aborted fetuses.

When a woman feels a lump in her breast, it is the scariest thing in the world. It’s the boogie man under your bed and hiding in your closet. When you have that mammogram and the doctor tells you that you have to come in for a follow-up, all the hairs on your neck stand up.

Women, no matter their socioeconomic status, should be able to get that lump checked out. By limiting their access to finding that help, I don’t find anything pro-life about that.

There are other charities out there, waiting for your help and donation. I suggest you find them.