Two Views of Breast Cancer

The New York Times ran an excellent review of two new books on breast cancer: Pink Ribbon Blues, by sociologist Gayle A. Sulik and Promise Me, by Nancy G. Brinker. Pink Ribbon critiques the social cost of issues such as Pinktober and the concept of the overly chipper cancer patient. Promise Me is Brinker's memoir about her sister, Susan G. Komen, and the organization Brinker started in her memory. It's a no-holds-barred review that acknowledges the reality and legitimacy of breast cancer crankiness and the very real questions many have about Komen.

And while we're talking books, take a look at Barbara Ehrenreich's Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America. I love Ehrenreich and I love that she gives people permission to be cranky. It came out a couple of years ago, so you might be able to get it easily at your public library.

Review of Triple-Negative

The New England Journal of Medicine published an excellent article overview of triple-negative breast cancer--when it started, how it differs from other cancers, typical patterns of metastases, prognosis....

Online Discussion on Triple-Negative

I just discovered this excellent 2009 discussion on Medscape, "Triple-Negative: Current Approaches and New Frontiers." It's a blue ribbon panel of experts: Eric P. Winer, MD; Lisa A. Carey, MD; George W. Sledge, Jr, MD; and Elizabeth S. Frank, EDM. Some good information--a nice overview of triple-negative.

Don't Define Me By My Cancer

People who have lived through cancer just want to get on with their lives—head into the future like everybody else, free of cancer, free of its memory. That’s why the labels others affix to us can make us especially testy.

Take, for example, the label survivor. Please. It look me a while after diagnosis to understand why this word annoyed those who have survived. Finally, when I started to be lumped into that category, I got it. The word defines us by our disease. And how can we move past this diagnosis if we are forever labeled according to it?

Some women prefer the word thriver, and I get that. It is active—it shows we are fully engaged in life. It’s a positive, affirming word. Surviver, by contrast, means we exist. We didn’t die. Not dying is a good thing—an extremely good thing— but it is not the only thing. If it is, then we are not really living, are we?

Still, I need no label. I am Pat. I had breast cancer and I, thank God, got over it.

What do we call survivors of heart attacks? I call them Hank and Herb and Mike. What do we call survivors of strokes? I call them Jean and Gary. Cancer need not be in a category of its own—the big scary disease. Those of us who have weathered its storms want to move beyond it. We're wives, mothers, daughters, grandmothers, aunts, sisters, friends, lovers. We're proud of these roles and find these labels wonderful--they make us fit in, feel a part of the world, of society, of our families, our communities.

Survivor sets us apart, and we’re tired of being special in a cancer sort of way.

We're also writers, doctors, teachers, editors, students, artists, photographers, computer specialists, managers, volunteers, and tote a laundry list of other accomplishments. We have worked to earn these labels and encourage you to see us for what we have done, not what was done to us.

Then there is the issue of our courageous battle. I had several people tell me that I was so courageous while I went through treatment. My reaction was usually a highly articulate, “huh?” It is not courage to put one foot in front of another and just do what you need to do, usually while terrified and confused.

Some of us do it with less complaint than others, but that is not courage. It is just good luck—a positive attitude, perhaps a better diagnosis, smoother response to treatment, or a support system that keeps us grounded.

To me, courage refers to soldiers in Afghanistan, or the person who jumps into a raging river to save a woman whose boat has capsized, or politicians voting for what they know is right but might not get them reelected.

And, frankly, it applies more to our caregivers—like my husband, who never let me say, “I have cancer,” correcting me to “You had cancer.” Or the parents of children with cancer who have to fight for proper care and deal with the financial hit while supporting a confused and sick child. Or the children watching their mother lose her hair and reminding her how beautiful she is and how much they love her, all the while hiding their own fear.

The problem with calling cancer patients courageous, again, is that it sets us apart from everybody else. We are the Person with Cancer. How scary. How tragic.

Does an obituary say a person died of a courageous battle with heart disease? Why not? Why is cancer elevated to such a stage?

And why does it bother us?

It’s a problem because when you are constantly told you need courage to get through this journey, it makes the road seem that much rougher, the climb that much steeper, the destination that much less clear.

All we want is to be normal again. To be just a person who once got sick but hopes not to get sick again. As someone who is moving on, leaving cancer far behind, kicking dust in its nasty old face.

Read more about living past a diagnosis of TNBC in my book, Surviving Triple-Negative Breast Cancer.

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Updates from the San Antonio Breast Cancer Symposium

Cure Magazine is offering daily updates from the 2010 San Antonio Breast Cancer Symposium December 8-12. Sign up on the magazine's website, where you can also see highlights of last year's program.

Think Pink, Live Green

Breastcancer.org has launched a new column dealing with environmental influences on breast cancer. In her introduction, Dr. Marisa Weiss writes:

Everything is on the table: what we eat, drink, breathe, take, and use from the kitchen, pantry, cleaning shelf, and medicine chest; how we handle stress, sleep at night, make reproductive choices, treat ourselves, and interact with others. All of these factors affect how our outside environment affects the inside environment within our bodies.

Sound like a big job? In fact, it’s going to take a movement, called Think Pink, Live Green, which is based in science, grounded in medicine, and will be delivered in clear terms with easy-to-follow strategies. We’re certainly not starting from scratch. Think Pink, Live Green represents the results of a research project I’ve been working on for two years with Dr. Joan Ruderman of Harvard Medical School, identifying emerging environmental factors that can potentially contribute to the risk of breast cancer.

The first educational program of Think Pink, Live Green is this expert column on Breastcancer.org, with effective and practical information and tips on things like choosing the safest sunscreens and cosmetics, buying organic at the grocery store, and what cleaning and household products are safe to use. We know far from everything – but we know enough to have serious concerns about using various products and making different lifestyle choices.

For more, go to breastcancer.org.

Exercise cuts BC risk for postmenopausal women

Exercise once again tops the list of what women can do to help reduce their risk of breast cancer. The higher the activity, the better, with five hours a week of moderate physical activity such as brisk walking cutting breast cancer risk for postmenopausal women, according to the ongoing Nurses Health Study. The research was based on surveys of 95,396 postmenopausal women who were interviewed every two to four years since 1986. The results were the same regardless of receptor status (hormone-positive or hormone-negative), body mass index (BMI) and hormone replacement therapy (HRT). The study was published in the October 25, 2010 issue of the Archives of Internal Medicine.