Not So Pretty in Pink: The Uproar Over New Breast Cancer Screening Guidelines

Has feminism been replaced by the pink-ribbon breast cancer cult? When the House of Representatives passed the Stupak amendment, which would take abortion rights away even from women who have private insurance, the female response ranged from muted to inaudible.

A few weeks later, when the United States Preventive Services Task Force recommended that regular screening mammography not start until age 50, all hell broke loose. Sheryl Crow, Whoopi Goldberg, and Olivia Newton-John raised their voices in protest; a few dozen non-boldface women picketed the Department of Health and Human Services.  If you didn’t look too closely, it almost seemed as if the women’s health movement of the 1970s and 1980s had returned in full force.

Never mind that Dr. Susan Love, author of what the New York Times dubbed “the bible for women with breast cancer,” endorses the new guidelines along with leading women’s health groups like Breast Cancer Action, the National Breast Cancer Coalition, and the National Women’s Health Network (NWHN). For years, these groups have been warning about the excessive use of screening mammography in the U.S., which carries its own dangers and leads to no detectible lowering of breast cancer mortality relative to less mammogram-happy nations.

Nonetheless, on CNN last week, we had the unsettling spectacle of NWHN director and noted women’s health advocate Cindy Pearson speaking out for the new guidelines, while ordinary women lined up to attribute their survival from the disease to mammography. Once upon a time, grassroots women challenged the establishment by figuratively burning their bras. Now, in some masochistic perversion of feminism, they are raising their voices to yell, “Squeeze our tits!”

When the Stupak anti-choice amendment passed, and so entered the health reform bill, no congressional representative stood up on the floor of the House to recount how access to abortion had saved her life or her family’s well-being. And where were the tea-baggers when we needed them? If anything represents the true danger of “government involvement” in health care, it’s a health reform bill that – if the Senate enacts something similar -- will snatch away all but the wealthiest women’s right to choose.

It’s not just that abortion is deemed a morally trickier issue than mammography. To some extent, pink-ribbon culture has replaced feminism as a focus of female identity and solidarity. When a corporation wants to signal that it’s “woman friendly,” what does it do?  It stamps a pink ribbon on its widget and proclaims that some miniscule portion of the profits will go to breast cancer research. I’ve even seen a bottle of Shiraz called “Hope” with a pink ribbon on its label, but no information, alas, on how much you have to drink to achieve the promised effect. When Laura Bush traveled to Saudi Arabia in 2007, what grave issue did she take up with the locals? Not women’s rights (to drive, to go outside without a man, etc.), but “breast cancer awareness.” In the post-feminist United States, issues like rape, domestic violence, and unwanted pregnancy seem to be too edgy for much public discussion, but breast cancer is all apple pie.

So welcome to the Women’s Movement 2.0: Instead of the proud female symbol -- a circle on top of a cross -- we have a droopy ribbon. Instead of embracing the full spectrum of human colors -- black, brown, red, yellow, and white -- we stick to princess pink. While we used to march in protest against sexist laws and practices, now we race or walk “for the cure.” And while we once sought full “consciousness” of all that oppresses us, now we’re content to achieve “awareness,” which has come to mean one thing -- dutifully baring our breasts for the annual mammogram.

Look, the issue here isn’t health-care costs. If the current levels of screening mammography demonstrably saved lives, I would say go for it, and damn the expense. But the numbers are increasingly insistent: Routine mammographic screening of women under 50 does not reduce breast cancer mortality in that group, nor do older women necessarily need an annual mammogram. In fact, the whole dogma about “early detection” is shaky, as Susan Love reminds us:  the idea has been to catch cancers early, when they’re still small, but some tiny cancers are viciously aggressive, and some large ones aren’t going anywhere.

One response to the new guidelines has been that numbers don’t matter -- only individuals do -- and if just one life is saved, that’s good enough. So OK, let me cite my own individual experience. In 2000, at the age of 59, I was diagnosed with Stage II breast cancer on the basis of one dubious mammogram followed by a really bad one, followed by a biopsy.  Maybe I should be grateful that the cancer was detected in time, but the truth is, I’m not sure whether these mammograms detected the tumor or, along with many earlier ones, contributed to it: One known environmental cause of breast cancer is radiation, in amounts easily accumulated through regular mammography.

And why was I bothering with this mammogram in the first place? I had long ago made the decision not to spend my golden years undergoing cancer surveillance, but I wanted to get my Hormone Replacement Therapy (HRT) prescription renewed, and the nurse practitioner wouldn’t do that without a fresh mammogram.

As for the HRT, I was taking it because I had been convinced, by the prevailing medical propaganda, that HRT helps prevent heart disease and Alzheimer’s. In 2002, we found out that HRT is itself a risk factor for breast cancer (as well as being ineffective at warding off heart disease and Alzheimer’s), but we didn’t know that in 2000. So did I get breast cancer because of the HRT -- and possibly because of the mammograms themselves -- or did HRT lead to the detection of a cancer I would have gotten anyway?

I don’t know, but I do know that that biopsy was followed by the worst six months of my life, spent bald and barfing my way through chemotherapy. This is what’s at stake here: Not only the possibility that some women may die because their cancers go undetected, but that many others will lose months or years of their lives to debilitating and possibly unnecessary treatments.

You don’t have to be suffering from “chemobrain” (chemotherapy-induced cognitive decline) to discern evil, iatrogenic, profit-driven forces at work here.  In a recent column on the new guidelines, patient-advocate Naomi Freundlich raises the possibility that “entrenched interests -- in screening, surgery, chemotherapy and other treatments associated with diagnosing more and more cancers -- are impeding scientific evidence.” I am particularly suspicious of the oncologists, who saw their incomes soar starting in the late 80s when they began administering and selling chemotherapy drugs themselves in their ghastly, pink-themed, “chemotherapy suites.” Mammograms recruit women into chemotherapy, and of course, the pink-ribbon cult recruits women into mammography.

What we really need is a new women’s health movement, one that’s sharp and skeptical enough to ask all the hard questions: What are the environmental (or possibly life-style) causes of the breast cancer epidemic? Why are existing treatments like chemotherapy so toxic and heavy-handed? And, if the old narrative of cancer’s progression from “early” to “late” stages no longer holds, what is the course of this disease (or diseases)? What we don’t need, no matter how pretty and pink, is a ladies’ auxiliary to the cancer-industrial complex.

Copyright 2009 Barbara Ehrenreich

Comments

[Buena]

Do they screen men for testicular cancer by putting their balls in a vice, then irradiating them? Why not?

And yes, where the hell has feminism gone?

[Peter Beacham]

Oh Paleeeze. I know that "issues" like this are viewed as good career builders for journalists and activists such as you but your mean-spirited, ill-informed, overly-politicized scare-mongering is just so much froth. The entire mammogram issue is a red herring. It is much ado about nothing.

You call for "a new women's health movement", but all that is required is that women take responsibility for their own health care and educate themselves. The answer to eradicating breast cancer (and several other types of cancer as well) is as near as a bottle of vitamin D tablets. If every woman took 1000 IU of vitamin D daily there would be no breast cancer. (references upon request.)

I know this solution probably lacks the drama that crusaders and journalists seek but it is the truth and will save lives. In addition, it enables women to free themselves from depending on others for their own health care.

[Dana Hopkins]

I am a BC survivor [well before 50] but I am a "coulda been a poor teen mom" survivor too! I'll speak out! LEGAL.LOW COST, ABORTION PROBABLY SAVED MY LIFE i was 17, terribly abused & self abusing, suicidal, no taking care of my health & would not have survived the alternative, either at birth or after. Now a mom of 3 happy healthy sons sons [first conceived 10 years later] i'm sure of it.
I also had multiple BC screenings , bad biopsies etc from 35 on but i have a horrendous family history & would still be screened under the new guidlines as high risk.
Self awareness, researching my family myself, self exams AND medical screening saved my life.
taking my breast health into my own hands, intelligently, without hysteria was my choice too.

[Jane]

Dana, thank you for speaking out.

[Catia Conforftini]

Speak it like it is, Barbara!!! We can always count of you, thank you!!!

A BC survivor, who does the walks, but hates that they are corporate-sponsored and so politically vanilla

[Hattie]

Peter: I think Barbara Ehrenreich is a saint to let you comment here.

[Aftercancer]

Wow Barbara, I'm a huge fan but you're way off base with this column. I'm sorry that you had cancer at age 59 but the proposed changes to the recommendations would not have affected you in any way.

I however was diagnosed at age 38, an age where I was not looking to have my HRT refilled but the mother of young children who assumed that the lump must just be because of my menstrual cycle.

Oops, no, not my period but instead stage III breast cancer with no family history. 20 percent of the women who are diagnosed with breast cancer are under age 50 and when diagnosed in younger women breast cancer is more aggressive and more deadly.

Yes, there needs to be better technology. Yes there need to be better treatments. Yes there needs to be insurance for all but that's not what these recommendations were about.

The biggest problem with the recommendations is not that they were made but that they were made in the vacuum of academia. The doctors involved all seemed shocked when it was suggested that the information they were sharing could cost women their lives.

The decision to use mammography should be between a woman and her physician, but unfortunately we know that's not the way the world really works.

So yes, I have marched for abortion rights but I will also march for the right to services that will keep me and my daughter alive. I blog at www.aftercancernowwhat.com

[annie]

Thank you! Finally, a voice of reason.

[Adriane Fugh-Berman]

Wonderful column! For more information on conflicts of interest, see
Mammography and the Corporate Breast
http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=4194
Adriane Fugh-Berman

[Dean Garrett]

Your background as a scientist shines through in articles like this one. Thanks for stating, and backing up with research, what so many of us have thought. We do need more research into causes and non-lethal cures and less time spent being led through clouds of pink by the cancer industry.

[Monica]

My choice is to simply not get any screening whatsoever.

I think that the very fact that options are available and health care technically saves lives has the side effect of creating unrealistic expectations that affect happiness. Maybe it was better when things like disease, pregnancy, weight gain and death were seen as things that just happen or come from God instead of being things that can and should be controlled and a source of great disappointment if they happen anyway. People back then may not have lived longer, healthier lives, but they must have been happier.

[Edward Guerena, Pharm.D.]

My comment has to do with the administering and selling of chemotherapy drugs by oncologists. When I went to Pharmacy School back in the 1970's, we were told that the reason doctors could not own a financial part of a Pharmacy was because of the conflict of interest in being able to make money by what you prescribe to your patients. There is always a threat that the decision of what therapy to use to alleviate sickness will be determined by profit rather than the latest scientific knowledge.

I have been a hospital pharmacist since then and have seen things change. Sometime in the 80’s oncologists were allowed to sell drugs. Now there are great financial gains in prescribing and selling chemotherapy drugs to your own patients. This is not to say that all oncologists would prescribe for profit, but rather, since the possibility is there, some might lean towards that more profitable treatment rather than the less expensive course simply because it will make more money.

We need to remove all physician financial incentive in the selection of drug therapy in order to protect patients from the very few who would prescribe for profit.

[Lisa]

I have cancer 4 times in two years, with resulting 20 chemos, 9 hospital stays, seizures that left my right side very weak, 4 eye surgeries, low dose radiation and so much more. It nearly killed me, should have. Cancer treatment is a huge moneymaking farce, it is not a cure. I have not been back to an oncologist in 6 moths, I will never do traditional treatments again. I have found an alternative and I am doing so much better, starting to feel things I have not felt in the 2 years that cancer and cancer treatment consumed my life. I will never be the same, the treatments did some damage that can not be repaired, but I will NEVER do traditional treatment again. Thank you for speaking the truth.

[Anarcissie]

"... What we really need is a new women’s health movement...."

We need a lot of things, but I think the Left that ought to be supplying them is just exhausted for the moment. And so the corporatocracy steps in with its little pink ribbons, or its big Mr. O, or its next war or bailout, or whatever.

[Momstinfoilhat.wordpress.com]

Thanks for this post. My sentiments exactly.

[Kamal Muilenburg]

Dear Barbara,

Your opinion piece in the LA Times really made me think differently about the issue. While I do disagree with the new mammogram recommendations and with your opinion, I respect your analysis. But I know too many women, of all ages, who have been saved and successfully treated by early detection, including myself. More importantly, I agree with your perspective on feminism and how it has been sidetracked by easy-to-get-behind issues such as breast cancer. Feminism has become a dirty word in our society, and we continue to lose many of the gains made earlier. When I leave California, I am always appalled at the lack of basic access to services such as abortion in so many states.

[Suzanne]

I think you're on track and I wish more people would speak out about our medical and pharmaceutical industries' profit driven interests and accompanying propaganda. I live a a neighborhood where every weekend during the summer, the streets are closed for one "walk for disease x" or another.
I lived in Europe for almost a decade, and a completely different relationship to health and health care.
Our system glosses over the inhumanity of its market-driven goals. I won't wear a pink ribbon or donate to a walk. I will however pay more taxes so that everyone has health care.
I have a healthy skepticism of health care system because I can. I've health care differently.

[Hilary]

Mammography prior to age 50 (the "magic menopause number") isn't effective because prior to menopause most women's breast tissue is too dense to be read properly via mammogram, and even if a tumor is present (as in my own case) it might not be detected. Mammography is radiation, but does it contribute to breast cancer? Maybe for some. Inevitably, some people are going to be more susceptible to radiation or environmental factors than others.

In my own case, I was doing "everything right". I got lots of exercise, I took my vitamin D (Peter Beacham, take heed) and my calcium and my multi-vitamin, I exercised, I have a good job that I love, my kids are healthy, my relationships are healthy, I eat well and I was rarely ill. And I got invasive lobular carcinoma anyway. It didn't show up on the mammogram.

I don't know how women are supposed to get out of the pink-ribbon mentality and onto taking charge. I don't wear any ribbons. I slug through each day of radiation and wait for it to end so I can get on with my life.

Maybe in January, when it's all done, I will have a clearer answer to the question of how to get out from under all the brain-washing and the ribbon-wearing and the running for the cure.

[Steve]

Thank you sharing a rational discussion of an important issue that has become fodder for sophists.

[Liz Guertin]

You are awesome. Thanks so much for saying what I want to say.

[Stephanie]

I was just thinking about this same issue because of a New Yorker article along the same vein. It is sad to see that even the right to make such a personal decision like abortion may go the way of our already defunct medical system by only being available (i.e. affordable)for the top 10%. I had an abortion three years ago, and it saved my life. Thank you for sharing this.

[Jonathan]

I don't know how a smart journalist like Barbara E. can make misinformed comments like, "If the current levels of screening mammography demonstrably saved lives, I would say go for it, and damn the expense." Studies clearly show mammography screening saves lives. The fact is, the mortality benefit from mammography gets better with age. It's not great at 40. It's a lot better at 47.

All the 'critical thinking' here is leveled at those who support mammography, while the USPSTF findings and the claims of Susan Love are accepted unchallenged. Here's one example of what BE ignores: the USPSTF relied on very old studies, and gave the same value to poorly-run mammography programs (that showed no decrease in average tumor size detected) as it did to the well-run ones (that showed average tumor size dropping). This is below BE's usual standards.

[Tiffany]

This article was awesome! There are so many different experiences to the cancer treatments that its difficult to say who's right or wrong. But the important questions that you pose are: How is that so many women get it? And why are the treatments so harsh and extreme? I can only hope and pray that I never get any kind of cancer but I have decided that if I get breast cancer (God forbid) I will give up my breast in a heartbeat. Sorry society but I don't need breasts to remind me that I'm a woman. Keep writing and God Bless you on your continued survival of the "common disease" for women.

[Kim]

I am sick and tired of the entire focus on breast cancer being THE CURE.Why don't we focus on prevention?Could it be that too many are afraid of not making the money they are now on treating cancer?I fear it may be so.

[Sheila O'Shea]

What we don’t need, no matter how pretty and pink, is a ladies’ auxiliary to the cancer-industrial complex.

I love this line.

I read Bright-Sided in one day and I just wanted to pop in here and thank you so much for it. It was one of the most depressing books about positive thinking I've ever read, but, really, I mean that in a good way.

[BrightBlueLizard]

Ah, thank you, thank you!

I was always creeeped out by the massive prevalence of baby pink ribbons EVERYWHERE, but could never quite put my finger on the reason I was creeped out. You clarified a great deal, and I second the love for this line: What we don’t need, no matter how pretty and pink, is a ladies’ auxiliary to the cancer-industrial complex.

Awesome!

[Breast Cancer Conquer]

"Your mammogram is suspicious for breast cancer." "Your biopsy was positive for breast cancer." These are among the most terrifying words a woman can hear from her doctor. Breast cancer elicits so many fears, including those relating to surgery, death, loss of body image and loss of sexuality. Managing these fears can be facilitated by information and knowledge so that each woman can make the best decisions concerning her care. Knowledge is power and together we can make a difference! You can read more here Breast Concer Conquer. Happy Holidays!

[Breast Cancer Conquer]

I agree with Kim about the cure being the primary target."Your mammogram is suspicious for breast cancer." "Your biopsy was positive for breast cancer." These are among the most terrifying words a woman can hear from her doctor. Breast cancer elicits so many fears, including those relating to surgery, death, loss of body image and loss of sexuality. Managing these fears can be facilitated by information and knowledge so that each woman can make the best decisions concerning her care. Prevention, Awareness should be above curing. Knowledge is power and together we can make a difference! Happy Holidays!

[John W. Harding]

You are one whiny curmudgeon who preys on losers who like to wallow in their problems until someone else fixes them. It is a shame your cancer didn't kill you - we would all be better off. Hopefully it will come back and take you on a slow, painful path to your bitter grave.

[Chickensh*tEagle]

"...who like to wallow in their problems until someone else fixes them."

So, you got cancer of some kind and cured it all by yourself? Impressive! ;-)

[Nancy Dowell]

Ms Ehrenreich: thank you for placing in writing my exact thoughts on the pink ribbon, oh you poor dear, teddy bear race for the cure culture. I want none of it nor do I subscribe to the "cancer made me a better person" philosophy. I had a mastetecomy in 2007. It happened to me along with countless others each year. Did the teddy bears, the pink ribbons, the pink lingerie, the pink athletic socks did they make us all feel better. Hell no! I hated being treated like a child and a poor dear! I am a strong women, director of a county public library system, a community leader and spokesperson. Why would I suddently upon being diagnosed with one of the most common cancers be suddently interested in carrying around pink teddy bears? Let's put all of our efforts in honestly helping women deal with the lumpectomy, mastectomy, reconstructive surgery, radiation, and chemobrain and get rid of these trinkets that are supposed to make us get in touch with our cancer and take those funds to conduct more honest research. Your book is great. I am giving it to all my friends. Keep on writing the truth.

[Donna]

Hi Barbara,

Read the last two books, which I loved, and I'm delighted to find you have a new one. I will be picking it up tomorrow. When I read the new title I laughed and couldn't help but think that you and I are philosophical soul mates. Thanks for not being a brainless Stepford-person like everyone else and having the eyes to see what is woefully, pitifully wrong with society.

[Joan C Samuelson]

Thank you,Barbara! I first became suspicious of the mammogram industry when I had a few tests done. I had fibrous breasts when I was younger which usually resulted in at least duplicate and sometimes multiple screenings. I just thought, "How can being squashed and irradiated be good for my breasts?" I stopped going, despite a great deal of pressure from doctors and clinics. I do not regret it. I also resisted the estrogen treatments they were so anxious to give me at menopause. No regrets there either. I have sometimes wondered whether they will kill us with their "kindnesses".
Thanks again for being a sane voice in an insane world. Read you whenever I can.

[Joanne Watt]

How it is detected is not the point. Some BCs are found through mammograms, and some are found by the individual. I do agree that the whole pink-ribbon thing is out of control; that women are made to feel somehow inferior if we don't respond to Oprah-like outpourings of fellowship, and I also find the pink theme incredibly degrading. I am a 7-year survivor and still cringe every October when Walgreen's puts the pink lids on all their prescription bottles and the NFL players wear pink armbands.

[rcs]

great job at being a pseudoleftist, barbara. Great job at associating leftism with identity politics. ID politics is a major tool of the rich for fragmenting the populace and turning them against each other.

The rich people thank you, Barb, for perpetuating fakeLeftism-identity politics.

[gbl]

Oh do educate us women, Jonathan.

By the time a woman is 60 and has had all her breast cancer screenings under the old guidelines she is at (a minimum of) more than 2% higher risk than she was before she had any mammography. Barring any other carcinogen in her life, including the HT and HRT pharma is still pushing on her for hot flashes and other trivial (not life threatening) reasons.

[Jen Kossmann]

I just read your article in the SF Sentinel, and I LOVED it! My mother died of breast cancer in 2004, and I am sick of being reminded of that horrific experience on a daily basis. At the damn grocery store, for heaven's sake... breast cancer dish soap. It drives me nuts. My mom did that whole positive thing with menopause, and it did not help her with cancer, let me tell you. It spread immediately to her lymph nodes and came on so fast she didn't know what was happening. The whole family was freaked out because she was always such a "free spirit" but I knew she was terrified and I had to explain to her she was dying. She was very ill at that point, and could barely talk. I know you are exactly right to be mad, as I am, about all of this positive crap. It's a horrible disease, as I witnessed, and people should really be more angry about the lack of medical progress. Sorry this rambles so much, brings up a lot of emotions... and I can't talk about it with very many people. They tend to think I'm callused and heartless. Good for you! THANKS!!!

[Mary Knowles]

I turned down 100,000 dollars worth of adjuvant therapy after being diagnosed with Her2+ cancer. All three therapies, AC chemo, Herceptin and Arimidex can have heart toxic side effects and congestive heart failure runs in the family.

How about a blog on relative vs absolute statistics. The oncologist showed me the studies, on Herceptin, from the NEJM Oct. 2005 that deceptively claimed that Herceptin increased disease free survival by over 50%. Turns out that is a relative statistic, the absolute statistic is a little over 5%. I did my research. As Mark Twain once said, "There are lies, dam lies and statistics." They can be played any way you want and the researchers, to often with ties to the drug companies, tend to use the statistics that make their drug look better than it is, the relative statistic.

Breast cancer has become a very lucrative industry, so please spare me the "Pretty and Pink". It infantizes women, and puts them in a subjective roll. They are not encouraged to take an active part in treatment options. We are given a pat on the head, by the doctor, and encouraged to be a good girl and put up with the degradation and humiliation of treatment! Believe me, it isn't the cancer I resent, it is the barbaric treatments.

[Mary Knowles]

I turned down 100,000 dollars worth of adjuvant therapy after being diagnosed with Her2+ cancer. All three therapies, AC chemo, Herceptin and Arimidex can have heart toxic side effects and congestive heart failure runs in the family.

How about a blog on relative vs. absolute statistics. The oncologist showed me the studies, on Herceptin, from the NEJM Oct. 2005 that deceptively claimed that Herceptin increased disease free survival by over 50%. Turns out that is a relative statistic, the absolute statistic is a little over 5%. I did my research. As Mark Twain once said, "There are lies, dam lies and statistics." They can be played any way you want and the researchers, to often with ties to the drug companies, tend to use the statistics that make their drug look better than it is, the relative statistic.

Breast cancer has become a very lucrative industry, so please spare me the "Pretty and Pink". It infantizes women, and puts them in a subjective roll. They are not encouraged to take an active part in treatment options. We are given a pat on the head, by the doctor, and encouraged to be a good girl and put up with the degradation and humiliation of treatment! Believe me, it isn't the cancer I resent, it is the barbaric treatments.

[Mary Knowles]

I turned down 100,000 dollars worth of adjuvant therapy after being diagnosed with Her2+ cancer. All three therapies, AC chemo, Herceptin and Arimidex can have heart toxic side effects and congestive heart failure runs in the family.

How about a blog on relative vs. absolute statistics. The oncologist showed me the studies, on Herceptin, from the NEJM Oct. 2005 that deceptively claimed that Herceptin increased disease free survival by over 50%. Turns out that is a relative statistic, the absolute statistic is a little over 5%. I did my research. As Mark Twain once said, "There are lies, dam lies and statistics." They can be played any way you want and the researchers, to often with ties to the drug companies, tend to use the statistics that make their drug look better than it is, the relative statistic.

Breast cancer has become a very lucrative industry, so please spare me the "Pretty and Pink". It infantizes women, and puts them in a subjective roll. They are not encouraged to take an active part in treatment options. We are given a pat on the head, by the doctor, and encouraged to be a good girl and put up with the degradation and humiliation of treatment! Believe me, it isn't the cancer I resent, it is the barbaric treatments.

[Mary Knowles]

Have posted twice and it just keeps disappearing! Hmmmmm, gremlins? Wonder if this one will disappear as well!

[Mary Knowles]

I turned down 100,000 dollars worth of adjuvant therapy after being diagnosed with Her2+ cancer. All three therapies, AC chemo, Herceptin and Arimidex can have heart toxic side effects and congestive heart failure runs in the family.

How about a blog on relative vs. absolute statistics. The oncologist showed me the studies, on Herceptin, from the NEJM Oct. 2005 that deceptively claimed that Herceptin increased disease free survival by over 50%. Turns out that is a relative statistic, the absolute statistic is a little over 5%. I did my research. As Mark Twain once said, "There are lies, dam lies and statistics." They can be played any way you want and the researchers, to often with ties to the drug companies, tend to use the statistics that make their drug look better than it is, the relative statistic.

Breast cancer has become a very lucrative industry, so please spare me the "Pretty and Pink". It infantizes women, and puts them in a subjective roll. They are not encouraged to take an active part in treatment options. We are given a pat on the head, by the doctor, and encouraged to be a good girl and put up with the degradation and humiliation of treatment! Believe me, it isn't the cancer I resent, it is the barbaric treatments.

[Mary Knowles]

My comment doesn't want to stick. Hmmmmm, gremlins at work? Hey, I have some important things to say about the breast cancer "industry" and how treatment degrades and humiliates women. Oh well see if this one sticks!

[Dianne Dowling]

Dear Barbaba
I read your article Smile! you've got cancer' on 2 Jan 10 in the UK Guardian with much interest. I can indeed relate to some of your concerns, particularly about the fact that women are seen as 'weak' if they do not remain positive at all times. There are many emotions that we all go through when we are diagnosed with breast cancer. Since my BC diagnosis 14 years ago I have experienced a whole range of positive and negative emotions. My present campaigning energy comes not only from positive moments but also moments of anger which can propel me into 'challenge mode' whereby I adopt a rather cynical approach to traditional methods of breast cancer care that are just not acceptable. I will continue to campaign on the prevention of breast cancern. We should lift the blame from individual women and focus on just life style factors to include environmental factors and place this increasing problem in the laps of our politicians. We retain the spirit of feminism - the only difference now is that our voices are heard electronically. Let us not be silence by any more pink ribbons. Please take time to visit Breast Cancer UK's website for further news on our lates BPA Campaign to join in the fight against breast cancer. Much of our work is informed by research from the US and Canada and more recently, environmental partners in Europe.

Dianne Dowling, Secretary, Breast Cancer UK.

www.breastcanceruk.org.uk
www.nomorebpa.org.uk

[Nancy Jones]

My oncologist told me bluntly that keeping a positive attitude would not do a damned thing for my recovery, so I should not beat myself up for not being able to "keep it up" all the time while they were doing everything they could to zap my cancer. I love your blogs, your books, pretty much your opinions. Why not just keep treating breast cancer, as we treat every other cancer? It's a disease, not membership in some stupid "Pink Ladies" club.

[SG Griffith]

Thank you for this refreshing pink-free breeze. Everything women talk about has to be cute - family photos have replaced real talk -- and I haven't even been to Twitter.

I appreciate your candor.

[Tina]

Thanks for all the info. I still feel that early detection is the best even if it saves one life. If that life were mine, my children would be happy as they've already lost a father. I have small children yet to raise. I try to live healthy and taking away mammograms between 40 and 50 is ridiculous. I am reminded that if you give it another year or two, they will reverse their findings yet again.

[Andrea Giletti]

Dr. Cedric Garland of UCSD identifies breast cancer as a Vitamin D deficiency disease.In an open letter to the New York Times he notes that raising serum 25-hydroxyvitamin D levels to 40-60 ng/ml could prevent 75-80% of breast cancer incidence.
http://www.grassrootshealth.net/press-20091207

[Andrea Giletti]

The evidence for maintaining optimal levels of serum vitamin D is compelling! Here is a link to a comprehensive website about D.

http://www.vitamindcouncil.org/

[Chicago liposuction]

My sister-in-law underwent a breast removal surgery after being diagnosed stage 2 borderline 3. Initial lumpectomy followed by bilateral mastectomy, 4 rounds chemo , oophorectomy, delayed reconstruction (tissue expanders replaced with saline implants), Arimidex. It was too much pain and suffering for her. It is definitely not so pretty in the pink.

[realpc]

evil, iatrogenic, profit-driven forces at work here.

Yes yes yes to everything you said. It's about time someone spoke up about this nightmarish nonsense.

[Donna]

I just finished the fabulous new book. I loved it! I was particularly delighted about your coverage of Word of Faith ministry. I attend such a church, with a charismatic pastor who is a close friend and mentee of Fred Price. So out of control is the positive doctrine in my church that even at funerals grief is frowned upon.

I know a family who has lost two adult sons in their prime in the last few years. After the recent death, the pastor said when he made his pastoral support call to the family he thought he had dialed the wrong number because the mom of the deceased was so cheerful when she answered. This cheerfulness was labeled as great faith and closeness to God. At the funeral the parents were repeatedly admonished not to grieve for the senseless loss of their son.

I find falsifying and stifling genuine human emotions an affront to what it means to be human. It rejects and demonizes emotionality as weakness which angers me tremendously. I consider the ability to feel compassion and empathy my greatest gift as a human being. I also think that one of the reasons this is done is to make things easier for the pastoral staff. If everybody is grinning at the funeral, then the pastoral duties are much easier.

Thank you for this book. It galvanized everything I have been feeling about church, the workplace, and society in general for a long time.

PS. I believe that the positive thinking doctrine is also heavily rooted in male supremacy sentiment. If one is apathetic toward the world it is much much easier to present oneself as light and breezy and positive ( "Don't worry. Be Happy").

[Julie Hallett]

Pink is my least favourite colour. I am nauseated by the crowds of little and big girls parading in top to toe pink. I have had breast cancer and don't consider I battled or rank myself as a survivor. I thank my husband for finding the lump and a clever surgeon for removing it. I hated everything about chemo. I too would love to see more emphasis on the cause of breast cancer.

[Judy Wilyman]

Breast cancer is caused by the contraceptive Pill and by HRT therapy (WHO,2005). The medical profession continues to tell women "the hormones in recent conctraceptive pills are very low and breast cancer is a low risk for all women". This is untrue. Chemicals affect individuals differently. Plus a description of 'low' is not informative - we need a standard. This means the Pill will be a high risk for some women and no risk for others due to our genetics. The risk will vary according to our genes. If the medical profession informed women accurately we could choose the length of time we are on the Pill. Scientists are also aware that the longer women are on the Pill the higher our chances of getting breast cancer.
Judy Wilyman
PhD candidate Public Health

[Jean Grace]

Altho this is probably not the best place to make this comment, I just wanted to thank you for 'Bright-Sided.'

I just finished reading it and am already feeling better.

I have been admonished so many times to "quit being so negative, why can't you be happy, nothing is that bad, stop whining," that I would love to send your book to everyone who has ever told me to 'smile.'

Just because I don't treat everything in the 'accepted' Pollyanna way, does not mean I'm not a basically happy person. I don't expect grave and seriously bad things to happen, but when they do I also don't believe I brought them on myself by not being 'happy.'

If I am to believe that positive thinking is what just got me a new, nicely lucrative contract then I must also believe that wishing my grandfather dead killed him.

Instead, I will believe that good, solid hard work and attention to detail and knowing my stuff got me the contract. And my grandfather died of cirrhosis of the liver, not my hatred for him.

[Leo]

In Europe, this book is named "Smile or Die". It is funny that you've changed it to "Bright-Sided" in America. Are you trying to win more customers? :-)

[beth]

There is a great feature article of Barbara on the Big Issue website. one of the best articles iv read about her. check it out at http://www.bigissuescotland.com/features/view/216