Ambiguity Over Breast Cancer Awareness Month

Every October I think about my late mother.  It’s partly because October is National Breast Cancer Awareness Month and my mother passed away from breast cancer. But the larger reason is it’s her birthday this month.  The influx of pink ribbons, breast cancer campaigns, and happy birthday commercials sung by Justin Bieber (sponsored by the American Cancer Society) swarm me with reminders that we won’t be eating cake together.

I would seem like the perfect candidate to join the fight against breast cancer campaign given my personal story and my professional background in public health, but I feel ambiguous about the fight.  Maybe it’s my aversion to the color pink?

I’ve participated in my share of cancer walks and fundraisers but never, at those events, have I felt bright or hopeful that progress was being made.

Don’t get me me wrong.  The money raised for cancer awareness, research, advocacy, and support is invaluable and progress has been made. More people know about breast cancer screening, scientists can conduct their studies to learn more about the disease, and survivors and their families have support and resources which may not have existed a few decades ago.

So why the ambiguous feelings, perhaps even doubt?

For one thing I can’t get over the big picture catastrophe of cancer in our society and how we approach the solution.  Apart from skin cancer, breast cancer is the most common cancer among women and one of the leading causes of death from cancer.  An estimated one out of eight women will have breast cancer in their lifetime and almost 200,000 women a year are diagnosed with it.

There’s little more devastating to a family than watching someone you love weaken to the point where they can’t feed or dress themselves, wipe their own asses, and for some, lose the fight.  In my family, a single-mom household, my sister, brother, and I had to grow up quickly and make peace with the situation.  For me, making peace is still a work in progress, perhaps for rest of my life.

I’m far from being alone.  Too many of my friends’ families have shared similar and unfortunate experiences.  I’m sure you also know a friend or two.

Cancer is just too damn common.  At my most recent race for a cure event, I remember feeling overwhelmed by the sea of pink t shirts with signs written on everyone’s backs reading “I’m walking for/running for/in memory of…” There was an air of celebration, support, and fight.  But the message and the atmosphere of these campaigns are confusing.  There’s nothing celebratory about the overwhelming number of people with cancer.  And why are we so focused on finding a cure?  It’s way less painful (for the individual and society) to focus on prevention.

Not to be a Debbie Downer but isn’t walking for a cure one step too late?  Are we setting ourselves up for more disappointment when we put our hopes and dollars to find the all encompassing cure, that may not come in time for your loved one?

Among professionals in public health, we share a common frustration.  Our focus is predominantly on preventing illness and mitigating the ones that exist.  This is different from the more popular medical model which tends to focus on diagnosing illnesses and finding a cure.  Good prevention is like society’s unsung hero because it’s hard to see its efforts.  While it’s much easier to notice and react to waves of people getting sick. As a society we’re partial to letting situations get really bad then then trying to find a quick fix solution.  Dare I mention the economy, diabetes, or childhood obesity?

Imagine soliciting money from people for the “run for a disease we may never get” event.  Not too sexy.  After watching my mother battle cancer, I rather pour money and run millions of miles  for this kind of event.  Of course a cure would have been nice but one didn’t exist for her.  Also, I would much prefer to have never changed out bowls of vomit from chemotherapy, or to see my mom waste away and go bald.  Any day!

I don’t want to hold my breath for a cure to come because cancer is complicated.  Our risks for cancer are affected by age, race, income, sex, education, genes, environment, food consumption, lifestyle, attitude, etc.  Success in overcoming cancer are similarly influenced by these factors.

But we do know that risk can be reduced by eating well, regularly exercising, reducing stress, not smoking or drinking too much, and generally leading a healthy lifestyle.  But this isn’t always easy to do.  Our society praises those who work hard and long hours leaving little time and energy for leisure and physical activity.  We also tend to over-consume heavily processed foods because that’s what’s readily available and marketed to us.  And some of us can’t help living next to a landfill or in a smog filled city.

I still believe that cancer foundations and organizations are necessary.  We need the support, we need the advocacy, and we definitely need the research.  I just feel that prevention and reducing cancer risk deserves equal effort, money, research, advocacy, and attention, if not more.

No cure was available to my mother, and as we speak millions are fighting the fight with no steadfast solution.  There’s a strong need and urgency for a cure, no doubt.  But what are we going to do to significantly reduce this need for a cure?  I leave you with an Obama quote from his presidential campaign.

We all know the saying that an ounce of prevention is worth a pound of cure. But today we’re nowhere close to that ounce. We spend less than four cents of every health care dollar on prevention and public health even though eighty percent of the risk factors involved in the leading causes of death are behavior-related and thus preventable.