To put most of the effort into treatment is to deny all precedent." -- Harvard biologist John Cairns
My mother and my wife's mother were both born in 1951 and were raised on farms in the South. My wife's mother has nine older sisters and one younger one, but she is the only one who has been diagnosed with breast cancer. My mother, who died of breast cancer in 2010, was 16 years younger than her only sister. Similar to my wife's aunts, my aunt has never been diagnosed with breast cancer, either. Neither were our mothers' mothers, both of whom died in old age.
Our mothers' stories suggest that something other than a genetic predisposition caused their breast cells to go haywire. They're not the only women who've found themselves singled out by the disease. My dad's youngest sister was the only one of five DeBerry girls to contract and die from breast cancer. Yet, October's breast-cancer awareness events tend to focus on genetic causes to the exclusion of everything else. That, in turn, leads to the disproportionate amount of time and energy spent demanding a cure for breast cancer.
Have you ever stopped to ponder why there are no colorful campaigns, no three-day-walks, no bike-a-thons or marches demanding a cure for lung cancer? We don't fool ourselves into thinking there's a cure for that. Instead, we've imposed smoking bans. We haven't demanded a cure for mesothelioma. We've stopped using asbestos. There aren't a whole lot of rallies demanding a cure for skin cancer. We've learned to stay out of the sun or slather on sunblock at the beach.
Maybe there isn't one single thing - no equivalent to lung cancer's tobacco or skin cancer's sun exposure - that causes women with no family history to develop breast cancer. Maybe the causes are myriad. But it would behoove scientists to give more thought to prevention than racing toward a cure.
In his book "The Emperor of All Maladies: A Biography of Cancer," Dr. Siddhartha Mukherjee quotes Harvard biologist John Cairns who questioned the emphasis on curing cancer in a 1985 article for the Scientific American. He questioned the emphasis because no major disease had ever been stamped out with a focus on a cure.
"The death rates from malaria, cholera, typhus, tuberculosis, scurvy, pellagra and other scourges of the past have dwindled in the US," Cairns wrote, "because humankind has learned how to prevent these diseases ... To put most of the effort into treatment is to deny all precedent."
But denying all precedent is what we've been doing.
In her 2001 essay "Welcome to Cancerland," Barbara Ehrenreich rails against what she describes as the "breast-cancer cult" that demands that women diagnosed with the disease drape themselves in pink and declare the disease to be the scare they needed to live their lives to the fullest. And Ehrenreich makes an argument for breast-cancer advocacy led by feminists and not by corporations looking to bolster their public image with non-controversial contributions.
"Like everyone else in the breast-cancer world," she writes, "the feminists want a cure, but they even more ardently demand to know the cause or causes of the disease without which we will never have any means of prevention. 'Bad' genes of the inherited variety are thought to account for fewer than 10 percent of breast cancers, and only 30 percent of women diagnosed with breast cancer have any known risk factor (such as delaying childbearing or the late onset of menopause) at all."
Are plastics to blame? Pesticides, maybe? Is there something in the ground water that ought not be? Women who ask these questions are not generally welcomed into the mainstream breast-cancer awareness parties, Ehrenreich says. Theirs are the "discordant voices in a general chorus of sentimentality and good cheer; after all, breast cancer would hardly be the darling of corporate America if its complexion changed from pink to green."
In his biography of cancer Mukherjee tells the story of Fanny Rosenow, a breast-cancer survivor who in the early 1950s asked The New York Times to publicize a support group for women who'd dealt with the disease. But she hung up the phone in anger when an editor explained that the paper wouldn't publish the word "breast" or the word "cancer" and suggested that she refer to it as a "meeting about diseases of the chest wall."
We've overcome a major hurdle. We no longer insist that people with breast cancer - or any kind of cancer - keep their diseases a secret or hide their faces in shame. But if we can make that transition from talking about breast cancer with hushed voices to openly demanding a cure, surely we can make another shift and insist that researchers give necessary attention to the prevention of breast cancer so that a cure won't be so crucial to women's survival.
Nobody's opposed to breast-cancer awareness, but what do you make of the emphasis given to a cure and not prevention? What do you think of Ehrenreich's claim that there's a "breast-cancer cult" that prompts women to speak fondly of their experiences with the disease and discourages their anger and their research into possible causes?
Jarvis DeBerry can be reached at jdeberry@nola.com. Follow him at twitter.com/jarvisdeberry.
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