OCTOBER IS Breast Cancer Awareness Month. How could we not be aware?
My friends and I have just buried one of our own -- a wife and a mother of three school-aged children. She died of breast cancer at the age of 39, her cheerfulness, her optimism and her belief in a miracle undiminished until the last.
Her loss makes the tiny pink ribbons we wear this month as a reminder seem ridiculous. Will there be a day that her family and friends do not remember her? Will there not be reminders in every corner of their lives, their hearts?
Is there a woman anywhere who has not lost a friend or a neighbor or a mother or an aunt or a sister to breast cancer? Is there a woman left who is untouched by this disease?
Is there a woman who is unaware of breast cancer this month? Or any month?
I don't think so. Not for longer than she can distract herself with the busy-ness of her life. Breast cancer is a shadow across the life of every woman.
Why? Breast cancer is a common cancer, but it is not as common as lung cancer. More women die of that disease each year. Heart disease is a greater threat than breast cancer, and to more women. Why does heart disease not make us shudder the way that breast cancer does?
It is not just the disease that frightens women. The treatment does, too: The poisonous ritual of chemotherapy, the disfigurement. We can say that we are not our breasts, but I don't think we believe it.
And women fear that these awful treatments will not effect a cure. This is not just a fear of death, but a fear for everyone left behind if we die.
We believe we are indispensable to our husbands and our children. We can't imagine them without us. Who will shop for groceries? Who will braid her hair? Who will make sure his uniform is clean in time for the game?
How will the sun rise without us? How will it know when to set if we are not there to tuck it into bed?
Aware of breast cancer? If our own dark thoughts did not make us so, the media surely would.
Like AIDS, breast cancer has become a political disease. If the scientists who battle the killer diseases of gays and women are not flush with money, it is seen to be the fault of the powerful, straight men who write the checks.
The media report on this the way they do on political to-ing and fro-ing. Are you for mammograms before age 40 or are you against? How could you be against an effective screening device at any age?
Do you believe in lumpectomy or full mastectomy? Is this about science or cosmetics?
Why don't women have a blood test for breast cancer when men have one for prostate cancer?
Newspapers and television newsmagazines are so on top of this story that their reports are often premature. We are aware, all right. Aware of how confused we are.
This much we know for sure:
A fair amount is known about breast cancer, compared with other cancers. We have a screening tool -- the mammogram -- that is effective. True, we don't have a blood test, but we can determine if we have the genes that might trigger the disease.
We have a fairly clear risk continuum and can learn where we fall on that continuum. That also means we can talk intelligently about prevention.
We have treatments that, no matter how fearsome, are far ahead of the treatments for prostate cancer. And we can tell how those treatments perform because studies have been done and we have information.
Surgeons and radiologists are working together on breast cancer. They are still arguing with each other about how to treat prostate cancer.
And we have choices: Lumpectomy and radiation or mastectomy. The downside is that you have to make that choice. It might seem easier if your doctor would just tell you what to do. But you have time to consider. You don't have to make your decision 10 minutes after getting the diagnosis.
And the medical establishment is increasingly open to alternative therapies and the conversations between doctors and women's advocacy groups are more conciliatory.
Because we are so "aware" of breast cancer, you might already have thought about your choices. You might already have some information. If not, there are lots of information sources, lots of help out there. The National Cancer Institute's hot line, 800-4-CANCER, is the best place to start.
October is Breast Cancer Awareness Month and that is a good thing. There are too many women in their 60s and 70s who do not get yearly screening mammograms. There are too many women who think they are too young to bother with self-examinations.
But so many women, so many husbands and children, so many friends and relatives, are painfully aware of breast cancer. This month and every month.
Pub Date: 10/14/97