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What Does A Cure For Breast Cancer Elude Us?

The public revelations of the private ordeals suffered by Rep. Debbie Wasserman Schultz were like shock therapy to a public that may have become inured to the brutal struggles of a breast cancer patient. After watching this woman as both a local and national political stage, it stuns the heart to learn that she was simultaneously recovering from devastating surgeries and drug therapies.

Her story cast new relevance on a column written a few years ago by Miami attorney J.B. Harris, known as one of the lead attorneys in the Florida lawsuits brought against Big Tobacco, and as the attorney who sued to stop the sale of Channel 6 (NBC/WTVJ) to a market competitor.  Harris updated the column, originally printed in the Philadelphia Inquirer in 2004, for the Grimm Truth. The article was originally published under the headline: After All This Time, Why Does Cure For Breast Cancer Elude Us?Mother's And A Sister's Diagnoses Spur A Call For Congress To Do What It Must:  

A few years ago, my sister and my mother learned they had breast cancer at the same time. Their annual examinations led to biopsies, and they received the devastating news within days of each other. The diagnosis for each was invasive ductile carcinoma, one of the most common and lethal forms of breast cancer. Because our family had no history of breast cancer, my sister and mother were always vigilant but never truly concerned - until then.

 

My sister, a physician, was 38 with three young children. My mother was 70 with four children and nine grandchildren. They live in Cherry Hill, NJ.  My sister underwent an emergency double mastectomy and reconstructive surgery at Thomas Jefferson University Hospital in Philadelphia. If anyone thinks a mastectomy is like a tonsillectomy, consider this: The operation lasted eight hours and required two surgeons. The first surgeon removed all the breast and malignant tissue, while the second transferred my sister's latissimus muscles and other tissue forward from her back to help build her a new chest.

 

The surgeons in my sister's case did a phenomenal job. As chilling as the operation sounds, this is the procedure of choice for mastectomy and breast reconstructions in this country, especially in younger women. But it does not stop there. Chemotherapy, radiation and Herceptin treatments awaited my sister's initial recovery, as well as additional surgery to fully rebuild her body. According to the National Cancer Institute, 25 percent of the women who endure this regimen do not survive, and those who do often do not learn they are "cancer free" until years later. My mother is scheduled to undergo a similar, age-appropriate procedure soon.

 

News that a loved one has cancer is bad enough. Learning that your mother and sister have cancer at the same time is overwhelming. Upon hearing the news, I was struck with utter, paralytic fear, unlike anything I had ever encountered. I saw my sister's kids without a mom, my siblings and me without a sister or a mother, and my kids without their grandmother or their aunt. Making my way home, I told my wife, who grabbed me and would not let go.

 

As the news and shock spread among our family and friends, condolences and prayers began pouring in. Everyone knew someone who had died from or survived this dreadful disease. Whispering the names of those who had been afflicted was like being initiated into a secret society of sufferers that I had not known existed. It opened my eyes to the sheer multitude of victims among us. We were now members of this group.

 

Because breast cancer is at once such a private disease and a public scourge, I felt oddly embarrassed by the sympathy of others, uneasy with their knowledge of my sister's and mother's conditions, yet buoyed by their concerns and the news that others had survived. Equally strange was the response of some who now view breast cancer as a rite of passage, like a man's first heart attack, rather than a killer. Sadly, this disturbing and fatalistic view foretells a certain complacency about the disease that saps our initiative and shapes our national policies toward combating it.

 

According to breastcancer.org, a nonprofit organization for breast-cancer education, in 2008 doctors expected to diagnose an estimated 182,460 new cases of invasive breast cancer in women in the U.S., along with 67,770 new cases of non-invasive breast cancer.  About 40,480 women in the U.S. were expected to die in 2008 from the disease, though death rates have been decreasing since 1990. These decreases are thought to be the result of treatment advances, earlier detection through screening, and increased awareness.

 

Even women who are not genetically predisposed to the disease remain at risk. The BRCA1 and BRCA2 genes, which are culprits, can surface in women whose families, like ours, have no history of breast cancer. Women who have these genes, which can be detected through genetic screening, are also more likely to contract ovarian cancer, according to my sister's oncologist. Moreover, the National Cancer Institute reports that breast cancer kills more women than the men and women combined who die from all other types of cancer except lung and respiratory cancer. As a result, the institute allocated $572 million for research in 2007 to help find a cure – about 12 percent of its annual research budget.  But that is not nearly enough.  The federal government needs to do much more.

 

Compared with overall expenditures in the federal budget, breast-cancer research ranks up there with foot fungus in terms of our national priorities. Is there some cunning force beneath our social fabric preventing us from finding a cure? Perhaps a cultural misogyny infects our male-dominated Congress, preventing politicians from allocating the resources necessary to finding a cure. Or do our good-old-boy legislators simply choose to subordinate women's health issues to those of others?

 

Whatever the case, I am left thinking that while we idolize women's breasts in this country, and place them on display in almost every conceivable medium as a form of seduction, we nevertheless tolerate breast amputations as an acceptable means of combating cancer rather than finding a cure or, better yet, identifying a cause that we can hold accountable and rectify. That speaks poorly of us as a nation.

 

At the end of the day, I want my sister and mother to continuing living -- both are now  survivors -- as well as the 40,000 other women in this country slated to die unnecessarily from a disease that has gotten far too little attention. I also do not want my daughter to suffer the same fate as my mother and sister and do not want another family in this country to undergo the pain my family endured. As a society, we owe these women - our women - nothing less than a cure. Until that day, every woman in America is at risk.

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Charlotte Greenbarg

Raising awareness and providing information about genetic testing for susceptibility to breast cancer in young women is critical to their survival. Dr. Olufunmilayo Olopade, professor of medicine and human genetics at the University of Chicago, was discussing the risks of breast cancer in young women (Chicago Tribune 12-27-07 Reporter: Judy Peres). The article was about the BRCA1 genetic mutation that’s not only found in Ashkenazi Jews but also in “significant numbers of Hispanic and African-American breast cancer patients as well...”

Dr. Olopade was quoted: “A lot of young women die of breast cancer because they’re not even aware that lump in their breast could be cancer. If you know you’re at high risk, you’ll get that evaluated.”

I speak from experience. Three weeks after my husband’s funeral in 2006, my daughter, then 39, found a lump in her breast and was examined and diagnosed with BRCA1. Her doctor, a couple of months prior, had suggested that she should start yearly mammograms since she would soon be 40. She had extensive chemo and surgeries, and thankfully the cancer had not spread. My family had no awareness of genetic mutations prior to this, and we immediately got testing and counseling. I urged and continue to urge everyone I know who may be at risk to get testing and make others aware of the situation they may have to face and the decisions that they will have to make. Women with the mutation obviously cannot wait until 40 to begin yearly exams.

Dr. Olopade also observed that Medicaid does not cover genetic testing. She said, “This is an issue of equity and justice. You’re born with your genes. It’s not something you choose.” Indeed it is not.

We’re fortunate to have Dr. Olopade for our advocate, and my family is blessed to have her for my daughter’s physician. The surgeons at the University of Chicago who work with Dr. Olopade on such cases have our gratitude for their skill and compassion.

It’s time for all advocacy groups to work with that kind of concerted effort as well so that we can save as many people as possible. It’s incomprehensible that any of them could opine that Congresswoman Wasserman Schultz’s bill could do “HARM.” It’s not about prevention in the usual sense. Knowing that one has the gene opens the possibilities of prevention by being proactive, well before a lump is discovered. And that is never “misguided.”


mlgreen1976

I read an article at http://breastcancerinvesting.com about a new breast cancer treatment that focuses on a molecule found only on cancer cells which will help them treat patients without surgery or chemotherapy.

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