Wednesday, October 01, 2014

It's October

So today – unbelievably – is October 1. Unbelievable not just because this was the strangest summer ever. Not just because we have been experiencing unusually warm weather (yes, I had the a/c on a few days ago although it's cool and pouring today). But because we are about to embark on the dreaded Pinktober, known to most people as Breast Cancer Awareness Month.

I’ve been complaining about BCAM for years, so I won’t do that again (much). I’ve already noted that most people are quite aware of breast cancer, and that we don’t need pink oil trucks or pink newspapers or pink gloves on football players to remind us of the existence of breast cancer. That buying pink products won’t help prevent or cure breast cancer. That breast cancer is actually many different types of cancer, that there won't be ONE CURE ever, that removing your breasts won’t prevent you from dying from breast cancer, and that what you really need to worry about isn’t the cancer in your breast but the cancer cells that have spread throughout your body before you even know that you have breast cancer. Metastasis is the killer, not the tumor itself.

The main problem is, all this early detection and treatment of smaller and smaller tumors hasn't really impacted the death rate. More and more women are finding their tumors earlier and earlier, and undergoing all kinds of treatments, but basically the same number of women are still dying from breast cancer. Why? Because the tumors found early probably wouldn't have killed them in the first place. And in spite of advances in treatment, once breast cancer has metastasized, women die. 40,000 women die from breast cancer metastasis in the U.S. each year. That's a lot of women.

So what has happened this year in the world of breast cancer?

For me, personally, I have reached the 5 year mark since my diagnosis, for what it’s worth. I am grateful, but still apprehensive. I have completed the surgeries, radiation, and 5 years of tamoxifen, and now I’ve decided to stop the tamoxifen as it caused a blood clot in my leg, and even though it is recommended now to continue it for another 5 years, that might not do me much good. So I’m stopping. I stopped. What’s scary is that some women have their breast cancer recur, either in the breast or in another part of their body as metastasis, even many years after their initial diagnosis. I could be one of those women, or I could not be. Results of my Oncotype DX test showed that I have a 10% chance of a “distant recurrence.” That means 90% chance of no recurrence. That’s what I have to live with.

But enough about me.

In other news, yet another friend in my circle had her own breast cancer diagnosis this year. Although the tumor itself was tiny, it unfortunately had spread into her lymph nodes, and she therefore needed not only a lumpectomy but chemo and radiation. She has been bravely facing all the treatments and challenges with grace and dignity. But it's nothing that I'd wish on anyone.

In the larger world, the world of entertainment, many were stunned to hear this spring that actress Angelina Jolie had a double mastectomy due to her genetic predisposition to a high risk of breast cancer. This has put BRCA testing back on the map, and apparently many women have been asking for it since Jolie’s announcement. One scientist is insisting that all women should be tested for the breast cancer genes, which is very controversial. More recently, TV news personality Joan Lunden announced that she has triple negative breast cancer, and she is now making the rounds on TV discussing her experience.

In the world of science, folks are still fighting about mammography. Is it useful? When should women start getting mammograms? Drugs and treatments make the news all the time, but really there is nothing significantly new. We keep hearing about "personalized medicine" but in reality, treatment still consists of surgery, radiation, chemotherapy, and medication. We just aren't there yet in terms of true personalized medicine. 

There seems to be a better understanding among the general public that things in our environment - pesticides, chemicals, household cleaners and personal care products - have ingredients that aren't adequately tested and that are showing harm to human health, and some may be cancer causing. This is promising, but change is slow in this area. We still aren't in a place where prevention of breast cancer is a high priority.

To sum up, I'll quote Heather Cooper Ortner, CEO of the Dr. Susan Love Research Foundation:
“Progress has been made in the diagnosis and treatment of breast cancer, but sadly, the number of breast cancer deaths has not changed substantially. Until we find the cause and how to prevent it, those dreaded words, ‘you have breast cancer,’ will continue to disrupt lives.”