Celebrities and breast cancer

I admit that I’m not well-prepared for this post.  Some television journalist named Amy something apparently had a mammogram for a television show then found out she had cancer then decided to have a mastectomy.

Oh yay.  More celebrities and cancer.

While I’m sure the details matter to Amy and those who love her, I really don’t care.  If you’d like to read about the journalistic ethics of this, please see Gary Schweitzer’s article. He does nice work analyzing the reporting of heath care information.

To me, what matters is that we’re again flirting with the uber-simplified and less than accurate idea that a mammogram saved someone’s life.  Thankfully, Dr Susan Love brought some facts into the discussion.

Did the mammogram save her life, as one doctor was quoted as saying? The answer, of course, is we don’t know. While mammography is capable of finding about 26% of cancers at a point where it makes a life-saving difference in the outcome, it also finds many lesions which would never have gone on to be life-threatening and others which will still be life-threatening in spite of early detection and rigorous screening.

The problem is not the mammogram as a detection tool, but the natural history of the disease, which brings us to the crucial point…not all breast cancers are the same. Before a treatment is prescribed or chosen, it is critical that a woman or man knows what kind of breast cancer they have of the roughly 5-7 kinds we can now recognize. There are probably many more kinds that we just don’t know about or know how to recognize yet. The behavior of the cancer is dictated not as much by when it is found as by what kind it is and how that kind usually behaves. This information informs the decisions about treatment.

This is a shitty disease, people.  Let’s not make it worse by making things up just because we want to see triumphant heroes and happy endings.  They are about as real as Cinderella, and about as important too.  The people who survive this disease do so largely because science was able to cure their specific subset of disease.

And we who come through it are damaged:  physically, emotionally, spiritually, even cognitively.  And those who don’t leave big holes in the lives of their loved ones.

There.  I’ve said it.  I don’t think it’s useful to try to make it anything other than it is in an attempt to make it easier for an outsider to hear.

Can we turn off the television and focus on things that matter now?  Things like how to cure and/or prevent this crapstorm of a disease that kills more than half a million people in the world every year?

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