Photo by Pablo Heimplatz.
It's breast cancer awareness month, but I think we're already aware that breast cancer exists and that mammograms can detect it. So as long as we're surrounded in pink, let's take a look at some important facts that actually need a little more awareness:
You Don't Need as Many Mammograms as You Think
Mammograms can detect cancers that would otherwise kill you, but they also can give false positives that result in more scans and biopsies that turn out to be negative. And they can result in you getting the full cancer patient experience for slow-growing or benign cancers that didn't really need to be treated. So mammograms aren't a "more is better" kind of thing.
The US Preventive Services Task Force says you should get your first mammogram at age 50 (unless you really want to start earlier) and should get them every other year until age 75.
Other organisations disagree slightly. The American Cancer Society wants people to start at age 45; the American College of Radiology and the American Congress of Obstetricians and Gynecologists says age 40. Each organisation also has its own ideas for whether you should get them every year, every other year, or some combination that changes as you age.
You also get to stop getting mammograms at age 75 according to the USPTF. Other organisations recommend different end dates, but generally there's no point to detecting breast cancer if you're likely to die of something else first. The American College of Radiology says it's time to stop if you know you have less than seven years left to live, or if you wouldn't act on an abnormal finding.
Not Everyone Thinks of Their Cancer as a "Battle"
Nobody wants to be a "victim" of cancer, so it feels positive to shift the focus toward the person with cancer as an active participant. Maybe they're "fighting" cancer, or they're a hero or a trooper. And if the worst happens, we say they "lost their battle." But many people who have cancer don't like this metaphor.
If somebody is tough for beating cancer, that implies that people who died or whose disease got worse were somehow not tough or active enough. Many cancer patients feel uncomfortable with the idea that they're supposed to be someone's hero.
UK charity Breast Cancer Care asked a few people who had had breast cancer what language they'd prefer. Here are a few suggestions that don't rely on war metaphors:
'I tend to prefer terms such as "living with cancer" and "recovering from cancer treatment",' says Vicky.
Susan says: 'I simply say I have had treatment for breast cancer. The treatment is now finished. I really don't want to be labelled by an illness.'
Caroline also likes to keep things simple. 'I much preferred to say factual things like "I am having treatment for cancer" or "I've been in remission for three years and it's good to have passed that milestone".'
Cancer Treatment Is Incredibly Expensive
Even if you do catch your cancer early and "fight" your "battle" like you're supposed to, you'll face steep medical bills. A study of women with private insurance -- that's the kind you get through your employer or buy for yourself -- found that women under 45 incurred $US97,486 ($124,219) of extra medical costs (including those paid by insurance) in the year following diagnosis. Women aged 45 to 64 were more likely to catch their cancer earlier; their costs averaged $US75,737 ($96,506).
A previous study, on patients who were treated in 2010 (before the Affordable Care Act) also found costs to be astronomical. There was a large gap between how much the insurance company would pay and how much the treatment actually cost -- on average $US15,000 ($19,113) for stage I/II cancer and $US50,000 ($63,711) for stage IV. (People's out-of-pocket costs should be lower today. For example, the ACA made it illegal for insurance companies to cap their total benefits.)
But even today, people with cancer still have plenty of expenses in the form of copays, deductibles, and coinsurance. Half of Americans would have a hard time affording even a $US100 ($127) emergency, much less the thousands that cancer patients have to cough up.
Cancer charity PinkFund surveyed women who have had breast cancer, either recently or years ago, to ask where they found the money to pay their bills. The numbers are sickening: 47 per cent dipped into retirement savings, 26 per cent added to their credit card debt, and 41 per cent skipped medication or treatment to save money. Meanwhile, 23 per cent increased their work hours to get extra money, but 36 per cent lost their job or were unable to work.
These costs might not be what you expect when you see a chipper pink-hued commercial urging you to get a mammogram -- but they're a reality for many breast cancer patients. While we're encouraging people to be "aware" of cancer and to get checked out, let's also remember that cancer comes with serious medical, emotional, and financial baggage.