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November 17, 2009
I like to think I'm above rubber-necking at train wrecks, or even seeking them out on YouTube, but I'm not. Proof: I regularly go to news sites and read the comments posted to controversial stories, even though I know they'll get my adrenaline going. Once my adrenaline gets going, I have to post something myself -- either that or eat a significant quantity of chocolate. This is why I rarely have chocolate in my apartment.
So a government study suggested that most women don't need to have mammograms as often as was previously recommended. The flap-flap-flapping is predictable. Ditto all the people who are absolutely 100% sure that this is part of the Obama administration's plot to foist death panels off on the citizenry, even though the panel was appointed by the Bush administration -- and while we're at it, why don't these people ever accuse the insurance companies of being de facto death panels? I just read the Boston Globe story on the subject and (trying to keep my cool) was struck by this sentence: "Advocates of screening frame the debate differently: If a single life can be saved or prolonged through early detection, isn’t that justification enough?" Mea culpa, mea maxima culpa: I had to respond. This is what I wrote:
No, it's not. Anecdotal evidence is important, but it only gives part of the picture. I'm 58. I've never had a mammogram. My mother never had a mammogram, neither of my grandmothers ever had a mammogram, and none of them had breast cancer. I could extrapolate from this that mammograms are unnecessary, but that would be stupid, so I won't. Instead I'll consider my experience in the context of studies like this one, which combine the experiences of tens of thousands of women.
I know plenty of women who've had breast cancer or who are currently being treated for breast cancer. I've known too many women who died of it in their 30s, 40s, or 50s, when they had so much more to offer the world. But I also know many, many women whose lives have been cut short or seriously affected by other serious illnesses -- and don't get me started about women who've been victims of rape, incest, battering, and other forms of (usually) male violence.
The medical industry and certain giant nonprofits have turned breast cancer into a fetish. As long as they're kowtowing to that fetish, they think they're paying enough attention to women's health. They aren't. Turning mammograms into a political litmus test, one that supposedly indicates your position on women's health, or women's issues in general, is equally misguided.
To those screening advocates who believe that a single life saved through early detection justifies recommending frequent mammograms for all women, I add: No life was ever saved by early detection. Lives are saved or prolonged by the treatment that follows early detection. If you want to talk about saving lives, then talk about making competent treatment accessible and affordable to all women with breast cancer. While we're at it, let's make it available to all women, period. And all men, too.