Susan G. Komen for the Cure, with their ever present Pink Running Ribbon, fights for a world free of breast cancer. I was fortunate to have had the support of Susan G. Komen for the Cure; they supported my Breast Surgical Oncology Fellowship at the Winthrop P. Rockefeller Cancer Institute in Little Rock, Arkansas. Susan G. Komen for the Cure advocates for eradication of breast cancer in many ways: they advocate for mammography to enhance successful treatments; they advocate for basic science research to hunt for the secrets behind breast cancer; and they advocate for translational research to bring those secrets from “the bench to the bedside.” And there are many advocacy organizations that have similar, if not identical, goals, including the American Cancer Society, Y-ME, FORCE, etc…
But just as important is the advocacy for patients. Patients with Breast Cancer are our wives, our mothers, our daughters, our grandmothers and our friends, most of whom will initially feel some shame that they have cancer. People who are ashamed will not seek treatment. Our national and local breast cancer organizations advocate for these women and let them know that there is no shame is having cancer; that there is no humiliation in being diagnosed with a tumor. These organizations create a home for women with breast cancer, a place to feel secure, to feel part of something bigger, to be part of a community. Women feel empowered with these groups behind them, who help women and their families by providing financial support, transportation support, emotional support, and spiritual support.
However, a recent article in the New York Times Magazine raised the question: Are we raising too much awareness about breast cancer? The author wanted to know whether we are finding too many breast cancers? She wondered if many cancers needed no treatment, i.e. that those indolent cancers would never pose a serious health risk to women. As physicians we do ask, “are we over treating breast cancer?” Our answer is, “We are.” There are many cancers that can be left alone and a smaller number that will pose a significant health risk no matter what treatments we offer. We are exposing too many women to significant side effects and to many families are exposed to financial strains that they perhaps do not need. The author posits the idea that Susan G. Komen for the Cure is too successful and as a result we are wasting billions of dollars and exposing too many women to too many side effects, including death.
As a physician, we are always searching for tools to help us identify those women that do not need aggressive treatments, but where treatment with less side effects and less cost can be just as effective. We have many tools today and many more are in development.
What the author does not realize is that all of this awareness is not about marketing; it is not about profit. All of this awareness is about the patient. We are treating cancer to save the lives of wives and mothers and daughter and sisters and friends. We are raising awareness to improve the quality of life for breast cancer survivors.
The author of the New York Times Magazine article does a disservice to those of us trying to fight breast cancer. Yes, we do have some failures. And yes, we have many victories that we did not need to fight. But there are many breast cancers where we can and do make a difference. There are cancers where early intervention can make the difference between life and death. There are those cancers where intervention can delay the inevitable and prevent some pretty nasty complications.
Advocacy is about raising awareness. Advocacy is about finding a cure. Advocacy is about patients and ensuring that they remain in good health so that they can raise a child, spoil a grandchild, or to simply be a supportive sister. I never forget that I am treating grandmothers, mothers, daughters and sisters – and that we are all God’s children.