because I think there really is 'awareness' now...however I'd hate to let the awareness everyone has created slip. 

I also wonder if maybe it just feels like overkill, but it does seem like everyone - including the NFL and NHL have gone pink. I appreciate the efforts, I really do... but at what point is it just 'cool' to be pink?

Politics & News Contributing Editor Queen of Spain

Denise, you raise some interesting points about Breast Cancer Awareness Month. I work for the American Cancer Society and we know that some of those pink promotions raise money for worthy organizations and some not so much. Here's some interesting perspective from my colleague, ACS Deputy Chief Medical Officer Dr. Len Lichtenfeld on the subject of pink promotions.

As for breast cancer walks, I'd hate for your readers to stop participating in those where the proceed go to advance the work of legitimate cancer organizations.  The ACS's Making Strides Against Breast Cancer walk, for example, funds amazing things for the breast cancer cause.

But most importantly, I'd hate for your readers to choose breast self-exams over mammograms. What would happen if women did that? Quite simply, alot more women would die from breast cancer.  Dr. Len offers some very moving perspective on that subject too as a doctor who remembers what life was like before mammography screening was available.

Amy S. Up With Moms

It's such a personal issue....Denise on an evidence-based scale I don't know enough to argue with you but for me, I want self-exams and mammograms. My mom missed her mammogram two years in a row, finally went, and I'm so grateful she did.

Morra Aarons-Mele
www.womenandwork.org

You're right -- the research community has long debated whether mammograms really save lives.

In looking for a cure, few people seem to realize there are many types of Breast Cancer, so it's not going to happen overnight even if something does happen overnight.

And few people understand how diverse are the more than 200 types of cancer. Or how some cancers -- notably, breast and prostate -- are funded far in excess of either their numbers diagnosed OR mortalities. Because Brca gets so much funding, money is actually taken away from research on other cancers, like the one that killed my husband. Most cancers are rare cancers.

I have several friends who've lost spouses, young, to forms of Breast Cancer, and I'm not without sympathy. We need better methods of detecting the most aggressive cancers in young women, and mammograms do essentially nothing for these women, who are in a very different situation than the average Brca patient. 

You'll hear Brca advocates mention how research on that cancer often serves to illuminate other cancers. But you never hear the equal and opposing argument that research on a rarer and deadlier cancer (like kidney cancer, or colon cancer) will advance breast cancer.

Raising awareness of breast cancer (especially since it's not "awareness" of the nature or true rate of detection of the disease) actually pulls a cloud over many other cancers.

Honestly, I'd rather spend the money raising awareness of the fact that we are all human and encourage folks to plan Advanced Care Directives and learn about hospice care. But I don't think I can sell special black garden gloves branded with a "hospice" logo on them.

Best,

Supa Dupa Fresh, cancer widow

freshwidow.blogspot.com
twitter.com/freshwidow

Amy,

I disagree that the numbers are that clearly in favor. The mammogram has significant limitations, and there is by no means consensus among leaders in research (many of whom I have spokent to) that overall the mammogram has been the factor (among many changes) that has made the difference.

And treatment for the youngest women with the most aggressive cancers has improved, but not much, and none of that improvement is due to mammograms because mammograms are not indicated for women under 50.

I will give "awareness" credit for increasing self-exams and self-detection, but at this stage, increasing "awareness" is actually making people know LESS, because they think it's a simple disease. I'd argue that our daily practice has changed enough that we should start pushing some other color and awareness. For example, Red for Women's Heart Health in February -- an advance where all the benefit is ahead of us and therefore it can make a big difference.

So I take it no one is interested in my "dress in black for Hospice in January" campaign? Promise, there will be promotional frisbees! Because "Life's a breeze when you have an advance care directive." ;-)

Let's stop pushing the pink monolith! It's just an engine for consumption, and our poor economy doesn't need any more of that.

freshwidow.blogspot.com
twitter.com/freshwidow

people have access to treatment.  And many don't.  That's the irony of making mammograms free for people without insurance who otherwise can't afford them.  What are they supposed to do if the mammogram finds something?  I haven't seen anyone offering treatment for free.

I'm the daughter of a woman who had breast cancer at age 33 (she discovered it when pus oozed out of her nipple), and that's just one of my many beefs with the baloney that has become the Breast Cancer Awareness Profit Month - http://www.blogher.com/breast-cancer-awareness-month-bunk.

Suzanne Reisman, Contributing Editor - Feminism & Gender Campaign for Unshaved Snatch (CUSS) & Oth

Hi Amy, of course you're right about the 40/50 thing. But the most aggressive cancers are found in women under 40 so my point holds exactly the same weight: mammograms have not helped the women who are the worst off. 

And I'm sorry I let it go that you work with the American Cancer Society. (I saw "Up with Moms" in your sig, saw "ACS" but passed over the important detail in the text that you work for them).

Because laypeople are unfamiliar with how ACS is perceived in the cancer community I will recap the general view: while clinical guidelines, registries, etc are vital functions of the ACS and have been an invaluable part of the progress we've made in the past 30 years on cancer, cancer advocates in general are NOT pleased with ACS's advocacy, outreach, and lobbying. It is generally understood that ACS is captive to Breast and Prostate Cancer interests, diseases which, as I stated before, are funded far in excess of incidence and mortality rates. People with rare cancers and their families and doctors know not to rely on ACS.

There are also many who decry the minimal progress we've made against cancer in 30 years: just 10% overall decrease in mortality, with dramatic increases in some cancers (I know that kidney (1/3 cases are women) and ovarian (3/3 cases are women) are among those that have increased). Many of those research advocates blame the overemphasis on Brca and CaP for the low rate of progress.

I'm not one of those: I got zero from ACS when my husband was dying of Kidney Ca but I am not generally unhappy with the progress that's been made. After all, during the two years he was ill, the number of approved drugs for his disease went from zero to two (both of them were subjects of controversy for their outrageous and uncontrolled costs)(and minimal benefit, including to my husband, who died after taking them both).

Most important, we need to promote reform of our overall system, which is quite broken. Pharmas, M.D.'s, research, insurers, gov't payees, patients of all income levels ... where does ACS stand on these?

I understand that science is complicated and slow, and that it's important that public health efforts be concise and targeted, and that messages be simple if they are useful.

I still think we've reached sufficient "awareness" of this deadly cancer and public health efforts can be concentrated on areas where there is still a lot of work to be done.

Like ovarian or cervical cancer or even... hospice. :-)

Supa

freshwidow.blogspot.com
twitter.com/freshwidow

It was a good idea at one point. Now it's just corporate profits, since apparently nothing will sell in October unless it's painted pink. Don't get me started on the damned yogurt lids. To Yoplait: Just donate the million and a half if you're going to, without the idiocy of mailing in nasty lids. 

As much as the corporate chest-beating disgusts me, there is still awareness to build, and a group to reach. I think that many women of a certain age are still squeamish about the idea of touching or having someone else touch their breasts during the course of BSE or mammography, even though their awareness is more important than ever as they age. I know that my mother is horrified by the thought of mammography, and has convinced herself that since there is no BrCa in our family, she is somehow exempt from the possibility. A friend's mother ignored a lump and then a skin lesion and only thought about going to the doctor when the lesion became too large to cover with a gauze pad and tape. She "didn't want to be difficult", and "no one in the family has ever had BrCa." Yes, it was inflammatory BrCa, and may have been treatable had she sought medical attention earlier.

Will pink ribbons on health sites and yogurt tubs and dried apricots and bread yeast help these women -- our moms and aunties -- with their body issues? No. Do we need those pink ribbons everywhere to remind our own selves that BrCa is a bad bad thing? No.

Why not drop the pretense and talk with our moms, aunts, sisters about personal facts of the disease? Why not support the groups that DIRECTLY support the women who have BrCa, not the ones who put on a big show of virtue and goodness, but you can't really tell who exactly they are helping? And why not all year round, instead of just in October?

First let me start by saying that I don't know all the stats and history that you do ... That said, I just wanted to comment that I am someone who works at a multi-national multi-billion dollar company.  I work in the marketing department of this company that is a household name worldwide.  I work side-by-side with a wonderful woman who I am very proud to call me friend - a woman who is a breast cancer survivor.  This woman harnessed her position and access to resources in our company to support a recent Breast Cancer Awareness event held in our city.  She had products donated, professionals on hand to assist in the use and education of these products and also coordinated a monetary donation to the cause.  

Now, I'm in marketing and I know a company won't do anything without seeing the upside either monetarily or otherwise in the immediate or future - that's just business.  So yes, the company agreed to the above with the likelihood of upside for us.  At the same time, the woman who negotiated these things made a sincere effort to benefit the cause ... and the cause was benefited regardless of the upside for the company.  

I guess my point would be that there is upside for the cause regardless of the upside for the companies that contribute and benefit as well to the cause.  Perhaps the ratio of benefit should be different ... but it takes individuals at these companies who care to make it happen.  And the companies are now the vessels that have and continue to give momentum to the movement.  

It is overkill.  My mom dealt with breast cancer 3 different times and lost the fight the last time at the young age of 53.  All of the points made here are very valid.  Mamograms are not the be all end all.  My mom found got her first diagnosis at 36 with breast leakage.  That is a full 4 years BEFORE the reccomended age of 40.  Then my sister found hers at 40 a full 6 mos afeter her mamogram and 6 months before the next one was scheduled.  My sisters aunts and I have had our smash day as we call it every year the thursday before mothers day. We do it because we know the risks up close and personal.

WHat good is the free mamogram without any treatment to follow it up?  NONE.  My mother was not insured whit her second diagnosis.  So she had to go to the hospital that offered the free treatments.  It was a 75 min drive to and 75 min from the hospital.  When her treatments made her sick we had to make that drive with her in agony on the backseat with the bucket.  Then there were the times when she got sick at home. We take her to the local emergency room and they would do what they could and direct us to her treatment hospital.  A 75 min drive at night with a very sick person is not something I reccommend. THe free treatments were a God send but the distance was a bear.  Driving that distance just to get new meds or just for a checkup.  Even with free treatments we spent a very large amout of money. Someone to get her to and from the hospital, gas nurses and sometimes the full price of meds because of the distance.

I do agree that other cancers and some way more deadly are overshadowed.  My uncle died of bone cancer. Very very not pretty to watch.  The pain for him was just unbelievable.  There is still not much improvement in the treatment from 25 years ago when he passed.  There is ovarian cancer and bladder cancer all of which I have had the distinct hooror of seeing the effects up close. Yet most of the treatments for these cancers have not improved.  I think the emphasis on Breast colon and prostate cancer has been becuse they have a much better chance of being curable if found early.  But I think we need to working on ways of detecting these other cancers earlier as well.  As Supa Dupa Fresh ( I LOVE that name!!) siad there has been just a 10% increase in mortality in the last 30 years!  We can do better if we spread the resources around.

Denise you amaze me how you can work the patriarchy into conversations.  But you are so on target with this one.  I have an aunt who got her FIRST pap at 35 because she did not want "people" looking down there.  She is 60 this year and I physically make her appointment and take her to the Dr for her yearly and mam because she is so uncomfortable with "people" seeing those parts.  It took the biggest fight EVER to get her to go for her colonoscopy.  I know many many women like her.  THey don't want to do it themselves and cannot stand the thought of someone else touching them there.  I often remind her of the days we spent with my mom redressing wounds, cleaning the car from the last chemo and that smell! The sad part is I don't even think she would go through the treatments if it happened to her. In my family we teach our girls to do their self exam on the day they get their period.  We tell them that they are their own best advocatesd and it is OK to let us or the Dr know if they think someting is wrong. They need to know those moles, smells and all.  We also do a safe person.  Each kid in our family has a safe adult in the family they can go to without any judgement or condemnation. We tell them if you don't want to tell your parents then tell us and we will see to it that what is best gets done.  As parents we have agreed to trust each other and to make decisions we would want made for our kids. I am my neice's safety and when it started to hurt when she was having sex she told me.  Even though she was 17 I did not call her mom I called her Dr and explained the situation and made her an appointment.  I told her that if there was any medical issue we would have to tell her mom.  She had a bacterial infection and there was no need to tell her mom but it did give us an opportunity to talk about sex and other things that would probaly be very akward if I were talking to my daughter. After that she has come to me every time she has some problem at 26 she is now a safe adult.  I have picked her up in states she was not supposed to be in in college and helped her deal with things I had to deal with on my own. You are right we need to make damn sure we do not repeat the same mistakes becuse some of them can be deadly.

Michelle

I blog at http://www.mommycan.blogspot.com/

2/3 of all breast cancer in Hispanic women is found via self exam

Two-thirds of breast cancers in Hispanic women are discovered by accident, while only 23 percent are detected through mammography; another 6 percent are found during a clinical exam.

Yet screening mammography rates were 83 percent among US-born Hispanic women and 62 percent among non-US-born Hispanic women, say researchers from The University of Arizona College of Public Health.

Why did women wait so long before seeking help? Study author Rachel Zenuk says it is due largely to the lack of health insurance or inability to afford medical care.

I say again, our focus on providing free mammograms is off-target.

~Denise BlogHer Community Manager
Flamingo House Happenings