Friday, February 03, 2012

Breast Cancer Imbroglio: I'll Never Look At A Pink Ribbon The Same Way Again

 The reversal of field today by the Susan G. Komen for the Cure foundation on its decision to terminate funding to Planned Parenthood clinics is doubly heartening.
This is because a grave injustice has been corrected and it was corrected to a substantial degree by the pushback by many thousands of people who vented their displeasure with Komen on Facebook and Twitter, the first such instance in the U.S. of social media playing such an important role as it has in Arab Spring protests. 
Breast cancer is a very real and too often fatal disease, which made Komen's decision as the leading breast cancer advocacy group all the more disturbing. 
The more we learn about breast cancer the more links to lifestyle, diet and such become apparent. And who doesn't know women who have survived breast cancer, as well as succumbed to it. I can count four of the former and one of the latter among my friends alone. 
But beyond all of this is a puzzling conundrum: Why are more women dying for breast cancer-related reasons despite the increasingly sophisticated screenings that they undergo? And why has the disease become a right-wing Republican cudgel? 
A big part of the answer to the first question is that the benefits of breast cancer screenings have been overstated and come with the risk of overtreating small cancers while missing cancers that are deadly. Same for prostate and some other cancers. 
The Dear Friend & Conscience has been a health-care professional all her working life. She has toiled for many thousands of hours in intensive care units and is certified every which way. She regularly self examines her breasts but refuses to have mammograms because she has long believed their benefits to be wildly exaggerated. And the American Cancer Society, of all organizations, acknowledges that she is correct.  
"We don’t want people to panic,” says Dr. Otis Brawley, chief medical officer of the cancer society. "But I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated." 
The American Cancer Society bombshell came on the heels of a recent study that recommended most women should start regular screenings at age 50, not 40, women age 50 to 74 should have mammograms every two years, rather than every year, and self-breast examinations are not what they're cracked up to be. 
Left unsaid in Brawley's candid and perhaps even courageous comment is that breast-cancer screenings and the invasive radiation treatments, painful needle biopsies and surgeries that often result are a multi-billion dollar industry that gets filthy rich on overdiagnoses. Then there's this: Too many women who have been treated for breast cancer-related reasons cannot get health insurance or are dropped by their insurers. 
Being a woman can be pre-existing condition in and of itself, of course, and it will not be until 2014 that the Affordable Care Act will fully prohibit insurers from using pre-existing conditions as a pretext for denying or dropping coverage. 
Though breast cancer researchers and advocates perpetually plead for more money, the disease is awash in it. 
Last year, the National Institutes of Health, the nation's top agency for health-related research, allocated $763 million to the study of breast cancer, more than double what it committed to any other cancer. The Department of Defense also funds breast cancer research ($150 million this year), as do several states. All that is in addition to the money raised by the roughly 1,400 IRS-recognized, tax-exempt charities devoted to breast cancer. Komen grossed $420 million last year alone. 
Some breast cancer organizations, including Komen, have been highly critical of the screening study, asserting that more lives will be lost because of later and fewer screenings, and it is a fact that American women have the highest incidence rates of breast cancer in the world, 144 per 1,000 among white woman and 122 per 1,000 among African American women. 
Komen, of course, is in the news because it had joined forces with the right-wing Republicans who wield that cudgel. And irony of ironies, it made a choice -- now reversed -- where many women cannot without Planned Parenthood. 
The foundation had said it cut off funding to the group because it is under investigation, as in guilty until proven innocent. It is under investigation because of a right-wing Republican witch hunt against Planned Parenthood, which does 750,000 breast cancer screenings a year. Abortions make up only about 3 percent of its work, but the witch hunters also object to its leading role in providing access to contraceptives, many of which go to women who could not otherwise afford them. 
Komen's demonization of Planned Parenthood came at a time in which the Republican Party is doubling down on denying women many rights, when rape is viewed by one of its president candidates as “a gift from God,” and workplace gender discrimination is tacitly approve of by the U.S. Supreme Court. 
Foundation CEO Nancy Brinker Komen, who was a protocol chief and ambassador during the Bush administration, tried to cover her tracks yesterday in claiming that the decision had nothing to do with Planned Parenthood specifically. 
In a statement released today, the foundation asked everyone "who has participated in this conversation across the country over the last few days to help us move past this issue. We do not want our mission marred or affected by politics – anyone’s politics." 
It was the perception that Komen was inserting politics into providing health care services, especially to underserved women, that helped prompt the firestorm of debate. 
Koman's president is Karen Handel, a conservative Republican who ran for governor in Georgia in 2010 and is believed to have pressured Koman, while the foundation's board includes the general chairman of the virulently anti-choice Susan B. Anthony List and the wife of right-wing Supreme Court Justice Antonin Scalia. 
The backlash against Komen was been severe with all seven California affiliates of the foundation saying that they opposed the decision. Several board members resigned in protest, and in the end the foundation, perhaps realizing that its public image had been sullied and this might result in a drop in donations, reconsidered its decision. 
Twenty-six senators had urged the foundation to reconsider, while pledges to Planned Parenthood of $250,000 each from New York Mayor Michael Bloomberg and Lee Fikes, a Texas oil baron, as well as small donations, have more than make up the $700,000 it lost, which was a tiny part of Komen's $93 million budget. 
To Planned Parenthood, the decision amounted to a betrayal of the organizations' shared goal of saving lives through breast cancer screening programs. Cecile Richards, Planned Parenthood's president, said her organization was gratified by the support the controversy has brought and later praised Komen's decision to resume funding. 
"We provide care to one in five women in America, and over the last two days it seems we’ve heard from every one of them, through Facebook, Twitter, e-mail and all sorts of ways," Ms. Richards said. "It's a true show of women standing for women." 
They say that the sisterhood is powerful, but in the case of breast cancer the sisterhood is caught between an industry that gets rich off of it and a political party that uses it as a punching bag.

In addition to pulling funds from Planned Parenthood, Komen also decided to stop funding embryonic stem cell research centers, which makes it clear that the organization has morphed from non-political non-profit to a partisan advocacy organization. 
That means the loss of $3.75 million to the Johns Hopkins University School of Medicine, $4.5 million to the University of Kansas Medical Center, $1 million to the U.S. National Cancer Institute, $1 million to the Society for Women’s Health Research, and $600,000 to Yale University. That’s a loss of nearly $12 million dollars in research money to eradicate breast cancer this year alone.

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