Tag: breast cancer

Breaking Rural Health Barriers

For those of us that are fortunate to live near hospitals and primary care clinics, that question of rural vs. urban care is unlikely to even cross our minds. But for those living in remote locations, lack of access is a common issue. Unfortunately, what many of us take for granted is another person’s struggle, especially if they are plagued with chronic conditions, such as asthma or diabetes. And in many cases, most folks in this situation often go without treatment.

The National Rural Health Association reports that while a quarter of the U.S. population lives in rural areas, only one-tenth of our nation’s physicians choose to practice in these areas. And while only a third of automobile crashes occur in rural locations, two-thirds of deaths attributed to those accidents occur on rural roads, indicating a shortage in acute trauma care.

These figures certainly give rise to the need for increased access to care within rural communities. Another factor that contributes to this issue is that Medicare reimburses rural hospitals at a lower rate than urban hospitals, resulting in fewer physicians choosing to practice in such locations. Over the last 25 years, nearly 500 hospitals have closed, many of which were located in rural communities.

Fortunately, this is the age of digital know-how. Technology is king, and health care is one of the leading industries taking advantage of such innovation and wisdom. General Electric (GE) is doing its part to improve women’s health in remote areas like Wyoming, where the average woman has to commute 70 miles just to receive a mammogram.

In 2014, the company started the GE healthymagination program, to expedite cancer innovation and improve cancer care to 10 million patients, over the next six years (until 2020). One of the program’s most influential aspects is the GE Mammovan, equipped with mammography technology to provide free mammograms to all women living in remote areas.

GE chose to pilot the program in Wyoming, which has the lowest number of citizens and lowest population density (after Alaska). Many of the women using the van cited it was their first time having ever received a mammogram, stating that travel time or insurance requirements had precluded them from being screened for breast cancer. GE’s website reports that because of Wyoming’s uneven population distribution, a third of women living in that state over age 40 never receive a mammogram.

Since nearly two years ago, the mobile unit has traveled throughout the state, setting up in locations where women can receive a mammogram within an hour, allowing them to avoid the hassles of taking off from work and/or driving long distances. In many ways, the van serves a dual purpose—by eliminating the barriers rural residents previously faced and improving access to preventative care. By detecting breast cancer as early as possible saves the health care industry billions and ultimately, saves lives.

While North Carolina isn’t as rural as Wyoming, you might be surprised to learn that 85 percent of our state’s counties are, in fact, considered to be rural. And with nearly 2 million people receiving Medicaid, access to care is certainly an issue of interest among health care workers and lawmakers. And while mobile units are pricey to create and maintain, the progress the GE Mammovan has made in Wyoming is a good example of how health information technology can work to address some of our most pressing issues that impede quality health for everyone.

Risk of Breast Cancer Rising Among Black Women

It used to be a safe assumption that African American women had a relatively low risk getting of breast cancer, but a recent study published on behalf of the American Cancer Society (ACA) has found that black women now have an equal risk of developing the disease as white women.

Previously, the disease was most common among white women, but as rates among black women increase, researchers are seeing the rates for white and black women become more balanced. Since 2008, the risk of occurrence among African American women has increased 0.4 percent each year, translating into roughly 124 black women per 100,000 being diagnosed (the rate for white women still remains slightly higher, around 128 per 100,000). Incidence increased slightly for Asian and Pacific Islander women (88 per 100,000), while the rate for Hispanic women remained the same 91 per 100,000).

In terms of mortality, black women continue to be the most at-risk group, with nearly 32 per 100,000 women dying from the disease (compared to 22 per 100,000 white women). One significant reason for this is likely due to the fact that African American women tend to receive a later diagnosis, and thus, the cancer is more likely to have spread to other areas of the body. Another occurrence being looked at is the amount black women being diagnosed with estrogen-positive breast cancer. Researchers believe this could be due to an increase in obesity rates among black women, since more fat increases estrogen, a known risk factor for certain forms of breast cancer. According to ACA, in 2012, 58 percent of black women are obese, compared to only 33 percent of white women.

Another interesting fact resulting from the study’s results was that rates of breast cancer among black women tended to be higher in the South – Alabama, Kentucky, Louisiana, Mississippi, and Tennessee (rates were higher in Missouri and Oklahoma as well).

Of course, all women, regardless of race, should be aware of common risk factors for breast cancer, and should be proactive in maintaining a healthy weight, getting enough physical activity, and limiting their alcohol intake. One of the single most important acts a woman can take at decreasing her chances of developing the disease is by getting mammograms on a regular basis, to ensure treatment begins at the earliest stage possible.

American cancer society revises the mammogram guidelines

The American Cancer Society now suggests that women at “average risk” of breast cancer begin mammograms at 45, five years later than it had long recommended. Also according to the new guidelines, starting at 55, women can get mammograms every other year.

The American Cancer Society issued these new guidelines based on its observation of data showing that younger women are only at a slightly higher risk for breast cancer and thus mammograms may not be always necessary for them so early. Also, the newly issued guidelines can be said to be attempts to address the potential harms and unnecessary procedures that might occur from annual screenings, such as increased anxiety, false positives, unnecessary biopsies, and overtreatment.

Despite of quite understandable explanation of why the guidelines have revised, however, people, including health care professionals and women in the general public, are not sure about sticking to the new guidelines, since suggestions of the earlier or later ages to begin mammograms still hold their own strong rationales. And, of course, ecology should be counted, as well: doctors and professional groups make more money when more and earlier mammograms are conducted.

Breast Cancer: A Look at How Far We’ve Come

As National Breast Cancer Awareness month comes to an end, it’s important to reflect on how far we’ve come. Breast cancer mortality has fallen by more than a third since its peak in the 1980s, and can be attributed to the vast improvements made in regards to breast cancer screening, treatment, and prevention over the last 20 years. Here is a quick look at some of the most effective advancements so far:

Screening- Early detection of breast cancer by mammography has a variety of benefits, including a greater range of treatment options. A combined effort of both the increase of programs designed to improve access to breast cancer screening and improvements with early detection testing techniques (mammograms, clinical breast exams, genetic testing and magnetic resonance imaging) has allowed for over 90 percent of breast cancers to be diagnosed at an early stage.

Treatment- When treatment for breast cancer first began, radical mastectomies were one of the only options, regardless of the stage of the disease. Now, many women have the option to receive much less evasive surgery, such as lumpectomies, with no loss in effectiveness for treatment. Refined chemotherapy regimens and improved radiation techniques have also allowed for women to safely undergo less extensive surgery and has overall improved the quality of life for patients.

Prevention- Recent clinical trials have shown that the drugs such as tamoxifen and raloxifene can significantly reduce the risk of breast cancer in women known to be at increased risk. [1] Preventative surgeries have also developed and been proven effective in reducing cancer risk.

National Breast Cancer Awareness month may be at its end, but it is still important to be aware of the risks and screening options available year-round. For more information visit: http://www.cdc.gov/cancer/breast/basic_info/index.htm


[1] Nelson HD, Smith ME, Griffin JC, Fu R. (2013). Use of medications to reduce risk for primary breast cancer: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 158(8):604-14

October is Breast Cancer Awareness Month

October has arrived, and with it came the changing of leaves, pumpkin flavors and a flood of pink ribbons in recognition of Breast Cancer Awareness Month, an annual health campaign organized to increase awareness and raise funds for the disease. However, while you may be tempted to go buy Panera’s pink ribbon bagel or a pink NFL t-shirt, purchasing from the overflow of pink ribbon branded products in the marketplace may not the best way to support the cause.

Over the last few years, the commodification of breast cancer has been under increased scrutiny, especially because some of the companies partnering with non-profits to raise money have been found to manufacture products that are contradictory to the cause. For example, in 2010, the Susan G. Komen Foundation’s partnership with KFC received a lot of criticism due to the fact that KFC plays a large role in the obesity epidemic, a health issue that has been found to increase the risk of several cancers.

It can also be difficult to determine how much of the proceeds are actually going to the cause, as many companies are not required to disclose this information directly. So before you spend your money on that pink ribbon pack of gum at the grocery store, here are some more trustworthy and reliable ways to make a difference:

  • Donate directly to the non-profit organization. (some organizations will even let you choose where the money goes)
  • Participate in a nation-wide breast cancer fundraising event, like American Cancer Society’s Making Strides or Susan G. Komen’s Race for the Cure
  • Host or plan your own fundraising event
  • Volunteer with a local non-profit and spread the word about the importance of early detection
  • Schedule your annual mammogram appointment and encourage friends and family to do the same


Type One Tuesdays: Celebrity Advocacates – You Can Be One Too!


Krysta Rodriguez, Broadway actress and film star, added another credential to her name last week.  She began writing a blog about her journey with breast cancer, which coincided with her admission that she has breast cancer.  She uses her website, Chemocouture, to use humor and a very blunt approach to share her very difficult journey with cancer.  Since her announcement, there has been an outpouring of support from celebrities and fans.  In her blog, she describes her cancer.

“Now as far as cancer goes, I have the Cadillac of tumors. It’s slow growing, highly treatable and not really interested in spreading. My doctor calls it an “old lady cancer.” I always knew I was ahead of my time! Picture a lump sitting in a BarcaLounger eating Cheetos and enjoying the warm, cozy studio apartment I’ve been providing for it on Left Breast Lane.  No one would want to leave that, am I right?  Well, sorry buddy.  I’m the landlord from hell and it’s eviction time.”

Krysta Rodriguez is a true inspiration for people dealing with cancer or any chronic illness.  She is using her fame to make a difference in health of others, which is amazing and admirable.  Celebrities, discussing their health problems, can bring attention to topics many people may not have the courage to talk about.  This can be beneficial for other people with the same disease, but also for others who are supporting loved ones or just dealing with difficult life experiences themselves. Celebrities can help inspire and educate people dealing with the disease to be their own advocates and speak out like the celebrities do.  Krysta Rodriguez is not the first to be a celebrity health advocate.  Some other notable celebrities who advocate for their diseases are Michael J. Fox (actor, Parkinson’s disease) and Nicole Johnson (1999 Miss America, Type 1 diabetes).  Each of us has the ability to do what these celebrities have done, by being our own advocate and embracing our disease(s).


I am by no means Krysta Rodriguez, but I hope to have a positive impact on the Type 1 diabetes community.  I have chosen to focus make my career and my life on helping others through my experiences with T1D.  If I learn something new and helpful, I want to share it with others.  Even difficult or challenging experiences provide opportunities to help others by sharing how I dealt with the issue and to let them know that I got through it.  Do you embrace any diseases you have? Do you incorporate them into other aspects of your life? Are you your own advocate? Do you think more people should be like Krystra Rodriguez, Michael J Fox and Nicole Johnson and speak out about their health problems?

Photo Credit: Steven Mezer (Photo 1: Krystra Rodriguez and Amanda Mezer; Photo 2: Nicole Johnson and Amanda Mezer).


Pink You Know Where Your Money Is Going?

As we settle into fall, we see the same seasonal markers surface each year—sweaters and jackets, Halloween décor, and pumpkin everything. But with Breast Cancer Awareness Month occurring in October, we also need an influx of pink everything in the name of raising money for breast cancer research.

However, critical researchers, activists, consumers, and persons with breast cancer, such as those featured in the documentary Pink Ribbons, Inc., are very skeptical of the efforts to sell items, events, and the cause for breast cancer.

There are several reasons to be skeptical about the Susan G. Komen Foundation’s campaign. First, very little is known about the cause of breast cancer. If the cause(s) was known, then the month could be used to educate the public on these risk factors and how one can prevent breast cancer. This absence of this knowledge begs the question of what the awareness month is about: what is there to be aware about?

In the end, the focus is on selling things that are pink and participating in activities such as runs and walks while wearing pink with intentions to help a cause but having very little impact on any action.


The initial purpose of the awareness month was to promote mammograms, but even this purpose can be faulty. Early detection of breast cancer may lead to effective treatment, but there is also a great chance that it may not or the side effects of the treatment may lead to other debilitating health conditions.

Major corporate partners of the campaign have much to gain from increased mammogram screenings and breast cancer diagnoses. Companies that build mammogram machines such as General Electric and DuPont are big donors; AstraZeneca, a pharmaceutical company and primary sponsor of the awareness month, can profit greatly from more women undergoing breast cancer treatments.

Of the money raised, which happens to the primary result of all of the awareness efforts (as opposed to advances in research), a portion goes into research, with a primary focus on finding a cure, not discovering the cause or how to prevent it.


There’s also the observation that of all cancers or diseases for corporations to rally behind for a public-approved cause, breast cancer is conveniently a disease that affects women and a disease located in the breasts that can be easily sexualized. The campaign also sends a message of hope that women can fight and win the battle against cancer—often a losing battle that conveniently places the blame on those with breast cancer.

All things considered, is this campaign nothing more than a powerful business plan?





Are E-Cigarettes Effective for Quitters?

The debate has been growing alongside e-cigarette sales over the past few years, and the potential harm of e-cigarettes on society was discussed in a recent post on Upstream.  But each set of study results brings back the same question:

Are e-cigarettes (the battery-powered devices which simulates tobacco smoking by producing a vapor that resembles smoke) good or bad for individuals and society?

On the one hand, e-cigarettes could cause smoking to become normalized again in society, catapulting us back to before the 1970s, when most people were unaware of how bad smoking is for your health.

On the other hand, e-cigarettes could be a great way to protect people from the harms of tobacco smoking by providing a safer substitute, without making smokers completely cut out what, for many, has become a relaxing and enjoyable habit.

A recent study in the UK surveyed 5,863 smokers between 2009 and 2014 who had made at least 1 serious attempt to quit smoking in the past year, using either e-cigarettes or an over-the-counter cessation aid, or nothing at all.

The study found that a fifth of the smokers had quit with the aid of e-cigarettes.  This was 60% higher than those who did not use e-cigarettes.

Experts are still doing research on the safety of long-term use of e-cigarettes, though it’s currently accepted that the inhalation of e-cigarette vapors is less harmful than smoking.  And other recent studies have found that, in the more general smoker population (vs. smokers trying to quit), e-cigarettes are no more effective than other methods.

The American Lung Association makes it clear that they do not endorse nor has the FDA approved the use of e-cigarettes, and thinks there should be far more regulation and oversight to make sure they’re safe to consume.

And is it possible e-cigarettes are making smoking cool and okay again, especially for kids and teenagers?  Is there some way to ensure e-cigarettes are used as a quitting tool and not as a gateway into tobacco cigarette smoking and even more harmful habits?

Will history see e-cigarettes as a good or bad influence on the public health of society?


Photo credit: Michael Coghlan

Dr. William Li “Can we eat to starve cancer?”

One of my favorite TED talks is Dr. Li’s “Can we eat to starve cancer?”  What I love about this talk is that it is very accessible and provides interesting medical information as well as practical tips for how to stay healthy and hopefully avoid cancer.  After you watch Dr. Li’s TED talk (link below), be sure to check out the “Eat to Beat Cancer” website which has plenty of tips, recipes, research, and so much more! 


Dr. Li’s TED talk:




Fewer Pink Ribbons in 2013?

It’s Pinktober. Or as the cancer industry would remind us, “October is Breast Cancer Awareness Month!”

As one patient-friend recently called it, we’re nearing the end of what is usually quite a Pepto Bismol colored month. Or to put it differently: what is pinkwashing, and how might it affect us, as people targeted by breast health communication campaigns? ….Let’s explore further.

Originally sponsored by pharmaceutical company AstraZeneca and dedicated to breast cancer awareness/advocacy since the 1980s October is now frequently referred to as “Pinktober,” due to the ubiquity of “pink ribbon” paraphernalia throughout the month. On one hand, these campaigns may variously pump up legions of pink ribbon supporters, who engage in community fundraisers, buying products via corporate sponsorships, and partaking in “awareness” campaigns for breast cancer detection, or raising research funds for “the cure.” Or Pinktober may make many others of those who’ve been through the rigors and poisons of cancer diagnosis need a little dose of anti-nausea medication themselves. A growing movement of women who’ve been through breast cancer are speaking up to say “Pink Ribbons don’t represent me!” These current and former patients take a little more critical look at the health inequities and toxic pollutants they argue “pink ribbon campaigns” may in fact mask over.

However, this year, there seem to be substantially fewer pink ribbons than normal*. Have our readers noticed fewer pink ribbons, too?

– Could it be because of the controversy with Susan G. Komen For the Cure TM and the organization’s proposed defunding of Planned Parenthood last year?

– Could it be because of the increased scrutiny on charitable spending associated with Pink Ribbons?

For example, on the Pink Ribbon (Official) Website, the homepage banner features an articulation of the protocols and regulations of how fundraised dollars will and will not be spent. This is likely a result of increased scrutiny as to how pink ribbon dollars are being spent, following the work of campaigns like Breast Cancer Action.

– Breast Cancer Action has also inspired many with their “Think Before You Pink” campaign, which works to illuminate the stinky ties between companies that sponsor breast cancer awareness campaigns, while at the same time making products which contain chemical components causally linked to breast cancers. This is called pinkwashinga form of “bait and switch” in health communication-related advertising which has come under increasing fire in the last several years.

I am glad to see fewer pink ribbons on the shelves — if they are a part of eclipsing more substantive conversations about why so many people are getting hormonally related and “lifestyle” cancers in the US and in global cosmopolitan centers with rising rates of “life style disease.”

But I am hopeful that consumers are aware of the reasons why pink ribbons are, for many, not an ideal form for communicating support of (breast) cancer patients we care about, or marking our status as family members who’ve lost someone to serious cancer. Perhaps the industry is laying lower this year. But will corporate sponsors and “girly pink” slogans be back — with yet more plans for selling “pink ribbon” products as their main goal in this endeavor for “cancer awareness”?

What do you think? If you’ve never noticed pink ribbon campaigns before, what has your experience of them been so far this year?





*Post-Script: Here’s how my 2013 Pink-quest started….

Several weeks ago, I visited my local “big box” store in search of pink ribbon products (working with metastatic cancer patients as research partners, I am always curious….). In Octobers-past I’ve called in to local Wal-Marts and gotten an extensive, often hilarious report on their multitude of “Pink Ribbon” lines: Pink Doritos, Pink bubble wrap, Pink Ribbon underwear lines, Pink jewelry lines, Pink teddy bears, Pink t-shirts, Pink hand-tools/drills, Pink bakeware, and more. This year, however, in the entire store’s warehouse, I found only 1 dish detergent with a pink ribbon seal, and an NFL-sponsored Pink Ribbon Pepsi case. Asking the store manager what “pink” products were in stock for “breast cancer awareness” this October, she looked at me with confusion, and said, “I don’t know what you mean by ‘pink ribbons’?”

Pink Ribbons are certainly not “gone” from the scene of our consumer landscape, however.


On the way home, I noticed a local real estate agency will have a “PIG OUT FOR CANCER AWARENESS” Barbecue fundraiser, with a 20-foot pig structure calling out “We are Tickled Pink!” (For reference, see the China Study controversy, for linkage between fatty meat consumption rates and hormonal and “lifestyle” related cancers).

The local BMW retailer had its entire building uplit with pink lighting and a banner asking its patrons to “Turn Us Pink,” ostensibly by buying a BMW and donating a portion of proceeds to a pink ribbon charity for breast cancer (For reference, see the controversy over whether car exhaust is a contributor to spiked cancer prevalence in the US and global cosmopolitan centers).

Though many of my research partners have gotten fewer fundraiser emails with “Think Pink” in the tagline this year — or seen fewer t-shirts with “I heart boobies,” and other tags, such as “Save a Life, Grope Your Wife” — we have noticed many companies are still on board with sponsorships “for the cause.” These are sponsorships which allow them to rack up brownie points for “Corporate Philanthropy” and “Social Giving.” As consumers, we still get to decide whether or not to support their “support” by buying into, or avoiding such potentially troublesome health campaigns.