Those New Breast Cancer Guidelines: Keep Doing What YOU Are Doing Right

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This episode just goes to show how much we are on our own as it comes to our own bodies: how we perceive them and how we heal them.

Women all over the country must have uttered, arrrrgggghhhh! yesterday, on hearing about the new guidelines for getting a mammogram, basically that women should begin screenings at age 50, not age 40 and get them every two years, not every year. Frankly, though, each individual woman is different.

“That is, the likelihood of having a false positive test with all the attendant anxiety, the additional imaging tests, perhaps even leading to biopsy that may have been unnecessary,” said Dr. Diana Petitti of the U.S. Preventive Services Task Force.

Major medical groups still recommend mammograms under 50 and worry this new advice may confuse patients.

“The worst outcome for this study would be for women to throw up their arms and say, ‘well, I’m not going to get screened at all,'” said the American Cancer Society’s Len Lichtenfeld.

They argue the government puts more emphasis on computer models than real patients.

“We’re not satisfied at this point that the approach that they used is sufficient and adequate to discard a proven way of saving lives from breast cancer,” Lichtenfeld said.

Sabrina Singletary’s 41 and says she’ll still get a mammogram every year.

But with the government now recommending against it it’s unclear if insurance will pay.

I didn’t panic. I have paternal aunts who are being treated for breast cancer. Which means that I am already alerted to the danger. I’m the next one on the fast track to have breast cancer. Then again, I may not, but I am not taking any chances. I self-examine myself every other month. I know what a lump feels like. One evening, someone came to see us at the women’s residence hall I once lived in during the Nineties to talk about breast cancer. She passed to us nearly accurate plastic representations of breasts that included abnormalities. The “cancerous” lump felt crinkly, hard…and scary. That’s what I look for every other month.

Here in Wisconsin, they finally offered Badger Care Plus to single individuals between the ages of 18-64. When I finally get my card, I will get my first mammogram in four years, and my first full physical work-up in several years that will include a gynecological exam. It will mean the end of rationing my own blood pressure and cholesterol medication that I sometimes cannot afford while on unemployment insurance. I’ll be able to get a better examination of my arms and head for the fall that I suffered this summer, when I nearly blacked out.

I do, however, take Vitamin D, which has been proven to be helpful for breast health and perhaps even warding off the onset of breast cancer. I am also thinking of taking niacin as well as getting back on policosanol, and pumpkin oil. Cutting down on fatty foods, drinking water instead of pop, drinking red wine once a week, eating more fruits and veggies and eating less in portions also helps. The heavier you are, the more cholesterol in your body, the more possibility of tumors. Keeping up with the prescriptions will be easier; but for continued use of the supplements and better food, employment stability is best.

Working, however, whether in academe or in business makes you do things–or exercise–as well as sit down at a computer. Like running for a bus, walking back and forth to the work place, climbing stairs, standing, bending, pushing. I have to do that job hunting online, and I’ve only gotten one interview for the first time in months today. I try to stay active and even walk around the Capitol Square some days, but it’s not easy.

The thing is, I have a feeling when my body is not as cooperative, and it has less to do with being heavy or older. It’s just that I get stressed because things are yet out of my control, when I have to delay making an appointment or reschedule it. When I was working and had a health plan, I was cognizant of yearly exams, dental exams, and so forth. There was a framework. If something went wrong between those times, I went to the doctor until I found out what it was. It’s been harder to get medical care because I haven’t had a medical or dental plan since 2005, and nothing before that time since 2000.

A back tooth has broken; masticating is harder without some pain. When I fell this summer, I told the emergency room doctors that I had hit my head. The paramedics had loudly announced to them that I had not been drinking. The doctors gave me nothing for it, except to suggest that I get over-the-counter Tylenol. When I felt the dried blood matting my hair a day later I was angry–more angry at myself than at the doctors, because I could not help and protect this body, this house where I reside. You cannot even demand the minimum of respect from doctors and nurses. My concerns and needs were not unreasonable. They don’t give, even of themselves, unless there’s money crossing their palms, and then perhaps, maybe they will take care of you. It’s like they’re gypsies, not health professionals. The stereotype about gypsies is that they tell fortunes, they don’t give you facts. They robbed you blind if you didn’t watch it. Sometimes I think that is exactly what health care is like. Bedside manner–and not just the bottom line–could save lives.

Which is one of the reasons why I am not upset over the new guidelines, which some argue are the same as the ones in Canada. After the anger and recriminations over the connections between hormone replacement therapy and cancer, I left it to myself to judge what to do, and not just leave it the people on high. Sure, I listen to them, but I also read up on alternative medicine experts and women’s health proponents, particularly those advocates who treat black women. And I listen to my own body, and sometimes I take notes.

And yet, 33.8’% of black women are more likely to develop and die from breast cancer, most probably because many of them do not have access to quality health care that includes mammograms. I may know when something is wrong and I may be kept financially from correcting a problem, but many other black women don’t know much about their own bodies and how they work, even sexually. They don’t even know what a mammogram is and why in hell they have to have it. Sometimes, they don’t even know how to examine themselves for lumps. To tell black women that they don’t need to have procedures that might save their lives, whether it’s poor or middle-class black women, sounds like a recipe for genocide. They are far too many black women dying at 25 and 42 from breast cancer.

Some tend to feel that the radiation risk for mammograms should rule the procedure out completely. However, the dose of radiation is very small. The older a woman is, though, the less of a risk. The fear of radiation exposure is for younger women who have also had extensive chest x-ray tests or radiation treatment for other maladies.

I find it interesting that these new guidelines should also pop up during the current debate over health care reform. Some more radical voices say that this is how the health care industry will eventually ration certain procedures after reform. Possibly, but I would say that every woman, including every black woman and woman of color, should follow her own counsel. If you feel that having a mammogram or a breast MRI would be effective because you have a family history of breast cancer, or that you are a black woman of 42 or 46 who wants to see what’s up, then you should have one. Period. If it’s only to set your mind to rest, you should ask your doctor for one. If you two should come to a disagreement about its feasibility in your case, then get that second opinion or even a third.

(Frankly, some doctors and consumers are upset about this development; they are not going to all submit to these guidelines just yet. There is something to be said about false positives and false negatives in mammograms, but there is also the fact that women in their forties–and even their thirties and twenties–have been accurately diagnosed with breast cancer.)

Be your own advocate in this and any other situations. Read. Keep a diary of your medical problems , what they feel like, and how you feel about them and discuss them with your doctor, specialist or nurse-practitioner. Get a group of girlfriends together and compare notes and educate yourselves. Even get together to watch The Doctors or Dr. Oz and talk about what this or that means, not just about breast health.

When it comes down to the final analysis, you have to become your own best friend and work on your own behalf, because they won’t. Not any more. Many medical schools got rid of the Hippocratic Oath in the 1970s. The doctors may not really be for you at all but for themselves and even the hospital model or rules. Nine times out of ten, you may know or sense more than they do, without the student loans, the expertise, the chi-chi car, and the McHouse or apartment.

Keep doing what you are already doing right, yet do no harm. Okay?

~ by blksista on November 18, 2009.

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