Braving breast cancer
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The patient in front of me appeared cachectic and weakened from the battle metastatic breast cancer was waging on her. On top of this, her weekly chemotherapy sessions were making her sick and destroying her immune system.

Yet, when she spoke, her voice was powerful and full of determination. “I will not die before my daughter graduates from high school”, she bravely proclaimed against the odds her oncologist had given her. Statistically, she wasn’t expected to be alive by the end of the year, and her daughter would not graduate for another two. I saw her many times over the next several months and years.

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She lived to see her daughter graduate high school and then college. Medically, there was no explanation of how she fought off her dire prognosis as her breast cancer continued recurring and spreading.

She never complained and when a new cancer location appeared, she asked us not to tell her family because she didn’t want them to worry about her. This was almost fifteen years ago and I will never forget her courage in the face of such horrifying suffering. I honestly believe it was her bravery that kept her alive more than any medication.

As a doctor, one of the tasks I despise most is sharing with a patient that their test came back showing they have cancer. And I am sure it is the worst information a patient wants to hear or face. It is scary and changes a person’s life forever. Yet, I am continually amazed how patients face breast cancer, or other cancers, with such extreme courage.

While we all probably know a woman with breast cancer, men face unique problems when they develop breast cancer. In fact, many people still do not know men can develop breast cancer. Steve Del Gardo, founder of Protect the Pecs (a non-profit organization advocating for male breast cancer), fought his disease with great bravery like many others.

And he continues to fight with courage on behalf of other men. He has received hate mail because of his advocacy. "The messages I received were vile”, he told me. “One man told me I am a wimp for having breast cancer and to suck it up. These people do not like that I am stirring the pot so to speak. They want it to stay the same and do not want men to be included in the month of October. Whatever. Life goes on! Not giving up".  

While we know October is breast cancer awareness month and everyone is whipping out their pretty pink ribbons, women and men are dying horrible deaths.

Patients with stage IV breast cancer (metastatic or advanced cancer) are suffering extreme pain and other symptoms while at the same time have little hope of surviving more than a few years.

Yet, many of the breast advocacy programs ignore this group of breast cancer patients. Sure, we need to encourage mammograms and detect disease early, but we cannot forget the people who wake up every morning and have to put on their coat of valor in order to survive until the end of that day.

Another group that is largely ignored is the LGBT community. While they do appear to have higher breast cancer rates than other populations, there are simply no statistics available because no one is studying this population.  The American Cancer Society has cited certain barriers that may play some role: this community has lower rates of being covered by health insurance, fear of discrimination, and past negative experiences with healthcare providers.  Additionally, many healthcare providers lack competency to treat these patients.

Over my career, I have treated hundreds of patients with breast cancer at all stages of disease from all walks of life. It does not discriminate based on socio-economic status, race, gender, occupation or any other factor.  I can honestly say I have never witnessed any breast cancer patient just give in to fear and give up the fight.

These women and men fought like it was a battle for their lives. Some lost that battle, but they did so with great courage and dignity. And many won the victory, even those that I and other healthcare professionals did not expect to remain alive. The virtual world and real world alike are filled with stories of these brave victims. Surely, to write them all would take a whole library of books.

October is here and it is important that we raise awareness of breast cancer. However, when we exclude groups we are not truly raising awareness. Rather, we are creating disparities in healthcare that should never exist. There are millions of dollars being poured into breast cancer awareness programs. Yet, much of this is for advocacy that ignores those with the most advanced disease and the poorest prognoses.

In this month of breast cancer awareness, perhaps the time has arrived to put that money to use to find new cures and save those suffering from metastatic disease and stop caring who looks pretty in pink?

Linda Girgis M.D., is a family practitioner from New Jersey.  


The views expressed by contributors are their own and not the views of The Hill.