Can Being Obnoxious Save Lives?

No great surprise, I suppose, that my interests coincide with my gender. I write about children because I am a mother; I write about sexual harassment because I am a woman. But some subjects of inordinate interest to women leave me cold. I feel I should pursue them but shy away. Denial, maybe?

Breast cancer is one of those.

I confess: Sitting around with a group of women on a brilliant weekday afternoon talking about this disease, the second-leading cause of death among American women, was not my idea of a great time.

I was wrong.


It was a panel discussion at Santa Monica College, actually, and coincided with the opening of a campus art show called "One in Eight: Women & Breast Cancer."

The big draw was UCLA's Dr. Susan Love, who has become to breast cancer what Loyola law professor Laurie evinson has become to high-profile criminal trials: a bona fide media star.

(After stories broke about the Montreal doctor who falsified data in a lumpectomy study, Love says she was paged more often by ABC, NBC and CBS than by her patients.)

When this woman talks, people listen. She is a renowned surgeon and author of a popular book on breast cancer. She is a co-founder of the National Breast Cancer Coalition, which has screamed and yelled its way to huge increases in funding for breast cancer research. She is the founding director of the UCLA Breast Center.

I think the infectious passion of a woman like Love will do more for this disease than 10 movies of the week. (Although her story would certainly make a good one. Producers?)

Panelist P.J. Viviansales, 44, whose bare brown skull was wrapped like a gift in a brilliant headband, is undergoing treatment for a second bout with breast cancer. Viviansales founded the Women of Color Breast Cancer Survivors Project. Just that morning, she said, she had received a phone call from a woman in need of advice:

"She has long hair. She called me up and said, 'I have been putting off chemotherapy and radiation because I was told that my hair would fall out.' And she had her lumpectomy two years ago. Two years ago! No treatment! Did she get a bone scan? Did she get a liver scan? Did she do any of those things? We are not being told that these processes need to be done. It is up to us to make women--especially African American women--aware. Every day we hear serious horror stories."

Viviansales' goal--and that of every woman on the panel--is to bring an end to the horror stories by bringing an end to breast cancer. But until breast cancer is eradicated, until a cure is found, a prevention discovered, the only way to combat the horror is through empowerment--that deliciously freighted expression that conveys education, resources, support and, in the case of these women, a whole lot of attitude.


Some things about breast cancer you should know:

* Mammography is an excellent diagnostic tool for women over 50. For women under 50, who have denser breast tissue, it is unreliable. Seventy percent of women under 50 have mammograms; only 30% of women over 50 have them. That is backward.

"The issue in not recommending mammograms to women under 50 is not that we don't think women under 50 get breast cancer; they do," Love said

"And women under 40 and women under 30 get it, too. The question is whether mammography is a good tool for finding it and whether the (radiation) risks of mammogram outweigh the benefits. . . . We are not saying, 'Oh, younger women should just die of breast cancer and we'll focus on older women.' It's just that this isn't necessarily the right tool to do it. So women say to me, 'Well, what do you recommend for women younger than 50?' And the only answer I have is: political action."

* The recent news about falsified data in the lumpectomy study has not changed the outcome of that study (which has been supported by others). Lumpectomy is an effective treatment for women in early stages of breast cancer.

* Tamoxifen, an estrogen blocker used to treat breast cancer, causes uterine cancer. But, Love said, it is not clear that the amount of uterine cancer it does cause is high enough to counteract the good it does in fighting breast cancer. A large study now under way should answer that question.

* We cannot have our cake and eat it too, Love said. If we want answers on women's health issues, we need studies; if we want studies, we need to volunteer for them.

(If your doctor cannot tell you what cancer studies you are eligible for, call (800) 4-CANCER.)

* Screaming and yelling works. "So I invite you to join me in becoming obnoxious," Love said, "so obnoxious that they solve this problem just to shut us up."


Hollis Sigler, a painter, was the last panelist. In 1985, at 37, she was found to have breast cancer. She felt a lump under her arm; a mammogram confirmed the presence of cancer. In 1990, she had a recurrence, and in 1992, discovered that the cancer had spread to her spine. At that point, she began a series of paintings about the disease, some of which are included in the Santa Monica College show.

Her fanciful paintings have such titles as: "What Does a Lady Do With Her Rage?" And "Maybe It Was Something I Ate."

Sigler was moved, she said, by poet Audre Lorde's vision of "an army of one-breasted women" and her hope that, "if the world could see all these women, they would know there are just so many of us out there and that something would happen."

Shall we begin by getting obnoxious?

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