Many Black Women Refuse Breast Cancer Treatment
Poverty, fear play roles in skipping lifesaving therapies, researchers say……
This is one in a series of post on breast cancer. The challenge to all my sisters is to commit to self-examination and introspection, to take concrete steps to maintain breast health.
Do you know of someone who has cancer? How are they dealing with it? What are you doing to protect yourself? What are you doing in your communities to help?
There are no pink ribbons on display; there are no pleas for donations to cancer foundations.
After decades of folks pouring money into various cancer foundations for cancer research, I’d like to know where is the cure? Wouldn’t you?
**Now take a look at the findings of a study done on black women and their refusal of breast cancer treatment:
MANY BLACK WOMEN REFUSE BREAST CANCER TREATMENT
Almost 25 percent of black women with advanced breast cancer refuse the chemotherapy and radiation treatments that could save their lives, a new study finds. (That’s ONE IN FOUR women!) Are you shocked and angered by the statistic yet? I am.
Black women have almost twice the rate of advanced breast cancer as white women do, largely because the disease is often diagnosed after it has already progressed. In addition, some black women have misconceptions about cancer and are reluctant to seek medical help, the researchers said.
Educating women is also important, Rizzo said. “Educate more women and dispel some fears that they can have about cancer and cancer treatment, and encourage them to have yearly mammograms to catch cancers at an earlier stage, when the cancer is more curable,” she said.
“We found in this study on locally advanced breast cancer, mainly done in black women, that almost a quarter of the patients [refused] chemotherapy and radiation therapy that are the standard of care for stage 3 breast cancer,” said lead researcher Dr. Monica Rizzo, an assistant professor of surgery in the Division of Surgical Oncology at Emory University School of Medicine in Atlanta.
Why these women balk at treatment is unclear, Rizzo said. “We looked at martial status, as well as religious background, of those women and, unfortunately, we were not able to find any clear identifier,” she said.
Things that may be associated with their refusal of treatment are fear of the medical system and poverty, which makes it difficult to get to the hospital and get time off work for treatment, Rizzo said. In addition, cultural differences may also play a role, she said.
Rizzo noted many more blacks refuse breast cancer treatment than women from other populations.
The report is published in the May 22 online edition of Cancer.
For the study, Rizzo’s team looked at the records of 107 women with advanced breast cancer reported in one inner city hospital from 2000 to 2006. About 87 percent of these women were black. Among these women, 29 percent had tumors that do not respond well to new targeted treatments.
Although the recommend treatments for advanced breast cancer are chemotherapy and radiation, many women chose not to be treated. In fact, 20.5 percent refused chemotherapy, and 26.3 percent refused radiation, the researchers reported.
To try to get more of these women to accept treatment, Rizzo’s group has started a community outreach program that uses a nurse practitioner and a social worker to follow breast cancer patients and their care.
The researchers speculated that factors such as cultural beliefs, access to health care, other illnesses and patient choice may all play a role.
We can not afford to allow fear and ignorance to become the grim reaper. What are we doing to ensure that we and our sisters can afford to receive the care and treatments they might need?
My twin sister died of this advanced form of breast cancer at age 33. She had a radical mastectomy performed one week after her fifth child was born. (Left breast and lymph nodes removed.)
She did 3 months of chemo, and decided to stop. She wanted to bond with her baby and the chemo made her too weak and ill to do so. That was twenty one years ago. I felt helpless because she made the decision, and there was no way to convince her to continue. It was painful to watch her die a painful death. She left behind 5 children.
My twin sister’s death became my impetus to take better care of myself, to become knowledgeable about not only the disease, but how to prevent it from inviting itself into my body. I vowed to take better care of myself. It has not been without its challenges. The fear Dr. Rizzo speaks of is very real.
Read more here.
Who are the faces of breast cancer? All races of women. Who are the faces of breast cancer with the highest mortality rate? BLACK WOMEN.
What steps will you take today, to ensure that you do not become or remain a statistic? Breast cancer is no longer considered an automatic death sentence.
Next series: Breast Cancer Risks and Prevention
Window Of Hope
For more about breast cancer, visit the American Cancer Society.










View Comments
October 13th, 2009
I read the post late last night. It very informative.
I look forward to reading more.
October 13th, 2009
There are no pink ribbons on display; there are no pleas for donations to cancer foundations.
After decades of folks pouring money into various cancer foundations for cancer research, I’d like to know where is the cure? Wouldn’t you?
Alright Now, Shanti's Keeping It Real. Where is the cure? WEESeeYou Cancer Foundations.
October 13th, 2009
Shanti,
This is a very informative post. I am currently writing a report on AA health & wellness and I wanted to find the original study that you referred to. Will you please provide a link to the actual online article/study? I can't seem to locate <italics>Cancer</italics> (magazine?) through the search engines with limited search terms.
Thank you.
October 13th, 2009
Thank you, Jacklynn. I hope you take a moment to comment on some of the questions from the thread.
Here's the link to the article:
http://www.forbes.com/feeds/hscout/2009/05/22/h...
October 13th, 2009
Indeed, WEESeeYou Cancer Foundations… It's a multi-billion dollar business… I'll be addressing this in the series too!
October 13th, 2009
Thank you, Shanti2. Also I'm sorry I forgot to offer my condolences on the tragic loss of your twin sister. My sister, while not an actual twin is an “Irish twin” (11 mos. age difference).
IMO, maybe you should set up a foundation in your sister's name to educate Black women about the treatments and possible cures for breast cancer. In my report I intend to encourage my audience, brands and ad agencies, to support health education efforts in the Black community.
J.
October 13th, 2009
This is a wonderful write up.
I do understand why women refuse the chemo and why there is no cancer cure.
Chemo is very toxic and the majority of patients are told they will not be cured and that they will be physically disfigured.
The entire therapeutic principle of chemotherapy is to simply kill as many cells as possible, health and cancerous…they take the patient to the brink of death for what their healthy cells can handle… and HOPE they have killed off more cancer cells than healthy one…when they stop the chemotherapy…cause it is simply to toxic for them to continue it..i.e. the patient will have long term harm.
I worked in oncology at BristolMeyerSquibbs…I represented them at ASCO the world's leading professional organization for physicians and oncology health care practioner. I helped set up clinical trials and did the clinical write ups for Principle Investigators as well at presentations at the 3, 6, 9, annual and 18 month reviews.
What I can tell you is that clinical bar for efficacy for oncology agents is all about remission, partial, complete and overall remission. Remission rates determine whether the drug is effective and whether the FDA Advisory Board will approve it for global marketing. The funny thing though about remission is that it has an ARBITRARY criteria for efficacy and that is 6 months. Chemotherapeutic agents have to demonstrate they are effective for 6 months i.e. how long was the patient 'without cancer'. Now, you may be asking why 6 months. It is simply arbitrary. Not that there is significant efficacy or therapeutic impact…rather…the vast majority of patients will have recurrence after 6 months …so the industry set 6 months as the efficacy bar, to determine Overall remission rates. Now what about this Overall remission rate…well that is about partial and complete remission which are added together to determine overall. So, if you have patients where the cancer returned in 3 months (partial remission) and some where it returned AFTER 6 months (complete remission)….you can ADD those together to say what the drugs OVERALL remission rate is.
Why this is impactful is because the cut off is 6 months…no one calcultes remissions after 6 months. So, if you can show that the vast majority of patients did not remit WITHIN 6 months…you can demonstrate a great OvERall remission rate for the drug.
And the patient when told that 30% of patients will have overall remission…doesn't hear that 70% died.
Finding a cancer 'cure' is difficult as the over arching treatment methodology suffers from a therapeutic principle not found for any other disease…and that is that it is perfectable acceptable to kill healthy cells in pursuit of killing cancer cells. Despite, this having not been an effective therapeutic principle, it has continued to guide cancer research.
There is new hope though…just last week researcher's announced a significant advancement in discovering telomererases in cancer cells. That can be the new target for therapies as it shuts down the proliferation of the cancer cell vs. the normal cell There is also hope for angiogenesis agents, which will target and shut off the cancer cells blood supply. Unfortunately, those therapies have lead to patients bleeding to death.
Personally, with what I know about cancer therapy…I would decline treatment unless I had Hodkins lymphoma, like Specter. Especially, if the diagnosis occurred at an advanced staged. The agents are just too toxic, and I would prefer to have quality of life in my last days…I would just get doped up on pain cocktails…and go about my daily routine, take trips to see the world…all painfree….rather than pewking and retching up my guts, having never ending nausea and just feeling god awful.
Sorry Shanti…I know this is real personal for you….and it is for me as well…lots of cancer in my family, both grandmothers, my grandad, brother, firstcousin, uncle and day all died of CA. So, I have seen what it does and watched folks suffer from radiation and chemo…and after that 6 months of hell…they were gone.
Me, I am floating out of here…with serious CNS enhancing agents.
October 13th, 2009
Good Morning Shanti,
Great post…excellent! It is so informative.
Why do you think black women fear breast cancer treatment? I know some that are afraid of getting a mammogram because they've heard it might be painful!
October 13th, 2009
You make some valid points, whiterosebuddy, and I agree chemotherapy does have debilitationg side effects. Don't you think all women should have as much information to decide before they refuse treatment. There are other alternatives too.
I have friends and other family members who have gone through chemotherapy successfully, and are survivors of cancer.
October 13th, 2009
Thank you, SG2. Information is POWER, but if it isn't put into use, we remain powerless. How did you respond to women when they say they are afraid to get a mammogram? Have you ever had one? What was it like for you?
I 've been getting mammograms annually, for the past 5 years. The equipment has changed. For me, the procedure is not as uncomfortable as it used to be.
Every one's pain theshold is different. I'd recommend going to a center that does only mammograms. I go to the Jane Bratain Breast Center in Minneapolis. It's all they do all day. Women only.. Women know women's bodies. They provide emotional support, and education.
October 13th, 2009
Excellent post. Very insightful. My mom had ovarian cancer and I make it a point to manage my health, get my wellness checks, inform my kids about the need for a healthly lifestyle and healthy choices (even if Mommy isn't looking) and to make the right decisions.
Wonderful post
October 13th, 2009
I understand women are encouraged to regularly examine their own breast for any lumps etc. At what age should women start getting mammograms? If I am not mistaken, I thought it was around age 35? I have a older sister that gets one every year and she's been doing it for the past 16 years.
October 13th, 2009
I am looking forward to seeing your series about the money going into cancer research. After decades of having billions of dollars pouring in for research…why hasn't a cure been found?
October 13th, 2009
It's up to the individual. Women should know their family medical history.
From my own nursing background and understanding, women are encouraged to
start getting mammograms at age 50 or get one at age 40 as get a baseline,
and if normal can wait until 50.
For women who are at risks, i.e., family history, like myself should get
them sooner. The chances of getting breast cancer increases with age and
annual screening do the most good as far as early detection.
October 13th, 2009
Keep it going Shanti!! This was a very informative piece and I look forward to reading your future write ups.
October 13th, 2009
Thanks Shanti!
You're so informative! Wee really appreciate your post!
Big Up!
October 13th, 2009
“Don't you think all women should have as much information to decide before they refuse treatment.”
Yes, most definitely. I also think that is why many decline. The outcome stats with chemo/radiation…just are not great news. Many women probably have one basic question after they recieve that info…oh so what you telling me is ” I can die after you burn me up and/or disfigure me…or I can die like I came here with my same body intact and without all that toxic medicine'
I truly believe that is how women are thinking about it. For one thing if they didn't want to go to the MD to begin with there is no way they are going to submit to the suffering that goes along with the therapy. Many folks don't get diagnosed until late out of that fear alone. They are in denial and just don't want to know. Ostrichs.
I understand that cause nothing makes a person feel worse than to know they are not going to get well again. Black folks just take that type of daily suffering as the status quo..and hear someone say it would just make them too depressed to get out of bed. So, they just soldier on with the harshness of blackness and find their joy in the church and with their music.
Cancer is not considered a chronic illness vs. acute disease that can be cured. The vast majority of individuals have recurrence and typicallly it has metastasized. We know that being in remission, does not mean disease freee, just that the level of cancer is too low to be detected by the tests used. There are some rare forms of cancer that appear to be far more sensistive to oncologic agents, like children's leukemia and Hodgkins..but that is pretty much it for complete recovery.
I am not advocating this…but I definitely understand it.
It is sooo wonderful that you have fam/friends that are survivors. You are fortunate and blessed.
October 13th, 2009
Mammograms are painfully uncomfortable!!
October 13th, 2009
Great article and I really, really, really love that picture of an AA woman wearing the mask. The mask women wear needs to come how so the hurts and pains so many women experience can heal.
October 13th, 2009
Thank you Val. Would you mind sharing one concrete thing you do in the way of healthy choices besides wellness checks?
Also, kudos on teaching your kids on how to make healthy choices.
October 13th, 2009
Are they painfully uncomfortable for you, WRB? Pain is subjective.
October 13th, 2009
Again, you make some valid points. Sometimes too much information can be very overwhelming and does not allay the fears of women who need it to survive.
Getting information to young women before hand is just as important as after disease has taken foot.
Ignorance is not bliss. And I certainly would not advocate that women just listen to music and attend church for solace when they are suffering with disease.
Do you think sometimes we don't value our worth? That could mean the difference between taking better care of ourselves and giving up, which masquerades as fear.
I think information can be diseminated in such a way as not to frighten women. Again, I would add, that it is such an individual experience for all of us. Therefore women need to choose a doctor they can trust and who cares enough to provide them with truth in a way they can cope with it.
Oftimes it might just take a good friend to go along with them for support and encouragement. Friends know us, and are likely to
October 13th, 2009
There is nothing natural about having boobs squished down…that smashing hurts.
If I hit you upside the head with a bat…would you say that was subjective pain?
lmao
October 13th, 2009
LOL! Great point about that bat upside the head, but we're talking about making a choice to get the mammogram.
There are a few things in life that might feel uncomfortable, and yes, even painful, but folks still choose to do it. Why do they choose to do something that is painful?
If women don't want to get a mammogram, they can choose to do self-breast exams. I think the important thing is to choose to do whatever not out of fear, but do it for love of self.
October 13th, 2009
Everyone woman should get her mammogram…they still hurt.
“but do it for love of self.”
Guuurl..you know what Oprah says…love don't hurt.
I still have those mammograms done, though.
owwww
October 13th, 2009
Shanti,
One of the things that I believe is helpful is to change the descriptor from lump to hardpea….I could not ever understand what a lump was.
Then will volunteering for the American Cancer Society they had breast model where you could learn to exam the breast and feel for 'lumps'…well…when I palpated the model…it felt like a HARDASSPEA inside the boob…not no darn lump.
So, I wonder if other women don't know what it feels like either or what it is going to feel like.
October 13th, 2009
You are definitely right. Ignorance is not bliss…
October 13th, 2009
Let's be real, love isn't always a bed of roses either. Touch choices
require courage. I'd surely advocate for women getting mammograms, and if
they've never had one, I'd share my experience with having one.
It's not painful for me, but there is some temporary discomfort.
Good for you! Sounds like you're taking good care of yourself!
October 13th, 2009
Good point. I think if women would take time each month and do the
self-breast exam, they would know what's normal for them, then if any
changes occur, they would recognize them.
I discovered my first cyst when I was 17 years old. I had a biopsy done,
and it was benign. The cyst was the size of pea. As we get older breast
changes and grows. That's why it is important to do the self-breast exams
when we're younger.
We need to know our bodies, our own rhythms. A lot of fear comes from not
knowing.
October 13th, 2009
Thank you, Jacklynn. How thoughful to suggest a foundation in her honor to educate. As a Registered Nurse, I've spent the past 30 years working in communties to educate our youth on a host of issue that will impact their lives; health and wellness is at the forefront.
I commend you on your efforts to educate and encourgage folks to support health education in the Black communities. “Wellness” is certainly something that needs our attention and efforts.
October 13th, 2009
Shanti,
A foundation in your sister's honor sounds like a great idea! IMO
October 13th, 2009
It is a great idea, but one that requires time, money, and resources to start. I'd prefer working directly with young women.
My sister's daughter graduated college last year. She's considering the idea of starting a foundation in her mother's honor. I'd support her.
October 13th, 2009
Congrats to your niece! Sounds good!