The problem with breast cancer awareness

As a cancer survivor, here’s a conversation I have occasionally.

“Did you hear such-and-such has cancer?” To which I might reply “Yes, I heard. I’ve also had cancer.”

“Are you okay now? Did you have treatment?”

“Chemotherapy and radiotherapy.”

Then follows the almost inevitable. “And which breast was it in?”

Now, apart from the problem with it somehow being perfectly okay to discuss my breasts in general conversation, there’s another issue. Why is it everyone assumes, because I am a woman, the only cancer I could have is breast cancer?

Before I go any further, I give well-deserved kudos of heroic proportions to everyone diagnosed with breast cancer, plus the millions of people who’ve campaigned to raise money for and increase awareness of breast cancer worldwide. God knows it has to happen. Thankfully we are learning more about breast cancer every day due to the billions of dollars raised for research, improved early screening and detection programs.

But while there are positive effects flowing from increased awareness of breast cancer I’m convinced, as both a cancer survivor and as someone who works with cancer patients, people are also making some general and quite dangerous, assumptions about breast cancer.

Marketing is about brand association, and the brand for breast cancer is the colour pink. There are two problems associated with this; firstly, not all women who get breast cancer identify with pink. And secondly, not all people who get breast cancer are female. Some of them, more than you probably think, are men.

My friend Gary has something like this conversation almost every day:

“Hey Gary, did you hear Frank has cancer?” “I heard that. Did you know I had cancer?” “Really? Prostate or bowel?”

“Actually, I had breast cancer.”

Incredulous stare, awkward silence. Men get breast cancer? Well, yes, they most certainly do. And Gary has nowhere to go with his cancer diagnosis in practically every sense; nowhere in conversation, nowhere in people’s perceptions, and certainly nowhere in terms of supportive care and services. For Gary, what’s of most concern is the widely held assumption is that only women get breast cancer, when the reality is that men (even those without man boobs) get it too. He has no idea how community attitudes can be changed, when so much work has been done to create an image of breast cancer as a female disease. And before you ask, blue is already taken – for prostate cancer.

Another issue is the dominant perception breast cancer is the only one women really need to be concerned about, however, many cancers previously associated mainly with men such as bowel and lung cancer are killing increasingly more women. Despite this, awareness programs for women continue to mainly target our boobs. Women may fear having their breasts removed more than they fear having a mole, a section of bowel or part of a lung taken, however, the negative implications of these other cancers can be equal to or even outweigh those of breast cancer. The sad fact is that most breast cancer caught early enough can be treated and even cured, but by the time many other cancers are detected it is too late.

Breast cancer is not the only cancer women need to be aware of. In 2003, at the age of 35, I was diagnosed with stage 3B Non-Hodgkins Lymphoma, and even my family doctor was unconvinced prior to my diagnosis there was anything wrong with me – that is, until I presented to the emergency department of my local hospital on the verge of collapse. I had no obvious lumps or bumps – and a perfectly healthy pair of D-cups. Pity about the tumour the size of a saucer buried 3cm under my sternum, but no one thought to check in there.

I have a friend who, like me, was diagnosed with cancer in its later stages. However, unlike me, she can’t talk about her diagnosis in general conversation, because no one wants to talk about vulval cancer. She didn’t even know there was such a thing, yet gynaecological cancers like hers, and blood cancers like mine, are not considered to be statistically that rare in women. Not rare, just unheard of – literally.

Increased awareness of breast cancer is a double-edged sword. It seems the very changes in perception and awareness that save lives every day may be creating a set of assumptions perhaps as dangerous as our ignorance ever was.

So, with breast cancer awareness month upon us, I’d like to advocate another kind of cancer awareness. Please consider that not everyone diagnosed with breast cancer is female. Also, when you pin on a pink ribbon and forward a chain email, I would like you to remember that not all the cancers women are diagnosed with are breast cancers. Check your boobs by all means, but check your moles and your motions too. Check your rashes, your rude bits, your lumps and your bumps. Thirdly, the other side of breast cancer awareness is realising the scope and the effect all kinds of cancer have on every diagnosed person’s family and friends, and on the community and society as a whole.

Now that’s what I call cancer awareness.

Jo Hilder is an author, blogger and cancer coach from Newcastle NSW, and recently released a book called Things Not To Say To Someone Who Has Cancer, a guidebook for those with a loved one diagnosed with cancer.