Sunday, February 2, 1997
Write if you think you're worth saving

The Cincinnati Enquirer

Nancy Carley from Anderson Township called to tell me that her mom, now 68, had a mammogram in her mid-40s. ''Cancer was detected and dealt with,'' was how she put it.

''Mom has lived to see all her children graduate from college and get married,'' she says. ''She has 11 grandchildren.''

Well, Nancy, I am sorry to report that your mother is statistically insignificant.

So is my college friend, Joanie, who has two kids still in elementary school. She was always late to everything, including motherhood. But, thank goodness, she didn't wait around until her 50s to check to see if she had breast cancer.

My dear friend, Mickey, was diagnosed through her first mammogram, just as she turned 50. By then, her cancer had traveled to her lymph nodes. She, therefore, had to have a longer and more punishing round of chemotherapy.

She also had surgery and radiation. And it still made its way to her bones. So she had a new round of drugs and eventually a bone marrow transplant. Very unpleasant. And expensive.

Like the rest of us who have had breast cancer, Mickey doesn't know how she got it, but you can bet that she didn't get it on her 50th birthday.

Cowardly, muddled

A lot of people called and wrote last week after I took a big swipe at the National Cancer Institute's cowardly and muddled recommendation that ''each woman should decide for herself whether or not to undergo mammography'' before the age of 50.

This is despite the fact that breast cancer is the leading killer of women in their 40s. This is despite the fact that mammography is the best available test. The panel urged insurance companies to pay for mammograms, while giving them the perfect excuse not to.

Dr. Leon Gordis, the chairman of the panel, an epidemiologist, says nothing had prepared him for the venomous reaction to the panel's conclusion. The reaction, according to Dr. Gordis, says more about the politics and psychology of breast cancer than it does about the science behind the committee's decision.

Or, more accurately, non-decision.

Politics? Psychology?

All we know is that breast cancer can kill you, and one in nine of us will get it. If it's detected early, we might be saved. The panelists think there should be more clinical trials. They are willing to wait, to gamble. But we statistically insignificant women are not.

Breast cancer strikes about 180,000 American women each year and will kill 44,000 this year. But only 10 percent of them will be under the age of 50.

Dr. Donna Stahl, a specialist in diseases of the breast, is fond of saying, ''If you are one of those 10 percent, then the odds are 100 percent.''

Let's talk numbers

What about us women who are alive because our cancer was detected in our 40s? The scientists are not interested in us. Nor are the statisticians. So let's not bore them with accounts of graduations attended, grandchildren hugged, jokes told, books read, birthdays, anniversaries.

Let's talk numbers. Just how much are we worth? And how pricey will it be if we have a cancer that doesn't behave, that doesn't wait until we're 50. In round terms, a lumpectomy is cheaper than a mastectomy, which is cheaper than a bone marrow transplant.

Well is cheaper than sick.

One doctor told me the issue probably will be resolved through legislation. So, I guess we should write our elected officials. Maybe if each of us would tell them our stories, it would help them decide whether we are worth saving. Or maybe some of the stories could come from brothers or husbands or daughters or sons or sisters.

Or write and tell me your story, and I'll send it to them. Maybe they'll notice that there are lots of us. Maybe they'll notice that we vote. And so do all the people who are glad we're still around.

How about those numbers?

Or how about thinking of us as people again?

Laura Pulfer's column appears in The Enquirer on Sundays, Tuesdays and Thursdays. Call 768-8393 or fax at 768-8340. She can be heard Monday mornings on WVXU radio (91.7 FM) and as a regular commentator on National Public Radio's Morning Edition.