Moyo Musings: Weekly Reflections for Growth
This post is dedicated to the memory of my mom Marjorie E. Collins (2012) and sister Christine E. Smith (2019) whose lives ended after long, painful battles with cancer.
October is Breast Cancer Awareness Month.
Why is one person or one group more likely get cancer than another? And given the similar incidences of the occurrence of cancer in women in some age groups, why is the death rate higher among women of different racial groups?
“Almost all of the cells of our bodies (except, interestingly, certain immune cells) have exactly the same genes — the same ‘hardware,'” says Myles Brown, MD, co-director of Dana-Farber’s Center for Functional Cancer Epigenetics and the Emil Frei III distinguished professor of medicine at Harvard Medical School.
“It is the specific ‘software’ that a cell is running that determines its cellular identity. In cancer, both defects in the hardware (gene mutations) and ‘bugs’ in the software (epigenetic alterations) play major roles.”
According to the Centers for Disease Control and Prevention (CDC)*, Black women and white women get breast cancer at about the same rate, but black women die from breast cancer at a higher rate than white women.
Compared with white women, black women had lower rates of getting breast cancer (incidence rates) and higher rates of dying from breast cancer (death rates) between 1999 and 2013. During this period, breast cancer incidence went down among white women, and went up slightly among black women. Now, breast cancer incidence is about the same for women of both races.
Cancer Death Rates are 40% Higher
Breast cancer death rates are 40% higher among black women than white women. This startling difference in outcomes begs the questions - Why? Are there socio-economic factors contributing to this higher death rate of black women?
Compared with white women, breast cancer incidence rates were higher among black women who are younger than 60 years old, but lower among black women who are 60 years old or older. Breast cancer was more likely to be found at an earlier stage among white women than among black women.
Do black women have less access to information about early detection and preventive health measures? Are we less likely to perform regular breast exams, or are we accustomed to paying more attention to the health and wellbeing of others than to our own? Does it have anything to do with the type of breast cancer among black women?
What Can Be Done
Black women are more likely than white women to get triple-negative breast cancer, a kind of breast cancer that often is aggressive and comes back after treatment. Scientists are doing research to learn why some women are more likely to get this kind of breast cancer, and to find better ways to treat it. Through this work, women have become more aware of the different kinds of breast cancer.
Public health agencies are working to make sure all women are screened for breast cancer as recommended, and those who are diagnosed with breast cancer can get the best treatments. They also are helping women reduce the risk factors that raise their chances of getting breast cancer. Together, these efforts could reduce racial disparities in breast cancer.
There is work for the scientific and medical communities and there is work for you. First and foremost perform regular breast exams. Second, do not put off seeking medical treatment if you suspect or discover a lump or other changes in your breasts. Third, practice radical self-care by taking advantage of the Moyo's meditations and courses that provide tools to manage stress and safely release trauma. Finally, get to know your body and don't wait until Breast Cancer Awareness Month. Make it a part of your regular routine to "Check Yo Self."
~ Gwendolyn Mitchell
*CDC Citation: Richardson LC, Henley J, Miller J, Massetti G, Thomas CC.Patterns and trends in black-white differences in breast cancer incidence and mortality—United States, 1999–2013.MMWR2016;65(40):1093–1098.