The narrative of the modern woman is chock full of stories of resilience in the face of adversity, resistance to tyranny and empowerment through action. In just a little over a century much has changed for womanhood the world over, with a continuous eb and flow that demonstrates that the fight for woman's rights, equity and representation is far from over. The advocacy on behalf of women is not only played out in political theater alone as one of the major fronts in the quest for equity remains in women's healthcare reform which has seen a number of women acting both as active participants within the healthcare system and as victims of a system in need of tremendous reform.
Year-over-year healthcare has experienced a steady increase in women doctors and practitioners in what was once a male-dominated culture. With women being more likely than men to visit a doctor according to the CDCi it's no wonder that healthcare has been the backdrop for some of the most critical wins in the fight for women's rights. The history of women's healthcare can be described as having a somewhat sordid past in the United States, particularly the history of breast cancer diagnosis and treatment which has often served as fodder for an emotionally charged advocacy for women's voices in the healthcare arena. This Breast Cancer Awareness Month we dive into the folds of healthcare history to see how breast cancer awareness turned into breast cancer activism and shined a light on an often-grim reality for women, and more importantly – fought for the lives of women all over America.
Breast cancer was known as an unspoken affliction and altogether incurable along with nearly all cancers throughout the 20th century. It wasn't until 1913 when Elsie Mead and Marjorie Illig served in leadership roles of The American Society for the Control of Cancer (ASCC) that this hopeless view began to change. In their time in leadership, the two recruited thousands of women to raise funds to promote cancer detection awareness. The two tapped into the social elite to pool together their influence and, of course, their overflowing pocketbooks to hone in on cancer awareness. This set the social backdrop for women in healthcare reform who at last had something to do to help in the fight against cancer. At the time though, society's views on women, their role in society and their place in the family served as the bounds for women's advocacy.
Naturally, spreading awareness and taking action are two very different courses to take in the fight against cancer with the former involving quite a lot of fancy dinner parties, with little to no progress to show in the case of saving lives against cancer. In fact, the sole focus of the ASCC on spreading awareness with little to no action would be the provocation that would lead cancer activist Mary Lasker in 1943 to mobilize the ASCC to begin cancer research. This was for the sake of her housekeeper who at the time was diagnosed with uterine cancer. Through her activism Mary Lasker led an uproarious radio advertising campaign that led to a codified agreement between the Lasker family and the newly named American Cancer Society to devote no less than 25% of its budget to cancer research.
In 1952, Lasker again felt the devastating toll of cancer – and the lack of available treatments – when her husband passed away from cancer. This only further invigorated her passion and led her to lobby the government tirelessly for funding for the National Cancer Institute (NCI) and Richard Nixon's famous declaration of the “war on cancer” in his 1971 State of the Union Address. Lasker's efforts thrust forth in the political stage the voice of women and helped to change the role of women in healthcare reform from nearly voiceless campaigners who spread awareness and raised funds at soirees and fancy dinners to active participants with a voice, a seat and a microphone at a table of men who pulled the strings on healthcare.
Radical Mastectomies Meet Radical Feminism
The ACS up until recent years was dominated by surgeons, and mostly from New York where the ACS had its headquarters.ii In those years the treatment for Breast Cancer was simple – just remove the entire breast. Typically, if a breast lump was biopsied and was found to be malignant a radical mastectomy was performed and was deemed a life-saving procedure. A mastectomy, which is the removal of the entire breast tissue to remove any chance of cancer spreading, was the only known treatment for any indication of a malignant breast lump all the way until the year 1970. Today, a mastectomy is an extreme reserved for the rear-end of breast cancer treatments and that is in large part due to the advocacy of women during a time where the doctor's word was law.
In this time of little awareness and little research there was nary a thing that could be said against this course of action. It was in 1952 when cancer activist Terese Lasser went in for a biopsy of a malignant breast lump that breast cancer got its own special chapter in the story of women's healthcare reform. Lasser like nearly all other women at the time had her breast lump treated with a radical mastectomy, however it wasn't so much the trauma of having an entire body part removed that triggered her activism rather the cavalier attitudes of her doctors, and the lack of support after the procedure that led her to start the Reach for Recovery program in 1954.
The Reach for Recovery program provided support and reassurance for women with breast cancer – which shook up the patient-doctor relationships amongst many surgeons, some outright banning Lasser from their patients. However, the Reach for Recovery Program's triumph was in the encouragement it gave women to participate in their own health care, and this would eventually surmount into a number of historical events that would lead to much needed institutional change in women's healthcare
Our Bodies, Ourselves
The conversation Terese Lasser started would eventually set the precedent for more and more women to take an active role in their healthcare and question the grim future that lay ahead for what was a growing wave of breast cancer patients. Starting from 1975, The National Cancer Institute's projections on cancer prevalence demonstrates that cancer rates have only grown and will continue to do so for the foreseeable future reaching some 26 million people by the year 2040.iii The Harvard Gazette equates the growing number of cancer diagnoses in those under the age of 50 to the many lifestyle changes that have become routine throughout the modern era such as poor diet, sedentary lifestyle and increased alcohol consumption.iv Meanwhile a growing aged population means more opportunities for exposure to toxins, and the effects of poor lifestyle choices and thus meaning more and more cancer diagnoses for older people.v
From the time of Lasser's work going from patient-to-patient, women from all over the country banded together to organize and let their voices be heard. In the very same year as President Nixon's State of the Union Address came the 1971 publication of the Boston Women's Health Book Collective entitled Our Bodies, Ourselves which sought to lay a groundwork for women's health by using understandable language and laymen's terms for often ill-explained medical concepts that only a doctor could make sense of. This publication is widely recognized as the beginning of the women's health movement.vii Today, the publication has evolved, organized and mobilized an ever-expanding network of women's health organization that together continue to advocate for women in healthcare with one of their main areas of focus being breast cancer care and treatment.vii
This was only one of many writings that challenged surgeons and how they treated women with breast cancer. From then on, the discourse on breast cancer treatment reached into the upper echelons of society, all the way to First Lady Betty Ford who shared her diagnosis with the American public through televised events. Not too long after, Happy Rockefeller the wife of Vice-President Nelson Rockefeller, followed suit by disclosing her diagnosis to the public.
Breast Cancer Awareness Becomes Breast Cancer Activism
By the early 1980s breast cancer support groups sprang up throughout the nation each taking action at the grassroots level. However, this was not nearly enough to bring about the institutional changes needed in order to affect long-lasting change for women's healthcare. It would be Rose Kushner, a medical journalist, who would rally these organizations to form the National Alliance of Breast Cancer Organizations and pool together the necessary resources to garner support at the national level. Kushner's writings would develop into the framework for today's culture on how breast cancer is addressed in medicine. By calling into question the zeitgeist around women with breast cancer and her writings on alternative treatments for breast cancer she and the coalition empowered women to take healthcare into their own hands.
Through the pen, women changed America's view on breast cancer and women as a whole especially taking on societal views on women living with the aftermath of mastectomy. Andre Lord in her writings in The Cancer Journals would unite the narratives of women' healthcare and modern feminism by taking to task the American public and their views on the female body. She was critical of the assumption that a woman was not whole without a prosthesis or breast reconstruction after a mastectomy and folded in to the conversation the shame many women felt after undergoing treatment for breast cancer.
The grassroots movements, prolific writings by numerous breast cancer activists, and the space afforded to advocates by a number of high-profile women and socialites changed the face of the political scene. In May of 1991 the fight against breast cancer converged on Washington DC with the establishment of the National Breast Cancer Coalition with a goal to increase research funding for breast cancer access to health care for all women, and the influence of activists in breast cancer decision-making. By 1992, the number of women in Congress nearly doubled and along with them came the fight against breast cancer. Only a year later then president Bill Clinton was brought to the table along with the NBCC and created the National Action Plan on Breast Cancer that brought together policymakers, scientists, providers, and consumers to work to improve women's healthcare around breast cancer.
The Pink Ribbon
Today, Breast Cancer Awareness months turn the nation pink on an annual basis. We can thank Susan Komen for that – who took the idea from the hyper charged AIDS movement that used symbolism to rally the American public around the LGBT community.viii As the battle against breast cancer rages on it's important to give credit where credit is due, and for the month of October that goes to the numerous women who have fought for their women's place at the table. This introspection into the history of Breast Cancer Awareness will hopefully serve as a lesson to all about the importance of taking an active role in their health. Although it is always good to listen to your doctor, it's just as important to voice any concerns you may have regarding your health. After all, as amazing as your doctor may be, they're no mind-reader. Only by asking questions and taking full advantage of your rights and responsibilities as a patient will you be able to stay fully informed on your healthcare. So, take a note from some of Breast Cancer Awareness Month's greats such as Mary Lasker, Audre Lord, Rose Kushner and the like and don't settle for awareness, but take action on your healthcare.
- National Center for Health Statistics - Interactive Summary of Health Statistics for Adults 2019-2020
- Battling Breast Cancer. [Review of: Lerner, BH. The breast cancer wars: hope, fear, and the pursuit of a cure in twentieth-century America. Oxford University Press, 2001]
- Cancer Prevalence and Projections in U.S. Population from 1975-2040
- The Harvard Gazette: Dramatic Rise in Cancer in People Under 50
- Why does cancer risk increase as we get older?
- A historical Perspective on Breast Cancer Activism in the United States: From Education and Support to Partnership in Scientific Research
- Our Bodies Ourselves Today
- This Is What Breast Cancer Activism Looked Like Before the Pink Ribbon