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HLTC02H3 (51)
Chapter 15&16

HLTC02 CHAPTER 15 & 16 NOTES.docx

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University of Toronto Scarborough
Health Studies
Joseph Bryant

Chapter 15 : Breast Cancer: Lived Experience and Feminist Action Risk factors:  The lifetime risk of getting breast cancer in Canada is one in nine. Being a woman is the biggest risk factor (only 1 or 2% of cases are in men).  Increasing age is biggest risk factor for 85% of women.  Not having children  Late first pregnancy  Greater number than average menstrual cycles  “life style” factors such as high-fat diet, being overweight and excessive drinking  Presence of environmental (including work place) carcinogens Statistical Facts:  Higher incidence in professional women is explained delayed childbirth or no childbirth  Although genetics is assumed to be a major factor, only 5-10% of breast cancer cases are explained by genetics  Fewer women are dying from breast cancer in Canada. mortality fell by 15% in the 25-year period to 1998.  However, morality rates in Saskatchewan is 22 deaths per 100,000 women and 29% in Nova Scotia, Newfoundland, and Labrador.  Canada does not keep a registry of race and ethnicity of women with breast cancer. In the States, it has been found that women of colour are at are lower risk of receiving breast cancer diagnosis than white women although their mortality rate is higher (particularly in African American women).  Poorer women are at a lower risk than women of higher economic class but their mortalities are higher. Women’s Experience of Breast Cancer Women’s lived experiences with breast cancer have been ignored or trivialized, overlooking the use of documenting and making sense of experience and diversity of experience to make social and political transformations. The author of this section uses results from her own and another focus group to explain women’s experiences in their own words. The first focus group comprised of women who are mostly working-class, white and all self-identified as heterosexual. Initial diagnosis  The women described themselves as “devastated,” “fear-stricken,” “gutted” and “terrified” by the news.  Disorientation and disbelief is common placeRelationships  Women in the Wilkinson’s study were often worried about the reaction of others.  They were careful about their timing in sharing the news.  Often downplayed their condition when they told others.  Almost three-quarter of participants felt others feared and avoided them.  Husbands were described has having a very difficult time coping with the news.  Lesbian partners may face additional difficulty under the pressure that as women, they should be more understanding. The news also evokes the realisation that the same could happen to the female partner. Treatment and appearance concerns  Lumpectomy, mastectomy and tamoxifen  Not being able to wash for several weeks after therapy, radiotherapy burns the skin, night sweats, etc...  After mastectomy, women felt “less of a woman,” “deformed,” and unwanted by men.  Homosexual women were often told they “don’t need” their breasts since they don’t need to attract/satisfy men and don’t need to breastfeed.  Lesbian participants explained, however, the significance of breasts in their sexual lives. Life Changes  Many women’s outlook of life changed after being diagnosed with breast cancer  Decided to do more and enjoy life. Emphasized the “urgency of life.” Politics of breast cancer: Art, Anger and Activism  Appearance, rather than survival is emphasized in cultures where women’s worth is measured by the size  Doctors reproduce this notion, seeking to do mammplasty (silicone breast implants) on women. Around the WWII, surgeons even invented “hypomastia,” disease of small breasts.  Breast cancer is also commercialized and infantalized by selling ultra-feminine pink ribbons. Not nearly as much attention is being given to environmental and pharmaceutical risk factors.  Feminist breast cancer movement started in the U.S in 1970s. Have campaigned for increased research, funding and improved health care facilities. Providing Support  Smaller networks in Canada, like everywhere, concentrated in urban areas.  Issue in meeting diverse needs of women.  Dragon boating exercise of the upper body has been found useful in women with breast cancer. This initiative is now joined by more than two dozen women in CanadaCampaigning for resources  Lack of funding is a major issue in breast cancer research and health-care facilities.  Activists compare breast cancer mortality of over 4,000 women 1987 to HIV mortality of 417 people the same year  Art being used to celebrate struggle against breast cancer. The Life Quilt for Breast Cancer. Exposing the link between profit and risk  The breast cancer “industry” is very lucrative. Drugs, radiotherapy, mammographic screening services account for about US$16 billion in a year in the U.S.  The primary sponsor of Breast Cancer Awareness Month, AstraZeneca, produces the estrogen- blocking drug Tamoxifen (widely used in breast cancer treatment) and herbicides, fungicides and carcinogen acetochlor (third-largest source of airborne carcinogenic pollution in the U.S.).  Tamoxifen was clinically studied for its ability to prevent cancer in high risk women but this “hype” has been contested by others who said it could actually have debilitating side effects like mimicry of menopausal symptoms, uterine cancer, blood clots in the lung and stroke.  Tamoxifen annually makes US$265 for AstraZeneca  Raloxifen now being tried as a preventive drug (under the claim that it has less sideeffects than Tamoxifen). There is no placebo group in this research.  The idea of “high risk” women mainly defined by who has a relative with breast cancer. Making social transformation in breast cancer requires doing a political analysis of women’s lived experiences. So much more is needed in terms of research, education, support, resources and advocacy. Yet the causes of breast cancer is not clear, many women are exposed to unnecessary risks. Chapter 16. The change in comparison of the dangers of hormone replacement therapy in profit verses the national health care delivery system.
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