Monday, January 16, 2012

For The Cure, Or Not?

The following print advertisement appeared in the January/February 2012 issue of the Brown University Alumni magazine.  Beneath the title, which read "Every 74 seconds a woman dies of breast cancer", was the following text:

The first item that struck me, in the above advertisement, was the logo.  Where's their famous strap line, "for the Cure"?  Compare to the logo at left that currently appears on Komen's website.

Does the dropping of the strap line represent yet another rebranding effort for the Komen organization?  Are they seeking to take the emphasis off being for the cure, in order to lower the public's expectations and avoid the criticism by the likes of the "Grumblers" with respect to Komen's spending priorities, specifically the relatively low amount allocated to research?

If this omission of the strap line does indeed represent a rebranded logo, then I have to wonder where the last thirty years and over $2 billion of funds raised actually went?  Is Komen finally admitting that funding research will never be their top priority, and that a reach-for-the-stars strap line is simply not delivering the kind of success metrics donors and the public alike might be starting to look for?

As I said I don't know if this a rebranding exercise.  Or whether Komen just picks and chooses which logos to use depending on the publication, but I'm keeping my ear to the ground on this one.

Next I looked at the text of this advertisement, which, as usual,  is full of decontextualized factoids and sound bites.

"Last year alone we funded more than 700,000 breast screenings"

To this factoid I say, so what?  Is the number of breast screenings the metric which Komen uses to define its success in early detection? Wouldn't a better metric be the number of deaths that were prevented as a direct result of screening and so-called early detection?  Trouble is, this kind of metric could only really be proven if the person screened ultimately died of something other than breast cancer, and would require a long-term research study.  As we know, people who are diagnosed early can still go onto develop metastatic breast cancer.  In fact, I personally have met a number of women, originally diagnosed at Stage 0/I, for whom this happened.

So of the 700,000 screenings, it would be far more useful to know how many women were diagnosed with invasive cancers? How many of women went onto develop metastatic breast cancer?  How many lives were really saved out of the 700,000 screenings?   Only then can the donating public really understand whether the "700,000 screenings" indicates a level of success worth investing in.

Recent studies have suggested that breast cancer screenings can result in a 20-30% reduction in breast cancer mortality rates.  But as Gayle Sulik, author of Pink Ribbon Blues aptly points out;

If the reduction in mortality is only 30 percent or less depending upon the country, the context, the follow-up, the level of expertise of providers, and the individual profiles of the women (and this is a short-list of just a few caveats), then what are we doing for the remaining 70 percent? [Editor: Emphasis added]

For the world's largest breast cancer organization to crow about 700,000 screenings without providing relevant success metrics is simply not good enough.

"We helped 100,000 people financially through treatment" 

In 2010, Komen spent about $20 million or 5% of their budget on treatment.  For 100,000 people helped, this equates to about $200 per person.  Whilst any money is good money to those in need, realistically $200 would pay for about fifteen minutes of consultation time with an oncologist.  I've been in treatment since 2004.  My first year alone, I paid close to $10,000 in charges that my insurance didn't cover.  What if I didn't have insurance?  $200 would be nice, but it certainly wouldn't even scratch the surface in terms of financial help for treatment.

Given that poverty has been associated with higher cancer mortality, I would argue that treatment assistance should be much higher in Komen's spending priorities, not the lowest as it currently is now.

"We educated millions about breast cancer"

Yes, to the tune of $141 million in 2010.  $141 million or 37% of Komen's annual budget, and Komen's number one spending priority by far!

Compare Education spending to their other allocations.  Extraordinarily high.

"We invested $66 million in breast cancer research and related programs"

It's interesting that this is the only dollar amount mentioned in the ad copy.  And yes, $66 million is a lot of money, but when compared to Komen's total revenue of $389 million in 2010* , and the amount spent on education, it's clear that research comes up far short in terms of priorities.

And perhaps more so in the future if Komen is indeed no longer interested in being for the cure as the ad logo would suggest.

* Note that 2011 financial statements are not yet available.


Given Komen's relentless pursuit of the almighty dollar, and its almost megalomaniacal status as the world's leading breast cancer organization, is it not time for Komen to be more transparent about where it's future priorities lie and how it evaluates it's success? 

Don't we, as the donating public, deserve better?   

Come on Komen, what's your plan for the next $2 billion, and if you are no longer for the cure, then what are you for?

Monday, January 9, 2012

2012, With No Apologies to 2011

We're well past January 1st, and I thought by now I'd have something meaningful and inspirational to say.  The blogosphere has been ripe with posts of self-reflection, transcendence, gratitude, resolutions and three words to guide us for 2012.

As for me readers, I've got nothing.  Except if you count the phrase "I'm still here" after my own annus horribulus in 2011, as my important three words.  Yes, that will do.

I also kicked off the new year with an invitation to my 25th high school reunion in November, of which my first thought was not "Do these jeans make me look fat?", but rather "Will I make it?", and by that I don't mean with some long-lost high school paramour.

That's the thing about metastatic cancer.  I'm feeling pretty good right now, even in my one-handed chemo-fogged state, but with the disease at this stage, you never know what fun is just around the corner.  The game can literally change overnight.  And I don't say that from a hopeless kind of perspective. In fact I'm far from feeling like that, it's just simply fact.  You never know.  [Editors Note:  Please don't come at me with the "hit-by-a-bus" analogy unless you want a serious tongue lashing].

Anyway I think I'll RSVP to the reunion with a "Yes! So long as I'm not dead or otherwise indisposed with collapsed lungs, chemo sickness or some other cancer-related crap".

So what I do I want for 2012?

Above all, medical stability.  Medical instability of the cancerous kind is highly inconvenient, especially with all the travel I dream of catching up on this year.  It's also not a good look for a high school reunion.

Secondly, I'd like to resurrect my Can-Do Women blog.  I was off to a really good start in the first half of 2011, then medical instability for the second half sent that priority to the bottom of the pile.  Incidentally, I'd welcome contributors to that blog if anyone feels so inclined.  Check it out.

Third, I resolved before Christmas to give my local in-person support group another chance.  I went to one session in December and of course I hated it.  One too many narcissists who love the sound of their own voices for my liking.  Huh? Bloggers, narcissists?  Noooooooooo.  Anyway, I've decided to give it a couple more attendances, and if nothing else I'll view it as an unacademic social experiment which should provide ample blogging fodder for the foreseeable future.  Unless Lucy Loudmouth decides to shut her mouth and let someone else talk, or I grow some balls and tell her to shut the hell up.

I also might try working on this "gratitude" thing that everybody seems to be buzzing about, even though the words gratitude and cancer don't go together in my mind.  Unfortunately, I tend to misbehave with exercises like this.

I'm GRATEFUL that I have at least one working hand.

I'm GRATEFUL that metastatic cancer is such a pile of crap that at least I have something to blog about.

I'm GRATEFUL that my dog only rolls in skunk excretions once a week.

I'm GRATEFUL that I have so little wherewithal to do much of anything around the house that it gets me out of all the chores I hate (with apologies to Beloved).

I'm GRATEFUL that so many breast cancer organizations are a waste of space, and that I still possess the energy to bitchblog about them.

I'm GRATEFUL that I still have blog readers despite my penchant for sacrilegious snark.

And with that dear readers, I'll leave you with these wise words and wish you all a Happy, Peaceful and Medically Stable 2012.

"Never go to a Doctor whose office plants have died" (Anonymous)

Th 80's have a LOT to answer for!