The Politics of Cancer

The last thing someone diagnosed with a serious cancer wants to hear about is politics. It's bad enough to think that whether or not you will live to see your child graduate from college may depend on your grandmother's genes, or the cigarettes you smoked before you knew better, or work and living decisions you made before you knew the risks involved.

But politics? How well organized your fellow sufferers have managed to be? Whether there are enough folks who get the disease, survive it, feel well enough and possess the skills to raise money and launch a movement?

It shouldn't matter. This should be about science and professionalism, about national standards that can be followed even by more isolated doctors in rural areas. Yes, we all know that when it comes to surgery, it's important to find doctors who have performed more and not fewer, who are up on the latest advances, who practice at hospitals with state-of-the-art equipment. But the least you can expect to know, or find out, is that you should be looking for such a person.

For many years, women, underrepresented in government and business and science and the rest, were also underrepresented in the machinations of determining, when it comes to cancer research, the answer to the essential question of politics: Who gets what, when, where and how? "Men fund what they fear," former Congresswoman Pat Schroeder so famously said. And they didn't fear mastectomy — at least they didn't until voters put the fear of God in them.

Politics worked. One thing all women — conservative and liberal, Democratic and Republican — could agree on is that breast cancer is a scourge that touches all of us, in increasing numbers. We were mad as hell and determined that someone — everyone — do something about it. And we vote. So, too, for AIDS activists. Does anyone doubt that so many of our friends and loved ones would be with us today, living full and productive lives, without politics?

So what happened to ovarian cancer?

A report out this week, which hopefully will receive the attention it deserves (one reason among many that I am writing this), discusses the findings of a study analyzing the treatment and results of 13,000 women diagnosed with ovarian cancer between 1999 and 2006.

The network is an alliance of 21 leading cancer centers. The care I'm talking about here is not the "pushing the envelope type." It's not the experimental clinical trials that you only expect to find at major medical centers and that haven't yet been confirmed as safe and effective. No, I'm talking about the basic protocols, the "standard operating procedure," the care that every woman with such a diagnosis has a right to get and should get, the care that might allow her to see her children grow up.

Consider the numbers. Women who receive the care they should get are 30 percent more likely to survive than those who don't. Thirty percent. Among those (sadly the majority) whose cancer is not found until it reaches an advanced stage, 35 percent of the women who received the proper care survived at least five years, as compared with 25 percent who did not.

Your wife? Your sister? You?

These numbers are simply unacceptable.

I pay attention to ovarian cancer because a friend had it in her 30s. Most doctors don't recognize it at first. I pay attention to those stories: How do we get doctors to see that the kind of symptoms so often seen as typically female — the bloating and discomfort and cramping and the like — can be deadly? But the very notion that once diagnosed these women don't even get the standard treatment is nothing short of horrifying.

Do we really need another color of ribbon? Do we need someone to do for ovarian cancer what Michael Milken did for prostate cancer — that is, create a political movement around it? Why isn't it enough to hope that doctors doing their jobs, aided by a new health care act that will encourage electronic health records and allow for easier monitoring and comparisons on a large-scale basis, will solve the problem?

We headed to the barricades for breast cancer. Today, the experts are debating whether too many women are being screened and not too few. In my mind, that's progress.

It's time to do the same for ovarian cancer. Yesterday.

To find out more about Susan Estrich and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

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