There are countless privately directed cancer research foundations. They operate under the guidance of a donor, or under the guidelines established by a donor or board. Most of these do not seek supplemental income, and many operate off of the interest on the funds held by the foundation. Since these are essentially private funds, they have the right to direct them as they please. I assume these are not the foundations you’re concerned about.

However, when it comes to non-profit organizations, corporate foundations and the like, accountability is a challenge! Most cancer non-profits are monitored by the IRS and do adhere to the tax codes. Each non-profit files an annual 990 Form which discloses some of this information, but it is also easy to hide overhead in program lines, a smoke-and-mirrors game that makes them look like a much healthier organization than they are. I have concerns about the salary lines at the top of some organizations, as well as whether the money they distribute is consistent with their stated missions.

My goal is greater transparency. Non-profits who are truly in it for their mission should disclose, in plain English, how their money is spent. Any donor should be able to readily discern how much goes to direct service, overhead, research, etc, BEFORE a donation is made. Non-profits need to keep in mind that donors are significant stakeholders.

Another concern I have is the emergence of cause marketing. Countless companies now brand themselves with a high-profile non-profit, or use these partnerships to sell products. In this case, I believe every product label or advertisement should include the nature of the partnership (i.e. how much per purchase is donated to which organization under what circumstances). Caps on donations should also be disclosed, and again, the information about what is done with the money should be readily available (for example, by visiting a website that is also included in the advertising).

Until we have such a system, if I do not feel I can get the information I need to assure myself that their giving is in keeping with my priorities, I tend to give to local, direct-service organizations and local research foundations, where a personal relationship goes a long way to being able to follow the money.
There are countless privately directed cancer research foundations. They operate under the guidance of a donor, or under the guidelines established by a donor or board. Most of these do not seek supplemental income, and many operate off of the interest on the funds held by the foundation. Since these are essentially private funds, they have the right to direct them as they please. I assume these are not the foundations you’re concerned about.

However, when it comes to non-profit organizations, corporate foundations and the like, accountability is a challenge! Most cancer non-profits are monitored by the IRS and do adhere to the tax codes. Each non-profit files an annual 990 Form which discloses some of this information, but it is also easy to hide overhead in program lines, a smoke-and-mirrors game that makes them look like a much healthier organization than they are. I have concerns about the salary lines at the top of some organizations, as well as whether the money they distribute is consistent with their stated missions.

My goal is greater transparency. Non-profits who are truly in it for their mission should disclose, in plain English, how their money is spent. Any donor should be able to readily discern how much goes to direct service, overhead, research, etc, BEFORE a donation is made. Non-profits need to keep in mind that donors are significant stakeholders.

Another concern I have is the emergence of cause marketing. Countless companies now brand themselves with a high-profile non-profit, or use these partnerships to sell products. In this case, I believe every product label or advertisement should include the nature of the partnership (i.e. how much per purchase is donated to which organization under what circumstances). Caps on donations should also be disclosed, and again, the information about what is done with the money should be readily available (for example, by visiting a website that is also included in the advertising).

Until we have such a system, if I do not feel I can get the information I need to assure myself that their giving is in keeping with my priorities, I tend to give to local, direct-service organizations and local research foundations, where a personal relationship goes a long way to being able to follow the money.

Very interesting question, but I think it’s quite individual. Each of us carries our own sensitivities, and wherever those abut our questions it can be hard to address. For some it may be the sexual side effects of treatment, for others the “blame game” of whether cancer is “my fault.” If there is a universally difficult question, however, I would venture to guess it is about prognosis. While most doctors (I hope!) no long give cancer patients an expiration date (the proverbial “you have six months to live”), taking in information about the likelihood that we will survive is never easy. Its one of those things that we often don’t know if we want the answer to…
Very interesting question, but I think it’s quite individual. Each of us carries our own sensitivities, and wherever those abut our questions it can be hard to address. For some it may be the sexual side effects of treatment, for others the “blame game” of whether cancer is “my fault.” If there is a universally difficult question, however, I would venture to guess it is about prognosis. While most doctors (I hope!) no long give cancer patients an expiration date (the proverbial “you have six months to live”), taking in information about the likelihood that we will survive is never easy. Its one of those things that we often don’t know if we want the answer to…

The Department of Defense (DoD) distributes approximately $150M a year in congressionally directed breast cancer researching funding. In addition to the Breast Cancer Research Program, the DoD runs similar programs for a variety of diseases. The programs are designed to provide support of innovative, hegh-risk, high-reward studies. The distribution methodology for all of these programs provides for Consumer Advocates at all levels of the decision-making process, from establishing research priorities for the year, to reviewing each and every proposal, to the final funding decisions. As such, advocates sit on panels right alongside scientists, and have an opportunity to share their opinions, concerns and/or support about all of the projects under review. We are there to put a face on the disease and to bring survivor concerns to the forefront.

Consumer advocates (typically survivors themselves, although not necessarily) can apply directly to the DoD. In addition to your application, you must submit a recommendation from a “sponsoring” agency. Finally there is a brief interview that gives both the DoD and you a chance to address any questions you might have. If accepted, you will be assigned to the next available panel, along with administrative support, a scientific review officer and a consumer advocate mentor to help get you through!

While nothing more is required, if you do not have a medial or scientific background, understanding the proposals can be daunting. I personally suggest that applicants get some measure of background in the science side of breast cancer. The place I turned, and highly recommend, is the National Breast Cancer Coalition Project LEAD. You can find more here: http://www.breastcancerdeadline2020.org/learn/project-lead/


In addition to the inclusion of consumer voices, another hallmark of the DoD program is that all funded researchers are required to share their results at their Era of Hope Conference. It is a way to ensure that both promising results as well as “bad” results become a part of the knowledge pool.

While the DoD model has been implemented in may other grant settings, both domestically and world-wide, DoD remains the most highly sought and respected funders in breast cancer research. You can learn more about being a consumer reviewer for the DoD on their website: http://cdmrp.army.mil/cwg/default.shtml.
The Department of Defense (DoD) distributes approximately $150M a year in congressionally directed breast cancer researching funding. In addition to the Breast Cancer Research Program, the DoD runs similar programs for a variety of diseases. The programs are designed to provide support of innovative, hegh-risk, high-reward studies. The distribution methodology for all of these programs provides for Consumer Advocates at all levels of the decision-making process, from establishing research priorities for the year, to reviewing each and every proposal, to the final funding decisions. As such, advocates sit on panels right alongside scientists, and have an opportunity to share their opinions, concerns and/or support about all of the projects under review. We are there to put a face on the disease and to bring survivor concerns to the forefront.

Consumer advocates (typically survivors themselves, although not necessarily) can apply directly to the DoD. In addition to your application, you must submit a recommendation from a “sponsoring” agency. Finally there is a brief interview that gives both the DoD and you a chance to address any questions you might have. If accepted, you will be assigned to the next available panel, along with administrative support, a scientific review officer and a consumer advocate mentor to help get you through!

While nothing more is required, if you do not have a medial or scientific background, understanding the proposals can be daunting. I personally suggest that applicants get some measure of background in the science side of breast cancer. The place I turned, and highly recommend, is the National Breast Cancer Coalition Project LEAD. You can find more here: http://www.breastcancerdeadline2020.org/learn/project-lead/


In addition to the inclusion of consumer voices, another hallmark of the DoD program is that all funded researchers are required to share their results at their Era of Hope Conference. It is a way to ensure that both promising results as well as “bad” results become a part of the knowledge pool.

While the DoD model has been implemented in may other grant settings, both domestically and world-wide, DoD remains the most highly sought and respected funders in breast cancer research. You can learn more about being a consumer reviewer for the DoD on their website: http://cdmrp.army.mil/cwg/default.shtml.

My son is now 13 years old. He was three when I was first diagnosed. While every child is different, I can’t imagine that there is a graver concern that losing one’s mother. And sadly, there simply is no satisfying response. Ultimately, I believe we need to look for the related but unspoken questions our children have, and address those. Among the things that scare him about losing me, for example, is his fear that there will be no one to care for him. So while I can’t tell him I won’t die, I can assure him that we are thinking about these issues as well, and that we put a priority making sure plans are in place, and that he knows what would happen.

Kids make up all kinds of things…like a fear that cancer is contagious. The younger a child is, the more important it is to dig deep and help them ask their questions. For older children, their fear of asking questions is often related to hurting the parent’s feelings…for example if they are embarrassed that mom is bald. Here too, the most important thing we can do for our children is to assure them that there is an open door…and then make sure the door remains open. They take their lead from us, and when we are comfortable talking about things, they will feel safe enough to ask.

My kids were scared, particularly my daughter, who was 16 when I was diagnosed. I did a couple of things that I think were helpful to them psychologically.

One was that I took them to chemo with me one day, and while they were there, they met with the clinical social worker at the cancer center. I'm not sure what they discussed, but I think it was good for them to know there was someone they could call if they needed further support. And it was also good for them to see the very comfortable surroundings in which I was being treated and meet the competent, loving people who were caring for me.

The second thing I did was give them tasks to help me out. My son, who had given saline injections to his cat, came over the day after chemo to give me Neulasta shots. The shots, which came in prefilled syringes, were very expensive, and I was worried I would botch it. And he was very good at it!

My daughter's task was to tackle her schoolwork without being nagged. Her grades went from mediocre to excellent within a few months. I think my cancer diagnosis is one reason she got into a competitive college! Also, when my nails grew back after falling out during chemo, she undertook to extricate them from the callus and maintain them. There is nothing a teenage girl does better than mani/pedis!

Allowing my kids to help me made them feel more in control, I think. And of course, I was grateful for the assistance they gave me. I don't have a lot of positive cancer memories, but I do think back fondly about the roles my kids played.

I'm not sure that fear ever goes away. No matter how far out we get, no matter how many clean scans, it lurks in a closet waiting...

I agree with everything written: make the healthiest choices possible and embrace the moments we have. The only thing I might add is to give yourself permission for the rough days. For me it was often a scan or test that yanked the fears out of the closet and demanded I confront them. It's so very normal to be afraid, and the only way to deal with it sometimes is to walk through it. Remember there was a day when an initial diagnosis was your greatest fear, and you had the strength to manage it, overcome it, and move on. Trust in yourself that while it's okay to be afraid, should you ever need to, you have the inner stregnth to do it again. I am sure I am not alone in saying that my greatest fear is of recurrence. That is a reality we live with post diagnosis.

The way I deal with this is by identifying the factors which are in my control and being proactive in these areas. For example, I know that women who exercise have a statistically lower probability of recurrence. So I ensure that I exercise regularly. I swim daily before work and work out 2 - 3 times a week.

I also ensure that I have a sensible work life balance. While I am happy to work extra hours at times of extra need, I am clear that leisure time is not a luxury, it is critical to my physical and emotional well-being. I also highlight that of course this makes me more productive!

I make a point of doing things in my spare time which I enjoy. This enhances my leisure time but furthermore distracts my mind from fearful thoughts. Meditation also helps to channel my thoughts positively.

Additionally, it is important to be vigilant and educated about signs or symptoms which I should have checked by a Doctor. Connected with this is the reassurance (and inevitable stress) or regular and thorough monitoring checks and scans.

In summary, I believe that this is about taking control over those factors within my control.

I was so lucky...I had a team of doctors who were very forthcoming in providing information I would need, so it's actually hard to say. I was also pre-menopausal so the options for hormone therapy were clear - tamoxifen was and remains the gold standard. I can tell you, however, that when I was diagnosed there wasn't talk about luminal A vs. luminal B vs. other cancers. I'm not sure when those categories came into view, but at the time Herceptin was new and Arimidex was just emerging from clinical trial (I THINK I have my timing right - please correct me if I'm wrong!) I'm obviously not a doctor, and I'd love to have one jump in here...

However, even today, the issues that remain for me revolve around what I can do to keep myself healthy. The challenge is that there is STILL so much we don't know about hormone status and also importantly, what in the environment (using that term loosely) impacts hormone levels. Since my treatments, hormone replacement therapy (HRT) is OUT. I've yet to hear a final word on soy. Obesity and wine both produce estrogen. On the other hand, hormone-free animal products, from meat to milk, are widely available.

And then, we can rest assured that another threat is around the corner. As an example of what it lurking, I offer the pesticide atrazine. I was at a program run by the California Breast Cancer Research Program, with a primary focus on the role of the environment on breast cancer. It was there that I learned about atrazine, used particularly on corn (which is, of course, ubiquitous in today's ready-to-eat world of processed foods). According to studies, atrazine has not only led to the development of ovaries in male frogs, but those frogs have actually been able to reproduce (http://www.livescience.com/10957-pesticide-turns-male-frogs-females.html).

I'm not sure I answered your question directly and sadly, there remains so much we don't know. For what it is worth, I work hard at finding that balance between remaining aware and vigilant, with embracing a full, rich life. I was so lucky...I had a team of doctors who were very forthcoming in providing information I would need, so it's actually hard to say. I was also pre-menopausal so the options for hormone therapy were clear - tamoxifen was and remains the gold standard. I can tell you, however, that when I was diagnosed there wasn't talk about luminal A vs. luminal B vs. other cancers. I'm not sure when those categories came into view, but at the time Herceptin was new and Arimidex was just emerging from clinical trial (I THINK I have my timing right - please correct me if I'm wrong!) I'm obviously not a doctor, and I'd love to have one jump in here...

However, even today, the issues that remain for me revolve around what I can do to keep myself healthy. The challenge is that there is STILL so much we don't know about hormone status and also importantly, what in the environment (using that term loosely) impacts hormone levels. Since my treatments, hormone replacement therapy (HRT) is OUT. I've yet to hear a final word on soy. Obesity and wine both produce estrogen. On the other hand, hormone-free animal products, from meat to milk, are widely available.

And then, we can rest assured that another threat is around the corner. As an example of what it lurking, I offer the pesticide atrazine. I was at a program run by the California Breast Cancer Research Program, with a primary focus on the role of the environment on breast cancer. It was there that I learned about atrazine, used particularly on corn (which is, of course, ubiquitous in today's ready-to-eat world of processed foods). According to studies, atrazine has not only led to the development of ovaries in male frogs, but those frogs have actually been able to reproduce (http://www.livescience.com/10957-pesticide-turns-male-frogs-females.html).

I'm not sure I answered your question directly and sadly, there remains so much we don't know. For what it is worth, I work hard at finding that balance between remaining aware and vigilant, with embracing a full, rich life.

Just as our kids are all different, so too are the ways in which we need to approach them. Ten years ago resources were hard to find, and I can clearly recall sitting on the floor at Barnes & Noble crying because I had no clue what to say to my 3 1/2 year old son. However...I came up with something that he could really understand and opened the door to all our future communication.

There are two things that I advise clients.

First, help your children, no matter what age, find reliable resources. It is all but impossible for a child to has his or her parent if she is going to die...and yet with cancer, that is what most children worry about above all else. Frankly, some of us don't want to confront that question ourselves. But giving kids other places to turn - a school counselor (who you've pre-informed!), your doctor or nurses, a family member or friend who offers to help, another child who has gone through this, AND the access to age-appropriate, reliable web sources, can help empower them to find answers to the questions that are keeping them up at night.

Second, answer every question directly, and carefully! I know others differ in their opinions, but I personally believe that kids deserve answers. This is happening to them too! And when you go from one voice mail a day to 30, they know something is up (btw, either send your calls to a cell phone or set your answering machine so that incoming messages cannot be heard as they are being left, especially if you have young kids!). At the same time, I personally, was cautious to be careful with my answers. My son DID ask if I was going to die...and I didn't know. As important as it was to reassure him, I also could not make a promise I couldn't keep -- and leave he and dad with that baggage. My mom actually came through with the answer to that question: "We have a whole team of people working very hard to make sure that doesn't happen." (Thanks, Mom!)

Hi,
I do not have children but in my work with breast cancer patients the feedback that I have heard from them is that Gilda's Club has a wonderful program called Noogie Land. They have great programs for children with cancer and programs with children who have a parent or sibling with cancer. There are also many books addressing this problem that you can read with your children depending on their age. One thing a patient reported to me is that she did not tell her daughters in the begining but the children knew something was wrong and ended hearing second hand and it was not a good situation. I guess it a person personal decision but I do think that kids are smart and if they sense that something is going on and not know what it is their imagination might cause fear and upset. Many hospitals have social workers or therapists that might help figure out the best way to deal with this tough situation.

It's a great question! To address first the issues of having lobular, I'm not sure I ever did find anyone else with it, nor do I think it mattered much since the treatment protocols are similar to those of patients with invasive ductal carcinoma. (Today they are often classified together as Luminal A, Luminal B, and so on anyway.)

As for where I turned, I think the most significant issues for me related to having been diagnosed at a relatively young age. My first concern was helping my son understand what was going on, and that took resources with particular knowledge, that frankly I did not find early enough. Today things are much better in that regard!!

As for my own support...my friends and family stepped up in truly moving and inspiring ways. In addition to a husband who never left my side, I had a tight circle of friends who were there for me each step of the way. That said, sometimes we need people who have "been there" when it comes to cancer...

One of the very best resources I found was the online community at the Young Survival Coalition (http://www.youngsurvival.org/). In addition to being a great place to ask questions (Talk About Health wasn't around!), the women there fully understood the complexity of parenting through cancer, feeling "too young," facing fertility issues, the limited treatment options for pre-menopausal women, building a career through cancer and so on.

Sometimes, after treatment, there is a drop that patients experience, and that was when I sought a local support group at weSPARK (http://wespark.org/). It was as inviting as walking into someone's living room, with services that ranged from traditional support groups to reiki, tai chi, meditation and reflexology, to support groups for my husband and son. They even have a gym next door that helps support women thought treatment and recovery! They also gave me the chance to "pay it forward" though support groups and scrapbooking classes I was able to lead.

Unfortunately they can be hard to find, but there are some amazing resources out there...and the online community makes them accessible, even for people in the most remote of areas. It's not always easy, especially as women, to acknowledge that we can't do it all alone. I try to remind women that in this, like it most things, we do best when we are in community...that seeking support is not "taking" but a process of give AND take. It's a great question! To address first the issues of having lobular, I'm not sure I ever did find anyone else with it, nor do I think it mattered much since the treatment protocols are similar to those of patients with invasive ductal carcinoma. (Today they are often classified together as Luminal A, Luminal B, and so on anyway.)

As for where I turned, I think the most significant issues for me related to having been diagnosed at a relatively young age. My first concern was helping my son understand what was going on, and that took resources with particular knowledge, that frankly I did not find early enough. Today things are much better in that regard!!

As for my own support...my friends and family stepped up in truly moving and inspiring ways. In addition to a husband who never left my side, I had a tight circle of friends who were there for me each step of the way. That said, sometimes we need people who have "been there" when it comes to cancer...

One of the very best resources I found was the online community at the Young Survival Coalition (http://www.youngsurvival.org/). In addition to being a great place to ask questions (Talk About Health wasn't around!), the women there fully understood the complexity of parenting through cancer, feeling "too young," facing fertility issues, the limited treatment options for pre-menopausal women, building a career through cancer and so on.

Sometimes, after treatment, there is a drop that patients experience, and that was when I sought a local support group at weSPARK (http://wespark.org/). It was as inviting as walking into someone's living room, with services that ranged from traditional support groups to reiki, tai chi, meditation and reflexology, to support groups for my husband and son. They even have a gym next door that helps support women thought treatment and recovery! They also gave me the chance to "pay it forward" though support groups and scrapbooking classes I was able to lead.

Unfortunately they can be hard to find, but there are some amazing resources out there...and the online community makes them accessible, even for people in the most remote of areas. It's not always easy, especially as women, to acknowledge that we can't do it all alone. I try to remind women that in this, like it most things, we do best when we are in community...that seeking support is not "taking" but a process of give AND take.

I have a friend who was recently diagnosed with a daughter who is also 15. I think most of us consider ourselves immortal until our own parents become ill or die...it is VERY hard to face that prematurely, especially when you are just finding your own wings. Moreover, I can only imagine how this plays out for a young woman emerging into her own sexuality. Quite a lot to process, I would think. Kudos to you for sticking with it. The same year I was diagnosed my son had a classmate who's mom had melanoma, and they never told the child. A year later they left the school to make sure that she never found out. While I do know we each need to process things in our own way, I will likely never understand her choices, or what her kids thought of all the phone calls, surgery, bald head, etc. that seems to come hand in hand with having cancer.

About a week after my diagnosis I saw my "tune up" therapist. I was still dumbstruck by it all, and feeling a little "why me-ish." He looked me in the eye and remind me that the only thing that had changed was my awareness. The cancer had been there months, probably years, prior. With this new awareness, however, came the power to DO SOMETHING. He is awesome... My favorite thing so far was to experience how loving and supportive people all around me have been... so different from day to day life pre-cancer!

I agree that, for me personally, this was as much a psychological issue as anything. Yes, I believe I got a better cosmetic result which was a bonus, but having had lobular, it was my understanding that there was a higher rate of occurrence on the prophylactic side (Docs, is this still what the studies are saying? I haven't kept up on that one!) Like Elyn I was young (35) with a 3 1/2 year old so my decision. On the other hand, I tested BRCA negative. The good news for me is that while we know there are no guarantees, my pathology in the "healthy" breast was not good, so no regrets. However, what I was unable to take into account is what it would mean down the road to have lost both nipples and almost all sensation in both breasts, and that loss is often part and parcel with intimacy. YES, I am glad to be alive, and yes it was a price worth paying. But I might have processed it differently at the time, and involved my husband in more of the decision, had I thought that part through... If the woman is young (i.e. pre-menopause) and has any family history of breast, ovarian or prostate cancer (on the maternal or paternal side of the family), she should consider genetic counseling and testing. Genetic testing can determine if she carries an inherited genetic mutation that caused her cancer. In that case, a bilateral mastecomy is recommended because her chances of getting cancer in the unaffected breast are very high.

The FDA recommendation re:Avastin is not about whether it will continue to be available for treatment of metastatic breast cancer. Since the drug is prescribed for treatment of other cancers, physicians will be able to prescribe it "off label" for breast cancer as well. The issue is largely one of health care coverage. Avastin runs as much as $8000/treatment, and without insurance coverage that is likely to be prohibitive. While, I have heard that Genetech is looking at capping fees at $55,000/a year, that is still WELL beyond the reach of most of us.

A related issue, as Dr. Attai discusses elsewhere, is the need to focus energy and funds on better understanding which drugs will work in which patients with which cancers, so that we can get Avastin to the right patients, and protect the ones who could be harmed. The FDA recommendation re:Avastin is not about whether it will continue to be available for treatment of metastatic breast cancer. Since the drug is prescribed for treatment of other cancers, physicians will be able to prescribe it "off label" for breast cancer as well. The issue is largely one of health care coverage. Avastin runs as much as $8000/treatment, and without insurance coverage that is likely to be prohibitive. While, I have heard that Genetech is looking at capping fees at $55,000/a year, that is still WELL beyond the reach of most of us.

A related issue, as Dr. Attai discusses elsewhere, is the need to focus energy and funds on better understanding which drugs will work in which patients with which cancers, so that we can get Avastin to the right patients, and protect the ones who could be harmed.

As a young survivor, diagnosed at 35 on a baseline mammogram, I know how heart-wrenching this debate can be. Unfortunately, the value of any given tool can't be measured by anecdotal evidence. Mammography is, for now, the best we have and yet it has serious limitations. We have to use it wisely. Take, for example, the number of young women who have been diagnosed with DCIS (ductal carcinoma in situ - a Stage 0 pre-cancer). Once found, it can hardly be ignored. But when these women opt for prophylactic bilateral mastectomies to ward off the POSSIBILITY of cancer, it troubles me. It is an example of how "catching it early" isn't necessarily improving quality of life at all.

Obviously when a woman (or a man, for that matter) has a family history of breast cancer, we want to be more aggressive in screening (though we must remember, too, that only about 5% of breast cancer appears to be hereditary). In other circumstances, the appropriate use of screening mammography has yet to be established. The most recent review of the literature points to a more conservative approach. Moreover the risks extend far beyond radiation exposure to the impact of false-positives, false-negaives and long-term anxiety, to name a few.

Ultimately, rather than argue for universal screening, I believe that we, as patients, need to accept shared responsibility for working with our doctors to determine the best possible screening schedule, based on the current science, our family histories, and our personal needs... I'd like to answer this from a different approach. Mamograms save lives and the quality of lives (i.e. caught earlier, less surgery, less toxic treatments). My mother was diagnosed in 95, but it was not a mamo that found her cancer...by time it was found the cancer was not in her breast, it was in her nodes (no breast surgery was done, details uncertain). However, two of her four daughters felt that mamos were not worth the risk. It was not until I was diagnosed with early stage that they could fully apprecitate the benefits of mamogram, as it was mamo that found my cancer. Yes, I do understand and fear radiation, however, the cost is too great to pass up on screening. I am excited that thermography is becoming more widely recognized....hopefully in the future this will be an option for all. Please, I urge you...get screened.

more...Yes, I agree with both of you. I am not certain that early detection always saves lives, and I am sure that in many cases, the body might have been able to elimate the cancer cells naturally, without intervention. So yes, the debate goes on....and coming from a person who often refuses dental x-rays, I look forward to the day that prevention and "cures" do not increase our risk for disease. One thing I will say in support of early detection is that often the remedy does not require toxic chemo and damaging radiation, and the misery and damage that goes along with them. In the meantime, I hope we can guide women to make the best possible choices for prevention and detection.