A few months ago, I was at a lunchtime fund-raiser for Gilda’s Club, a support organization for those living with cancer, when I heard Good Morning America's news anchor Amy Robach describe her own recent brush with breast cancer. It’s a story she’s rolled out in television interviews and in talks like this one, and it’s a story about cancer that is both wrong and hurtful.
I should know. I’m a doctor at a cancer hospital, so I’ve taken care of many patients who have breast cancer. I run a group that does health-care-policy work, so I know how patients with cancer get treated. I have led cancer guideline panels and advised organizations that set the standards for cancer screening and overall care. And my wife died of breast cancer a few years ago.
Every inch the network TV star with four-inch heels, runway model legs, a Mentos smile, and a light southern lilt wrapping broadcaster’s diction, Robach was off track right from the start. A mammogram saved her life, she told us. But that is not something she could possibly know.
Decades of research show that most women, if they get proper treatment, are going to have the outcome they’re going to have, whether their cancer is found by mammogram or another means. Mammograms will shift a few to a better outcome. Some experts say about one in five deaths from breast cancer are stopped by mammograms. But others say it’s closer to zero. The stance of United States Preventive Services Task Force is that starting mammograms at age 50 is utterly reasonable, as is doing them only every other year.
Even starting then, only one in 200 women who is regularly screened over ten years will reduce their risk of dying from the disease. Some organizations, such as the American Cancer Society, are more aggressive, advocating for starting at age 40 and screening every year. The organization acknowledges that only an additional 1 in 2,500 women will reduce their risk by starting so much earlier. In a magazine interview, Robach, who is 40, trampled over this rich debate: “Get screened. Every year. No excuses.”
But the effectiveness of mammograms isn’t the only thing Robach got wrong in her talk. She went on to tell us about having her healthy breast removed along with the one that had cancer, labeling it “the most aggressive treatment.” She told People magazine that she went this route because she wants to be around for graduations and grandchildren. But women at average risk of breast cancer (i.e., who lack the genetic defect that Angelina Jolie carries) increase the likelihood that they are alive in 20 years by less than one half of one percent through the surgery Robach chose. No expert or guideline advocates Robach’s choice as the standard for care; many warn it is inappropriate.
Her misinformation didn’t surprise — “Get screened” is an easier message to comprehend than the complex tradeoffs of the actual disease. What did surprise me is that these arguments were being made by a journalist whose job should be to appreciate and explain nuance, not look away from it.
Robach’s core thesis also troubled me. “I kicked cancer’s butt!” she told us, hitting each syllable, pausing for applause. She recently buttoned an interview with the phrase “Fight like a girl!” Using the pugilistic "fight metaphor" is nothing new — the American Cancer Society has a sword in its logo. So I shouldn’t have even blinked. But I winced.
If Robach kicked cancer’s butt, then what about the 40,000 women this year who will die of breast cancer, just like my wife did? In Robach’s lexicon, they must just not be up to the fisticuffs, to taking the schoolyard bully outside and showing him a thing or two about standing up for oneself. They must be dying for their lack of fortitude.
I started wondering if Robach thinks breast cancer is a zero-sum game where survivors are all Muhammed Alis, summoning the strength to rise from their stool for one more round in Manila, while those who die are all Joe Fraziers, just too fatigued and dehydrated to get up one more time; a deterministic world, framed by a medieval notion that ascetic denial and self-mutilation are guarantors of salvation, while all other paths lead to agony.
All told, that world view is damaging. I basically agree with the American Cancer Society's recommendations — but by claiming that a mammogram saved her life, Robach implies that those women who are now dying of the disease and did not have a mammogram before age 50 have only themselves to blame, even though many organizations say they made a reasonable choice. And those who did not have their healthy breast removed when they were diagnosed? They just don’t care enough about their kids, even though no expert would recommend the surgery she had.
Picking through my lunch entrée, looking around the room, I realized Robach had clearly missed the point of that day’s lunch: To raise money for Gilda’s Club, as in Gilda Radner, as in the woman who died tragically of ovarian cancer 25 years ago. The club is a sanctuary where people suffering from cancer can connect with others experiencing similar plights. It’s full of Joe Fraziers, who go to share in their loss and fears; to feel less alone; to play card games.
Families can attend meetings and support groups; children of those with cancer go on field trips and participate in “Noogie Nights.” It is a place suffused by joy and tinged with sadness, because the simple truth is that many of its guests are having their butts kicked by cancer, not the other way around.
In her interview in the magazine of the Federal Government’s National Institutes of Health, Robach declares that “there are nearly 2 million breast cancer survivors in this country, and we are thriving, excelling, living." Later in the article, she promises that having breast cancer leaves you stronger. Damn near invincible, actually.
But what about those women who now have heart disease or disabling limb swelling from their treatment? Are they thriving? Among these 2 million survivors she lists, does she know sprinkled among them are thousands and thousands who have metastatic disease and are terminally ill? Leaves you stronger? WTF?
I wish for Ms. Robach a long, joyful, and healthy life. I hope she never needs Gilda’s Club. But unlike Robach, I know as a doctor and a spouse that the disease has a lot more control over the person’s fate than the other way around. Positive attitudes are great; receiving appropriate care is critical. But if you want to understand cancer, you have to first understand that the die is often cast well before any doctor finds the first patch of mutated cells.
I know of what I speak. My wife also looked great in heels.
Most Viewed Stories
Mary-Kate Olsen Strains Every Muscle in Her Face in an Attempt to Smile
The Fashion Executive Who Doesn’t Wear Underwear on Dates
25 Famous Women on Being Alone
22 Intimate Lost Photos of Marilyn Monroe
Prince George Has No Time for Justin Trudeau’s High Fives
How Angelina Jolie Won the First Big Battle in Her Divorce
It’s Time to Get Over Your White Feelings and Start Taking Action for Black Lives
The Will & Grace Reunion Was Intensely Documented for Social Media
Madame Clairevoyant: Horoscopes for the Week of September 26
All It Took for Anti-Vaxxer to Admit She Was Wrong Was Her Entire Family Getting Sick
From Our Partners
powered by PubExchange
The Cut’s Latest Love and War FeaturesAva DuVernay on Hollywood Racism, Modern-Day Slavery, and Why She’s Still an Optimist
The director, whose new documentary The 13th chronicles America’s history of racial subjugation, talks to Rebecca Traister about Bill Clinton, Newt Gingrich, and the modern criminal-justice system.What No One Tells Couples Trying to Conceive
It helps to be rich.The Hidden Black Women Who Helped Win the Space Race
A segregated unit of mathematicians born of desperation during World War II became the secret to NASA’s success.Slut-Shaming Squids Are Everywhere
The “Bermuda Square” comic strip is back.Santigold’s New Video Is the Result of a Spontaneous Run-in With Kara Walker
The collaboration that dreams are made of.Emma Stone and Andrew Garfield Spotted Together Again, Love Might Be Real
They could be back together ahh!Teen, Forced to Go on Vacation With Her Family, Calls 911
The logical decision.Report: Hearst Fired Seventeen EIC Michelle Tan During Her Maternity Leave
Tan had been at the magazine for about two years.Good Morning America Host Amy Robach Apologizes for Saying ‘Colored People’ on Air
She quickly apologized.Unknown NFL Player Tries to Get Attention by Asking Aly Raisman Out in Video
That’s one way to do it.
Marissa Cooper is poised for a comeback ... maybe.California Votes to Remove Time Limit on Prosecuting Rape Cases
In light of the Bill Cosby case.Beyoncé’s Behind-the-Scenes Lemonade Photos Belong in a Museum
She had the "Boycott Beyoncé" sign already in formation on set.The Rise of the Male Celebrity Full-Frontal
An ex-publicist explains.Gabby Douglas Will Be a Miss America Judge
The gold-medal gymnast will help choose the 2017 pageant winner.Camille Becerra’s Photo Diary of Rockaway Beach
An ideal trip to add and cross off your summer bucket list.Sorry Nerds, Ian McKellen Won’t Officiate Your Expensive Lord of the Rings–Themed Wedding
Not even for $1.5 million.Miles Teller Is Still Upset About Being Called a Dick
He wants to set the record straight.Why Parents Shouldn’t Talk About Weight With Their Teens
New guidelines seek to banish weight talk.UVA Student Assaulted at Knifepoint During Orientation Weekend
But some students weren't notified until 24 hours later.