By Haleemah Atobiloye, M.A., she/hers, Program Manager
At this point in the history of the world, it is clear that capitalists and capitalism are currently winning in the national and global spheres. At this year’s San Antonio Breast Cancer Symposium (SABCS), my experience with listening to insights shared by patient advocates, not-so-subtle pharmaceutical adverts, questions posed by the audience, and the clinical research (findings) presented by cancer professionals was similar to watching the very rotten parts of capitalism. An example of how this rotten capitalist aura of people over profit played out was the obvious fact that patient advocates, members of the audience, and researchers who were there on the behalf of people living with and at risk of breast cancer were in the minority, while the big pharmaceutical companies had strategically placed paid ads shown on our screens at session intervals and researchers whose work is funded by billion-dollar organizations, were, if not more in number, made sure their presence was felt with the thank yous to their funding organization at the end of each presentation.
I joined the Spotlight Discussion on Obesity and Breast Cancer session, led by panelists who did not go into details about how breast cancer can be prevented by lifestyle choices, but rather focused on sharing their research (findings) which generally examines the relationship between obesity and breast cancer risk and outcomes. Some highlights from this panel include:
[Breast density is a term that came up a number of times during this panel. Breast density is determined by the relative amount of fibroglandular tissue (dense) and fat tissue (not dense). Dense breasts is a common problem found in people assigned female sex at birth.]
The findings of Dr. Colditz study confirm Dr. Ligibel’s point that people with higher levels of breast density are at an increased risk of developing breast cancer. Dr. Colditz and colleagues further show that mammographic breast density is inversely related to both age and to body mass index (BMI). Hence, as people age, their mammographic breast density declines, and interestingly, people assigned female sex at birth who are heavier have lower breast density. Another interesting revelation from this study was that the rate of decline of breast density was slower in a breast that ultimately developed breast cancer.
This post, however, is primarily inspired by April Finley, a patient advocate who stood up during this session to ask why there’s no conversation for individuals like herself to add a treatment plan for cancer-related bariatric surgery. April’s question is one that stuck with me because it highlights that a person’s multiple social identities is always very important when it comes to treatment of not just breast cancer but of any type of disease. It is imperative to note that these panelists, Breast Cancer Action, and I are not in any way promoting unhealthy lifestyle habits. In fact, over the years, many BCAction resources have shown that the presence of excess fat tissue means a high level of estrogen in a person’s body thereby increasing the risk of breast cancer occurrence. Health justice is part of the broader call for social justice, and Breast Cancer Action’s work has always reflected this. Therefore, the purpose of this post is to highlight the under-spoken health justice issues that overweight people living with, at risk of, and/or dying from breast cancer face.
Overweight and obesity are terms that refer to excess body fat. The prevalent method of measuring this excess body fat is the Body Mass Index. For many years now, society has deemed overweight and obese people as less desirable. Scroll through any social media platform, and one can see that a significant number of folx believe people are overweight or obese because they lead unhealthy lifestyles. Breast cancer activists, a number of cancer professionals, and some people living with or dying from breast cancer know that there is typically more than one causal factor that leads a person to being overweight or obese.
April’s question made me aware that currently, for folx privileged enough to have insurance and not fall within an insurance gap, bariatric surgery is not covered. April was diagnosed with triple-negative breast cancer and being BRCA1 positive in 2016. After her diagnosis, after going through chemotherapy, and after having a bilateral mastectomy, she gained over 30 pounds. April stated that she was not informed that there was a possibility she would gain so much weight after going through breast cancer treatment. Since her treatment ended, she has researched and implemented many efforts to lose weight, yet she stated it has been incredibly difficult and impossible to do so. According to her, the more stress she goes through trying to lose weight, the more weight she puts on. April also notes that prior to her diagnosis, she did not have high blood pressure or type two diabetes. Sadly, these illnesses showed up for her after her cancer treatments. The motivating factor behind sharing her story and asking this question is because her insurance company is not expanding coverage with the option of bariatric surgery, a surgical procedure April notes presents her with a possibility of extending her life.
The following are the responses to April’s question by the panelists:
Breast cancer still has no cure. Breast cancer treatments can be successful yet there are myriad side effects that come as a result. Putting on a significant number of pounds is one of the side effects. April’s story is one that shows there is typically more than one causal factor of being overweight or obese. She took prevention measures that include maintaining a healthy diet, exercising, and generally leading a risk-averse lifestyle but still got diagnosed with breast cancer. Sadly, one of the side effects of breast cancer treatment is that patients have to deal with the societal stigma that comes with being overweight.
When consuming content or adding to your opinion to the debate about overweight and/or obese people living with or dying from breast cancer, it is important to think critically, guided by social justice. and ask yourself questions like: Why do I personally feel this way about overweight and obese people? What factors has credible research shown to contribute to weight gain? It is important we educate ourselves, the public, and cancer care professionals that being overweight does not necessarily equate to being unhealthy, the same way being thin does not necessarily equate to being healthy. Our bodies should not be devalued and stigmatized. Making good lifestyle choices in this capitalist society we find ourselves in is not enough. Treatments are not enough. We need systemic change to address and end the breast cancer crisis. This is my stance.