My daughter was diagnosed with stage 4 aggressive breast cancer. She went the whole nine yards..lumpectomy, then mastectomy with lots of lymph node removal, followed by chemo and radiation. She was tested for the gene and was negative. She just turned 55. It was her amazing group of friends who arranged for her dinner every night for many weeks, drove her young kids to school and events, and were simply there. Lean on your friends and family…they will get you through this.
I am sorry to hear of the author’s diagnosis and commend her on engaging in the battle that is cancer treatment - wishing her many, many years of health and happiness.
I do want to be a voice of extreme caution, in that we shouldn’t use individual experiences and our emotional responses to them to drive screening and treatment policies - even for the simple fact that a lot of energy will be wasted by The Line readers. These policies HAVE to be data-driven. There are enormous issues with the benefits of screening as weighed against the costs at a population level. Not the least of which, imagine thousands of additional patients spending weeks worrying, as this author did, about a lump that turns out to be benign. This is not without emotional and financial costs, to everyone involved.
Self-exam away ladies, this is the best thing you can do for yourselves as you know your bodies best. But in terms of mammograms and other screening policies, I look forward to The Line publishing a more nuanced public health perspective.
I think you make a fair point about setting screening policies based on data and the nature of the tests themselves. False positive rates are just one example. Medical interventions come with consequences, even screening tests.
However, the author is advocating for lowering the self-referral age to 40, not the recommended screening age. It sounds like that lines up with your suggestion to “Self-exam away”. Being able to self-refer for a mammogram is an extension of checking yourself with a physical exam. It’s a grey zone between the black and white of recommending vs not-recommending a screening.
I have a friend who was diagnosed at 39 with breast cancer. Through her, I saw just how important it is to be an active and vocal patient, to believe in what she felt and was experiencing and acting on it. Her doctors were excellent, but they can’t see and feel everything, they aren’t with you all day every day.
Fair enough, there are also a lot of drawbacks to family physicians being gatekeepers in this way, and we have to weigh that again against the overuse of services by the needlessly hyper-vigilant.
I have started saying that we really need to consider a more segregated approach to family health by age and sex. I think there’s an argument to be made that a general practitioner whose focus is in women’s health would be a better gatekeeper for this specific cancer screening than the system that currently exists, where GPs see everybody and all conditions.
The biggest problem with Family Physicians being gatekeepers is that there are not enough of them anywhere in Canada. My 24 year old daughter here in BC has been told she may get access to one in two years. Other countries, almost all developed countries, do better. Best wishes to the author.
No arguments from me about that major issue, and because of the shortage, I would think it should be even more important to reevaluate the pitfalls of their role. We ask family doctors to have a huge breadth of knowledge, which really is under-appreciated by the public. At the same time, the public is right to be dissatisfied when the same physicians can’t provide the depth of care that is often required.
I don’t know what to say other than I think you are brave for sharing this, strong for pushing for the mammogram and advocating for others to do the same, and so right that Canada and the provinces need to do better for women. Fuck cancer.
I’m so sorry to hear this terrible news. If at all possible, find a treatment partner. I was a partner to my cousin & believe me, no one should do this alone. And lastly, my cousin received a lot of sound advice but one of the best was to shave her head. It was far less traumatic than watching her hair slowly fall out on her pillow or in the shower or on the kitchen floor etc. Just be done with it. And remember, it always grows back. Best wishes to you. ❤️
Thank you for sharing your story. The path ahead for you is one that no one would chose and I hope that your friends and family gather around you to lend you their strength.
This might be the most important article you ever write. Because people need to be reminded to trust their instincts, and follow up if they think something isn't right. People need the encouragement and to overcome the fear of what they might find out....like you did. Ignoring that feeling is never a good idea. I was lucky. They found mine early through the colon cancer screening test. Seriously; poop on the stick the second you get the chance(although the test has improved I'm told)
I have nothing but empathy for the year you have coming up, but it sounds like there's a great support group to back you up. You will need it. You're in a fight, but you're not alone. Cancer sucks. but you'll beat it. Good on you for writing this.
Wow Kristin - my heart goes out to you. This is such a powerful account - and I want to thank you for sharing such a personal story. You are saving lives and providing hope. Please know there are people in your corner who you haven't even met. KPB
A terrible way to start 2024 and I wish you complete success at the end of this journey. You seem to have strength and courage in spades but don't forget to rely on your support network of friends and family when you need them. Lastly, thank you for sharing your story to date. I too believe it will help someone. Reach out to all of us readers when you need words of encouragement. We will be here for you!
I am so sorry you got this terrible news. Gather your friends and family around you and lean in hard to them when you need to even if you don't want to. Thank you for your bravery in sharing your story. Sending strength and light your way.
Thank you Kristin for a thorough, honest and vulnerable article. I hope many women read it, or men give it to their female partners, sisters, mothers, and friends. It WILL save lives, not could.
I do this for a living: I am a radiologist who for 35 years has done a lot of women's imaging, including reading many thousands of mammograms and breast Ultrasounds, and done hundreds of those painful and distressing biopsies (yes so sorry, we try hard to reduce the pain, its almost impossible).
Self-referral and self-advocacy are crucial in doing whatever preventive medicine we can for ourselves and those we can influence.
You are actually correct about Ontario only in part. Ontario only allowed self-referral for women aged 50-75 until about 2 months ago. Finally, after 20+ years of showing data, and pleading by physicians and knowledgable advocates in all of the specialties involved in Cancer care -- surgeons, oncologists, radiologists, and pathologists, the Ministry of Health accented to expanding the OBSP (the provincial screening programme) to 1) women aged 40-49, but also and happily shockingly 2) to ANNUAL routine screening -from biannual - and 3) developed access to the programme for women with breast implants, and for transgender patients. These changes bring us into "the real world" of self-referred screening such as has long been available from age 40 as exemplified by British Columbia, throughout Europe, in Australia, and in New Zealand.
And at the same time the role of breast ultrasound has been redefined as what it is-- an adjunct or support to Mammography. Breast ultrasound is NOT a screening technique, and women should never be talked into accepting that as the first examination for any abnormality if they are over 40.
Also, that for women who have first degree family members with breast cancer -- or ovarian and uterine -- they may be high risk and warrant screening beginning up to 10 years before the age of diagnosis of their relative. There are risk calculators available online, and most of the provinces now , I think, have High Risk assessment and screening programmes.
My apologies to all for the lecture in screening, but maybe it will add to the good being done here by Kristen, and the other invaluable commentary in this thread.
The wonderful thing about the huge progress which has been made in Breast cancer diagnosis and treatment, over the past 20+ years, is that a disease which killed or severely impacted the quality of life of a whole lot of women when I started out, has been morphed into a serious but now for many sufferers "manageable chronic disease" for many women, with lower morbidity and mortality, as has AIDS, and some of the severe Immune-related diseases.
Kristen, I hope for you a great response to treatment. thank you for your bravery.
Thank you for having the courage to share this with your readers. My heart goes out to you and hoping that you are continuing to get the support from family and friends that you deserve and need.
You make an important case for patient advocacy. In so many cases the patient knows their body best. The points made below of the benefits of blanket screening at a population level are of course considerations but patient advocacy plays an important role at the individual clinical level. We should take a moment to reflect that millions of Canadians who have no access to a place where they can advocate for themselves except an emergency room or walk-in clinic, which are less than ideal settings. Also for the countless persons who haven't got the voice or courage to advocate for themselves. Such a complex problem.
My daughter was diagnosed with stage 4 aggressive breast cancer. She went the whole nine yards..lumpectomy, then mastectomy with lots of lymph node removal, followed by chemo and radiation. She was tested for the gene and was negative. She just turned 55. It was her amazing group of friends who arranged for her dinner every night for many weeks, drove her young kids to school and events, and were simply there. Lean on your friends and family…they will get you through this.
I am sorry to hear of the author’s diagnosis and commend her on engaging in the battle that is cancer treatment - wishing her many, many years of health and happiness.
I do want to be a voice of extreme caution, in that we shouldn’t use individual experiences and our emotional responses to them to drive screening and treatment policies - even for the simple fact that a lot of energy will be wasted by The Line readers. These policies HAVE to be data-driven. There are enormous issues with the benefits of screening as weighed against the costs at a population level. Not the least of which, imagine thousands of additional patients spending weeks worrying, as this author did, about a lump that turns out to be benign. This is not without emotional and financial costs, to everyone involved.
Self-exam away ladies, this is the best thing you can do for yourselves as you know your bodies best. But in terms of mammograms and other screening policies, I look forward to The Line publishing a more nuanced public health perspective.
I think you make a fair point about setting screening policies based on data and the nature of the tests themselves. False positive rates are just one example. Medical interventions come with consequences, even screening tests.
However, the author is advocating for lowering the self-referral age to 40, not the recommended screening age. It sounds like that lines up with your suggestion to “Self-exam away”. Being able to self-refer for a mammogram is an extension of checking yourself with a physical exam. It’s a grey zone between the black and white of recommending vs not-recommending a screening.
I have a friend who was diagnosed at 39 with breast cancer. Through her, I saw just how important it is to be an active and vocal patient, to believe in what she felt and was experiencing and acting on it. Her doctors were excellent, but they can’t see and feel everything, they aren’t with you all day every day.
Fair enough, there are also a lot of drawbacks to family physicians being gatekeepers in this way, and we have to weigh that again against the overuse of services by the needlessly hyper-vigilant.
I have started saying that we really need to consider a more segregated approach to family health by age and sex. I think there’s an argument to be made that a general practitioner whose focus is in women’s health would be a better gatekeeper for this specific cancer screening than the system that currently exists, where GPs see everybody and all conditions.
The biggest problem with Family Physicians being gatekeepers is that there are not enough of them anywhere in Canada. My 24 year old daughter here in BC has been told she may get access to one in two years. Other countries, almost all developed countries, do better. Best wishes to the author.
No arguments from me about that major issue, and because of the shortage, I would think it should be even more important to reevaluate the pitfalls of their role. We ask family doctors to have a huge breadth of knowledge, which really is under-appreciated by the public. At the same time, the public is right to be dissatisfied when the same physicians can’t provide the depth of care that is often required.
I don’t know what to say other than I think you are brave for sharing this, strong for pushing for the mammogram and advocating for others to do the same, and so right that Canada and the provinces need to do better for women. Fuck cancer.
I’m so sorry to hear this terrible news. If at all possible, find a treatment partner. I was a partner to my cousin & believe me, no one should do this alone. And lastly, my cousin received a lot of sound advice but one of the best was to shave her head. It was far less traumatic than watching her hair slowly fall out on her pillow or in the shower or on the kitchen floor etc. Just be done with it. And remember, it always grows back. Best wishes to you. ❤️
Thank you for sharing your story. The path ahead for you is one that no one would chose and I hope that your friends and family gather around you to lend you their strength.
Prayers up for you. May the force be with you.
This might be the most important article you ever write. Because people need to be reminded to trust their instincts, and follow up if they think something isn't right. People need the encouragement and to overcome the fear of what they might find out....like you did. Ignoring that feeling is never a good idea. I was lucky. They found mine early through the colon cancer screening test. Seriously; poop on the stick the second you get the chance(although the test has improved I'm told)
I have nothing but empathy for the year you have coming up, but it sounds like there's a great support group to back you up. You will need it. You're in a fight, but you're not alone. Cancer sucks. but you'll beat it. Good on you for writing this.
Wow Kristin - my heart goes out to you. This is such a powerful account - and I want to thank you for sharing such a personal story. You are saving lives and providing hope. Please know there are people in your corner who you haven't even met. KPB
A terrible way to start 2024 and I wish you complete success at the end of this journey. You seem to have strength and courage in spades but don't forget to rely on your support network of friends and family when you need them. Lastly, thank you for sharing your story to date. I too believe it will help someone. Reach out to all of us readers when you need words of encouragement. We will be here for you!
Thank you for calling attention to such an important issue in women's health! Your writing is informative and emotional!
I am so sorry you got this terrible news. Gather your friends and family around you and lean in hard to them when you need to even if you don't want to. Thank you for your bravery in sharing your story. Sending strength and light your way.
Thank you Kristin for a thorough, honest and vulnerable article. I hope many women read it, or men give it to their female partners, sisters, mothers, and friends. It WILL save lives, not could.
I do this for a living: I am a radiologist who for 35 years has done a lot of women's imaging, including reading many thousands of mammograms and breast Ultrasounds, and done hundreds of those painful and distressing biopsies (yes so sorry, we try hard to reduce the pain, its almost impossible).
Self-referral and self-advocacy are crucial in doing whatever preventive medicine we can for ourselves and those we can influence.
You are actually correct about Ontario only in part. Ontario only allowed self-referral for women aged 50-75 until about 2 months ago. Finally, after 20+ years of showing data, and pleading by physicians and knowledgable advocates in all of the specialties involved in Cancer care -- surgeons, oncologists, radiologists, and pathologists, the Ministry of Health accented to expanding the OBSP (the provincial screening programme) to 1) women aged 40-49, but also and happily shockingly 2) to ANNUAL routine screening -from biannual - and 3) developed access to the programme for women with breast implants, and for transgender patients. These changes bring us into "the real world" of self-referred screening such as has long been available from age 40 as exemplified by British Columbia, throughout Europe, in Australia, and in New Zealand.
And at the same time the role of breast ultrasound has been redefined as what it is-- an adjunct or support to Mammography. Breast ultrasound is NOT a screening technique, and women should never be talked into accepting that as the first examination for any abnormality if they are over 40.
Also, that for women who have first degree family members with breast cancer -- or ovarian and uterine -- they may be high risk and warrant screening beginning up to 10 years before the age of diagnosis of their relative. There are risk calculators available online, and most of the provinces now , I think, have High Risk assessment and screening programmes.
My apologies to all for the lecture in screening, but maybe it will add to the good being done here by Kristen, and the other invaluable commentary in this thread.
The wonderful thing about the huge progress which has been made in Breast cancer diagnosis and treatment, over the past 20+ years, is that a disease which killed or severely impacted the quality of life of a whole lot of women when I started out, has been morphed into a serious but now for many sufferers "manageable chronic disease" for many women, with lower morbidity and mortality, as has AIDS, and some of the severe Immune-related diseases.
Kristen, I hope for you a great response to treatment. thank you for your bravery.
I can't add anything to what anyone else has said but you have my best wishes for a good recovery.
I have so much respect for you, for sharing this. I wish for you the very best outcome and will keep you in mind this year.
Thank you for having the courage to share this with your readers. My heart goes out to you and hoping that you are continuing to get the support from family and friends that you deserve and need.
You make an important case for patient advocacy. In so many cases the patient knows their body best. The points made below of the benefits of blanket screening at a population level are of course considerations but patient advocacy plays an important role at the individual clinical level. We should take a moment to reflect that millions of Canadians who have no access to a place where they can advocate for themselves except an emergency room or walk-in clinic, which are less than ideal settings. Also for the countless persons who haven't got the voice or courage to advocate for themselves. Such a complex problem.
Best of luck on this journey. I am keeping a good thought for you.