Mortality disparity up between blacks and whites

Breast cancer incidence among African-American women in U.S. jumps to a new high

Blacks have lower mammogram follow-up rate.

A new study says breast cancer incidence among African-American women in the United States has equaled whites, according to a story by Tara Parker-Hope in The New York Times.

That's bad news because it's been less common (although deadlier) in the past.

The report, from the American Cancer Society (ACS), showed "that advances in diagnosis and treatment that have dramatically improved survival rates from breast cancer and saved countless lives [in whites] have largely bypassed African-American women."

Over all, Parker-Hope's Well blog in the Times said, "a black woman given a breast cancer diagnosis is 42 percent more likely to die from the disease than a white woman with breast cancer."

It also noted that in some major U.S. cities, according to an analysis published last year in "Cancer Epidemiology," the rate is even worse. In Los Angeles, for example, a black woman is "70 percent more likely to die," and in Memphis the risk rate is double that of a white woman.  

Why the disparity?

Black women, the report said, are more likely than white women "to be given a diagnosis with later stage, and less treatable tumors" — and twice as likely as whites "to be found to have an aggressive form of the disease called triple negative breast cancer, which has a poorer prognosis."

According to the Times, "researchers say…rising obesity rates among African-American women may explain some" of the jump — in contrast with a stabilized rate of 33 percent for Caucasians.

Obesity has been connected to a larger "risk of estrogen-receptor positive breast cancers," the type of tumor now being found more in black women, the Parker-Hope piece indicated.

The obesity rate in blacks leapt from 39 percent between 1999 and 2002 to 58 percent from 2009 to 2012.

But other reasons for "the racial divide in breast cancer mortality may be due to…disparities in the quality of care available to black women, who may have less access to quality screen and treatment."

Carol E. DeSantis

In addition, "lower rates of follow-up after a mammogram, cultural distrust of doctors, and lack of insurance coverage among black women may also play a role," Parker-Hope writes.

The Times writer quotes Carol E. DeSantis, senior epidemiologist at the ACS and lead author of the report, as predicting "the widening mortality disparity is likely to continue."

Comparisons between different groups of women can be found in the VitalityPress book I aimed at male caregivers, "Rollercoaster: How a man can survive his partner's breast cancer."

Screenings urged at age 45 rather than 40

American Cancer Society suggests women start getting mammograms at a later age

Mammograms: At what age to begin?

The American Cancer Society has done an about-face on mammogram screenings by recommending women get less testing.

In new guidelines released Oct. 20, the ACS, the nation's largest cancer charity and previously the main advocate for those screenings, said women at average risk of breast cancer should begin yearly screenings at age 45.

That's "five years later than it had previously recommended," the Associated Press noted.

By age 55,  the AP paraphrased the new guidelines, because the cancers "tend to grow more slowly after menopause," women should be screened only every other year if they're healthy and expect to live another 10 years. 

That conclusion stems from the notion that if women have a life expectancy of less than a decade, they're then apt to die with breast cancer, not from it.

Breast screenings: Still controversial.

If adopted as policy in the United States, the new practice would result in a major shift from the aggressive screenings that had been standard since the 1990s.

The action puts the ACS more in line with many other organizations (excluding the American College of Radiology, which still suggests starting at age 40). 

According to The New York Times, the National Comprehensive Cancer Network, an alliance of prominent cancer centers, all "recommends mammograms every year starting at age 40" — and the America College of Obstetricians and Gynecologists suggests them every year or two from age 40 to 50 and every other year after that.

As the cliché goes, ya pays yer money and takes yer choice.

But some skeptics, including me, think the medical profession is being unduly lobbied and influenced by big insurance companies that simply don't want to pay for the tests.

Those advocating the later start maintain, however, that the chief reasons are women's changing risk as they age and a growing concern some mammograms may produce more harm than benefit (because of "false positive" results that could lad to unnecessary follow-up tests, including invasive biopsies).

Still, according to the AP story, mammograms actually "reduce the risk of dying from breast cancer by as little as 15 percent to as much as 40 percent."

Another oft-cited issue is over-diagnosis, when screenings find slow-growing cancers that may never imperil life but still may lead to doctors choosing surgery, radiation or other treatments the patients really don't require.

Although some studies claim up the 50 percent of breast cancers don't need to be treated, the ACS has said in the past that the actual number is only between 1 and 10 percent.

The new guidelines, which have reignited debates over the testing, only take into account women of average risk, not those with family histories of the disease or genetic mutations.

In 2009, the U.S. Preventive Services Task Force had decided that women could wait until 50 to start routine mammograms — and then get them every other year.

The newest guidelines also suggest that "doctors no longer need to perform breast exams during women's checkups, since these exams have not been shown to save lives" — yet another ACS change in policy.

Those six-minute examinations, according to the latest flip-flopped medical consensus, simply don't accomplish much.

The latest American Cancer Society guidelines were published online in JAMA, formerly the "Journal of the American Medical Association," sharply contrasting with public ACS opinions as recently as 1992 that urged women to get a "baseline mammogram" between the ages of 35 and 39 so physicians could compare later screening results.

The constant flip-flopping of researchers, physicians and, in fact, the entire cancer industry is detailed in the book I, Woody Weingarten, aimed at male caregivers, "Rollercoaster: How a man can survive his partner's breast cancer."

Cavallo Point event honors awareness month

Woody Weingarten, author of 'Rollercoaster,' will speak at benefit for Zero Breast Cancer

Finally, I, Woody Weingarten, have worked my way out of the primordial slime that encases a novice book author and climbed into a world of public appearances.

Next up, I will be the prime speaker at a charity event that will benefit Zero Breast Cancer, a San Rafael-based nonprofit dedicated to identifying environmental factors that may trigger the diseases.

The “Make a Point for Good” event — in support of October being Breast Cancer Awareness Month — will be held from 11am to 4pm, Saturday, Oct. 17 at the Cavallo Point store, The Mercantile.

I will be speaking at 3 p.m,. about male caregiving and my VitalityPress book, “Rollercoaster: How a man can survive his partner’s breast cancer.” A book signing will follow my talk.

The charity event also will spotlight complimentary Luzern mini-facials, a Kathy Komei Designs trunk show and a cooking school display.

Cavallo Point — which features a spa, restaurant, lodge and cooking school — plans to donate a portion of its entire month’s proceeds to ZBC. The facility is located at 601 Murray Circle, Fort Baker, in Sausalito.

Later that day, from 5:30 to 10 p.m., another benefit for Zero Breast Cancer — as well as for the To Celebrate Life foundation, a second Marin County nonprofit that helps with breast cancer research — will be held at the Marin County Jewish Community Center, 200 N. San Pedro Road, San Rafael. 

That event, the 17th annual "Wine Women & Song," starts with wine, beer, cocktails and a buffet at 5:30, followed at 7 by a rock 'n' roll concert, dance party and live auction.

Featured will be music composed or made famous by artists who have battled breast cancer. 

Rose Barlow, executive director of ZBC, and I previously appeared together on a weekly KPIX-TV interview show, “Mosaic,” that’s been rerun twice, most recently on Oct. 11 as another bow to the awareness month.

Anyone wanting to see two of the four segments of the ‘Mosaic” show can click on: Mosaic, and Mosaic 2 for the second half.

Earlier this month, I also spoke to about 40 members of the North Marin Breakfast Club in Novato, a men's group.

Sure, these are unpaid gigs, but protect your podiums Tony Robbins, Richard Branson and Bill Clinton, I'm slowly working up to replacing you.

Jackie Collins blamed self for not checking lump

Why best-selling book writer Jackie Collins kept her breast cancer a secret for years

Best-selling steamy-book author Jackie Collins may have given away one of her best stories.

Or, at least, one of her longest held secrets.

Only days before she died last month, Collins was interviewed by Elizabeth Leonard of People magazine for a series of articles in which she revealed, for the first time publicly, her longstanding breast cancer diagnosis and impending death.

She said, from her Beverly Hills home, that she wanted on her gravestone the following: "She gave a great deal of people a great deal of pleasure."

That pleasure took the form of what severe critics called filthy or sexy trash, and more charitable detractors called cliché-riddled potboilers (defined in her case as melodramatic novels about Hollywood, celebrities and their glamorous lives that may have been written expressly to make money rather than for artistic purposes).

Collins' father, Joe, despite expressing pride in her accomplishments, told her he believed her books were pornographic.

Jackie (left) and Joan Collins

People noted that the 77-year-old writer had kept her secret from her older sister, Joan Collins, 82, star of television's "Dynasty," for six and a half years because she didn't want to be a burden. 

Jackie said that she'd protected her sister because "she's very positive and very social but I'm not sure how strong she is."

When Jackie died, Joan told People she was "completely devastated" by having lost her "best friend."

Jackie had informed her three adult daughters — Tracy, Tiffany and Rory — but only after Rory, too, was diagnosed with breast cancer.  

She told only them, however, because "I didn't want to be on the front of the 'Enquirer' with two weeks to live. And I didn't want people's sympathy. I think sympathy can weaken you. I don't live my life that way. I like to be in control and so I took control of the situation."

She also told People she'd had to deal with losing her mother to breast cancer, her husband to prostate cancer and a fiancé  to lung cancer, "and I did not want to put pressure on everybody in the family. So I happily, happily went day by day."

She had only one regret about the way she handled the situation, noting that she'd written five books since her initial diagnosis.

Over a period of four decades, she'd sold more than five million copies of her "naughty narratives" — 32 best-sellers in all — throughout the world.

At her death, she reportedly was still writing — and working on her autobiography.

The one regret? She admitted she'd delayed seeing a doctor for two years after being aware of a lump in her breast. 

Why the wait? Because she was "completely doctor-phobic" and believed, erroneously, that the tumor was benign. 

In truth, it had metastasized to her bones.

Her disclosure at the end, she said, was intended to prod women into getting regular checkups and to save lives. "Always get it checked," she told People, "And the sooner the better. That is the best advice I can give."

"I know we're all told to do it," she added, "but some of us are too stupid, and I was one of them."

In my book, "Rollercoaster: How a man can survive his partner's breastcancer," I, Woody Weingarten, detail how others deal with the diagnosis — some want everyone to know what's going on, some want no one to know.

Good Morning America host reveals struggle

TV anchor's marriage survives breast cancer, mastectomy, 'hurtful' People mag headline

Amy Robach, Andrew Shue at Breast
Cancer Research Foundation gala.

Statistically speaking, nine out of every 10 relationships will survive breast cancer, its treatments and its aftermath.

That may not sound so good, with 10 percent failing, but consider that conventional wisdom predicts as high as 50 percent of all marriages in the United States will fail sooner or later.

The positive 90 percent includes me, Woody Weingarten, and my wife, Nancy Fox; everyman John Doe and his everywoman wife, Jane; and 42-year-old Good Morning America host Amy Robach and her 48-year-old husband, actor-entrepreneur Andrew Shue.

Robach, who was diagnosed with the disease in 2013, admitted to People writer Emily Strohm in a series of stories last month and this one that the disease had threatened their marriage.

"All of a sudden I felt like I needed him in a very needy way, and that's not my personality," she said. "It threw everything up in the air. It was rough."

She said she had "completely crumbled" during the crisis.

He, in turn, explained that he struggled to find the right balance when it came to her emotions. "You find yourself walking on eggshells a little bit. Like, did I say the right thing? Did I do the right thing?"

After her diagnosis, which she'd disclosed — with Shue by her side — on television to Robin Roberts, another GMA anchor who successfully battled breast cancer, Robach underwent a double mastectomy and chemotherapy.

She was glad she'd chosen that particular surgery because physicians found a second malignancy that hadn't previously been detected.

But Robach and Shue both had to overcome their anxieties to reach the point where, she explained, she could learn "how strong we can be together. We're a solid team now." 

To get there, they had to "be honest about the fears" and change the way they were communicating. That included not withholding anything from each other.

Robach has also taken out the time to blast People for its negative headline, "Cancer Nearly Destroyed My Marriage," which she told "The View" had been "very hurtful." 

After her criticism, People softened its online headline.

Robach, who earlier had proclaimed that "I'm the poster child for someone who thought cancer couldn't happen to them," had been diagnosed after an on-air mammogram that had been intended "to help encourage women to get checked."

The news anchor has a new book, "Better," which tracks her battle with breast cancer and its aftermath.

Meanwhile, my book, "Rollercoaster: How a man can survive his partner's breast cancer," which is aimed at male caregivers, directly addresses how relationships can grow closer despite the ups and downs of the morass caused by the disease.

Check it out.

'Rollercoaster' author to speak at Novato men's breakfast club about being a male caregiver

Woody Weingarten

I, Woody Weingarten, have been running a weekly men's support group — Marin Man to Man — for 20 years. 

It's mainly for guys whose partners have, or had, breast cancer.

Tomorrow, Friday, Oct. 2, I get to talk to a different men's group about those years — and about my being the prime caregiver for my wife, Nancy Fox, who was diagnosed with breast cancer two decades ago and lived through the requisite "slash, poison and burn" treatments — surgery, radiation and chemotherapy.

And how she's thriving today.

I'll also speak about my VitalityPress book, "Rollercoaster: How a man can survive his partner's breast cancer."

Tomorrow's talk will be at the weekly 7 a.m. North Marin Breakfast Club in Novato, and is expected to draw some 40 men, including many of the county's leaders.

I'm pleased to have the opportunity.