Columns 2009

Happy Thanksgiving… and keep getting those mammograms

Here’s what I’m grateful for on this Thanksgiving. I’m grateful that two of my friends, both in their fifties, did not wait two years to get their next mammogram. Because if they had, both would have had well advanced tumors that may or may not have been treatable. And if the tumors had still been treatable, the treatment would have been much harsher and horrifying than it was.

Talking in abstracts about how many more lives are saved or not saved through an annual mammogram is one thing. Walking with a friend who stands a good chance of being around for a long time to come because she got one annually makes that statistic a concrete reality. Faced with that reality, I don’t know how anyone can claim that you shouldn’t bother to get a mammogram before fifty and, even after fifty, you should only get it every other year.

I think what scares most women about this latest pronouncement is not that it will stop them from getting a mammogram. Any woman with an ounce of common sense knows that the few minutes of discomfort caused by the test is well worth the chance to avoid the horror of radiation and chemotherapy. So most women will roll their eyes, put on those silly little gowns, grin and bear it.

The problem is that this pronouncement has given insurance companies an easy out for refusing to pay for an annual mammogram. Since being treated for metastatic cancer is very expensive, financially it seems to make sense for your insurance to continue to cover an annual test. Unfortunately, it seems most insurance companies will go for the short-term profit whenever possible.

If I sound a tad cynical about insurance companies, you’ll have to forgive me. I’m still trying to figure out how my insurance coverage has a rule that says if you’re a woman who has had a hysterectomy, thereby negating the need for an annual PAP smear, they won’t cover an annual breast exam. I can find no literature anywhere that links the existence of a womb in a woman with increasing her probability of getting cancer. So it would seem to stand to reason that the removal of said womb would not decrease her chance of getting breast cancer. Yet the rule stands.

It’s funny that a woman can’t get an annual breast exam for such an inane reason but a man can get all the male enhancement drugs he wants by just telling his doc he isn’t getting it on as often as he used to in his youth.  No awkward tests there. No need for the man to demonstrate the truth of his claim. Just a quickly written prescription that is just as quickly filled and paid for by most health insurance plans.

But an annual mammogram for a woman… well, we need to question those costs and the amount of unnecessary tests they create based on false positives. I personally would like to see a program that questions all the sex men get to have while on their male enhancement drugs. At a minimum they should have to bring a note from their partner indicating a willingness to participate in the program before their insurance coverage kicks in.

I watched a friend’s mother die because she didn’t get to a doctor quickly enough to have her breast cancer treated. It’s not a pretty way to go. Unlike some gushingly sentimental movies that periodically arrive on screens showing a person dying of cancer on a pristine white bed uttering some last pithy words of wisdom to mate or child, the reality of a cancer death is horrible. The patient is in pain. There are smells no movie can ever replicate. There are indignities to the body of someone well loved that cause you to just want to cry out for them. Dying of cancer is long, painful, smelly and ugly. It’s why Hospice is the best idea to ever come out of the turmoil of the sixties.

Even if a mammogram only saves ten women a year from that fate, it’s worth it. Especially when that woman is someone you know and love who still has so much to offer to her family, her friends and her world.