Dr. C.Bour, October 27, 2022
Marie Négré Desurmont is a journalist and lecturer who studied anthropology at École des Hautes Études in Paris in Social Sciences. She is a science journalist who has studied specifically on the subject of breast cancer after being affected herself and being struck, as Maëlle Sigonneau was, by the injunctions towards patients conveyed by language and that they have to face in their daily lives.
In a dedicated piece titled "Pink October or the Non-politics of the Breast," the author denounces what she calls the pink month's neutralization of social, environmental, and political issues. She advocates for a broader vision beyond the simple Pink October campaign to ensure a healthy future for the following generations.
"Let us have the courage to look beyond Pink October and require that we bring into the world little girls who won't have to waste so much energy trying to survive, cared for by the same world that made them sick," she writes.
She denounces:
"...rather than politicizing this serious disease, we prefer to repeat that it is best-treated cancer. We focus on individual behaviors by valuing the survivors who have learned so much from this difficult experience.."
The emphasis is placed, with a colorful and smiling veneer, on appearance and well-being "because," the author writes, quoting Audre Lordre (Cancer Journal*), "it is easier to demand that people be happy than to clean up the environment. Let's look for joy, shouldn't we, instead for healthy food, clean air, and a less crazy future on livable earth ."
*Audre Lorde, Journal du Cancer, translated from the American by Frédérique Pressman, Éd. Mamamélis, Geneva, 1998.
Cancer Politicization
In her book "Impatiente," Malle Sigonneau already called for a fight that must go beyond focusing exclusively on the particular behaviors of "survivors."
For her, it would be necessary to boycott Pink October, replacing pink messages with large posters on endocrine disruptors; we could imagine a month, she wrote, where we would 'sensitize' (to use an overused and meaningless word) on the carcinogenic effects of the environment, for example, pesticides...
Mrs. Desurmont sums up our society's attitude very well: "Our society has so much faith in its technological capabilities that it is more concerned with fixing the damage of growth than with creating another form of production and exchange, less mortifying."
Behavioral and environmental factors are responsible for almost half of all cancers. The author correctly points out that risk factors include not only tobacco, alcohol, or obesity but also endocrine disruptors, ionizing radiation (including mammography! ), air pollution, new chemicals (pesticides), exhaust fumes, occupational exposures, and general population exposure to chemical substances.
The pink campaigns and health authorities' messaging speak little about it. "By trying to make us believe that we are masters of our health, impenetrable to the surrounding conditions, and independent of our societal structures, we patients begin to anxiously seek the origin of our illness, psychologizing this sickness at any costs."
We talk about the injustice of a disease that hits women in their absolute femininity, but according to Desurmont, " What is unfair is what we have done to the world, not cancer that just can take advantage of the red carpet we roll out for it to thrive."
The reality is that by talking about injustice and little individual battles, we convince ourselves that cancer is anecdotal, that it's "poor luck," and that all it takes to beat it is a strong spirit. However, it is not a rosy epidemic and worsens as the environment deteriorates. Ladies, adopt a healthy lifestyle, but remember that while you jog, you breathe contaminated air."
Marie Négré Desurmont, like Malle Sigonneau, rightly condemns the guilt and responsibility put on cancer patients.
But what about the "epidemic"?
An epidemic?
What if the "epidemic" also came from medicine?
In his book "Dépistage du cancer du sein, la grande illusion" (ed.Souccar), Bernard Duperray explains:
"From the 1980s to the 2000s, the number of mammograms performed exploded. At the same time, the number of senographs, the devices used to perform mammograms, increased considerably: from 308 senographs in 1980 with 350,000 mammograms in 1982 to 2,511 senographs with 3 million mammograms in 2000. What was the result of this spectacular increase in mammography activity? 21,387 breast cancers were diagnosed in 1980, 42,696 in 2000, and 49,087 in 2005. An epidemic of breast cancer? Is epidemic independent of human activity or the result of uncontrolled human activity?
EPIDEMIC OR OVERDIAGNOSIS LINKED TO SCREENING ACTIVITY?
Two hypotheses can be considered to explain this surge of cancers:
-either it is a simple coincidence between the introduction of screening and the onset of a breast cancer epidemic
- or it is a plethora of breast cancer diagnoses linked to screening.
Let's look at the first hypothesis. If the continuous increase in new diagnoses each year corresponds to an epidemic of progressive cancers, the reduction in mortality due to screening would have to be considerable. There would be 1 cured cancer for every 1 death in 1980 and 3 cured cancers for every 1 death in 2000.
Neither the most optimistic results of randomized trials regarding mortality reduction, nor the therapeutic advances during this period, can support this hypothesis.
Let's look at the second scenario, in which screening is the cause of the increase in the number of new cases of cancer diagnosed each year.
Between 1980 and 2000, the incidence rate increased by an average of 2.7% per year. The increase affected all age groups but was most pronounced among women aged 50 to 75. This is the age group for which systematic mammography screening is performed (in the ten pilot departments). ......
The current epidemic of breast cancer is only apparent. Why apparent? Without screening, many of the cancers diagnosed today would not have occurred. With the overdiagnosis generated by screening, we are thus creating an only visible epidemic. When we admit to overdiagnosis, an increase in incidence does not imply an epidemic.
There is no concrete counterargument to the concept of increased overdiagnosis associated with screening. "Demonstrating its reality is based on indisputable epidemiological data and reliable facts."
I give a detailed explanation in my book "mammo ou pas mammo" (ed.Souccar), which I share with you here:
"A study has been conducted in France to allow this analysis of the situation: it is a survey conducted in 2011 by international epidemiologists, including a Frenchman, Bernard Junod, a prominent epidemiologist from the École des Hautes études en santé Publique de Rennes (EHESP) (Junod B, et al. S. An investigation of the apparent breast cancer epidemic in France: screening and incidence trends in birth cohorts. BMC Cancer. 2011;11(1):1-8. ).
Their observations are as follows:
- ✹ The number of mammography machines in operation in France increased steadily over 20 years, from 308 in 1980 to 499 in 1984, 1351 in 1990, 2282 in 1994, and 2511 in 2000. The number of devices has thus increased eightfold between 1980 and 2000. As a result, screening has intensified.
- ✹ When the incidence of breast cancer at different times in women of the same age group is compared, it increases over time. It is significantly higher when women are intensively screened. The most significant increase, 112%, occurred in 2005 for the 60-64 age group.
Thus, this increase in breast cancer incidence has occurred in parallel with the rise in screening intensity, as illustrated in Figure 1.
As screening increases, so does incidence. This increasing incidence rate as soon as the systematic screening is introduced is striking. It has been observed in all countries where screening has been introduced. "
The denunciation of the failure to consider environmental factors is entirely justified and relevant. Still, the role of medicine must be included and denounced in the same way.
We must ask ourselves the right questions in the face of an increase in new cases of cancer. The simultaneous absence of a reduction in serious cancers, the consequent lack of a reduction in these cancers that kill, that screening does not detect because they cannot be anticipated and evolve with a growth rate that makes them serious cancers. Incidence is increasing. Mortality is not falling in parallel with the intensity of screening.
At the same time, massive and systematic screening finds a plethora of tumors that would never have killed if undetected, a phenomenon known as overdiagnosis. Carcinomas in situ are a substantial source of overdiagnosed cancers and, according to some scientists, are wrongly labeled as cancers.
Why is overdiagnosis a real danger?
It excessively increases the incidence (the rate of new cancer cases) of breast cancer; as these are cancers that would never have been harmed, survival rates are artificially improved, leading to the reassuring slogan: "breast cancer is very well treated and often cured." Of course, it is cured all the better because we over-treat lesions that should never have been detected and would never have killed anyway. The medical profession cannot refrain from telling patients that they have been "saved," whereas screening may have harmed them.
Above all, overdiagnosis leads to overtreatment, which includes radiation therapy. Radiotherapy treatments, like breast surgery (partial and total mastectomies), which is not "lightened," contrary to what health authorities state, are only rising, contributing to what our two authors decry, namely exposure to ionizing radiation.
It is likely that the issue here is not so much the direct exposure during mammography (except for young, non-menopausal women under 50 years old who have an increased risk of radiation-induced cancer) as the treatment that a woman receives.
Speaking of "light" treatment, as the health authorities do, appears cynical because the issue is not one of the lightening therapies but of ensuring that women are not overdiagnosed and do not receive abusive therapy that they should not have had.
Radiation toxicity, downplayed in breast cancer screening, is a reality; radiation-induced cancer should not be ignored.
Radiation-induced heart disease is the biggest killer in survivors of treated cancer.
Hematological cancers can occur after radiation and chemotherapy.
Experiencing this is not harmless; sharing it abusively because a woman has not been alerted to the risk of overdiagnosis inherent in screening is ethically unacceptable.
Conclusion
So yes, let's return to Ms. Desurmont's conclusion: "Let's have the courage to look beyond Pink October and demand that we be able to bring into the world little girls who won't have to waste so much energy trying to survive, cared for by the same world that made them sick."
But this courage must include questioning medicine and how it makes healthy people sick by making them go through tests, they don't need.
This is what the public, the sick and the healthy, and especially the politicians need to be "made aware of." And this is done by telling women the truth about the risks and benefits of screening, not by using pink propaganda that wrongly makes women heroes when some of them should never have known they had this disease and others have this disease in its most serious form, which makes them invisible, impoverishes them, and isolates them from society.