The language of cancer

Firstly, I realise that I've left those of you who don't follow me on Twitter or Facebook anxiously waiting to hear the results of my tests, and I'm truly sorry. I'm delighted to be able to tell you that everything was clear, and my lymph nodes were just reactive - enlarged because of a bad cold I had.

I now feel really guilty about sharing the anxiety and dread that I was feeling. It's bad enough that my family and close friends had to suffer with me, and I didn't need to bring everyone else along for the ride. At the time, I wanted people to know just how strong the scanxiety can be, and how we have to carry on as if everything is normal whilst waiting for the results. If there is a next time, I promise not to do it in real time! Read More…

Tamoxifen to prevent breast cancer?

The Independent and the Daily Telegraph published articles yesterday saying that less than half of all GPs knew that Tamoxifen can reduce the risk of breast cancer, and that they are denying women this cheap drug that could slash their
risk of breast cancer by 40%.

I thought I'd try and explain this a little, as it's not as simple as - take Tamoxifen and you won't get breast cancer. It may be that GPs need to be educated about the benefits of Tamoxifen, but we also need to educate the patients so they can make their own, well-informed choice.
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....and relax

If you remember, I was waiting to see my surgeon to have my neck nodes looked at. It was meant to be Friday but my surgeon was poorly, and so my appointment was moved to Tuesday. However, last Thursday night I was having a rummage around. I'd seen my GP who couldn't feel any other nodes, but I thought I'd double check. And I found a couple of large lymph nodes in my right armpit (the other side to my original breast cancer). And this worried me a lot more than the neck nodes.


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World Cancer Day

As a breast surgeon, I was always vaguely aware of World Cancer Day, but the significance of it passed me by. And then I got diagnosed with breast cancer myself, and I went from being a doctor to a patient, having the very illness that I was an expert in. I never thought breast cancer could happen to me, and I didn't check my breasts regularly – which goes against everything I tell my patients. But I did get cancer, and I got the full works when it came to treatment, as you all know. Five months of chemotherapy, a mastectomy and implant reconstruction, followed by further lymph node removal and then radiotherapy. The finishing touch was an instant chemical menopause, which was not what I had planned at the age of 40. Read More…

Gender sterotypeds article

Int women day
Joke I got wrong

Here’s an old riddle. If you haven’t heard it, give yourself time to answer before reading past this paragraph: a father and son are in a horrible car crash that kills the dad. The son is rushed to the hospital; just as he’s about to go under the knife, the surgeon says, “I can’t operate—that boy is my son!” Explain. (Cue the final Jeopardy! music.)
If you guessed that the surgeon is the boy’s gay, second father, you get a point for enlightenment, at least outside the Bible Belt. But did you also guess the surgeon could be the boy’s mother? If not, you’re part of a surprising majority.
In research conducted by Mikaela Wapman (CAS’14) and Deborah Belle, a College of Arts & Sciences psychology professor, even young people and self-described feminists tended to overlook the possibility that the surgeon in the riddle was a she. The researchers ran the riddle by two groups: 197 BU psychology students and 103 children, ages 7 to 17, from Brookline summer camps. (They did the latter study through the Undergraduate Research Opportunities Program (UROP).)
In both groups, only a small minority of subjects—15 percent of the children and 14 percent of the BU students—came up with the mom’s-the-surgeon answer. Curiously, life experiences that might suggest the mom answer “had no association with how one performed on the riddle,” Wapman says. For example, the BU student cohort, where women outnumbered men two-to-one, typically had mothers who were employed or were doctors—“and yet they had so much difficulty with this riddle,” says Belle. Self-described feminists did better, she says, but even so, 78 percent did not say the surgeon was the mother. (The results were no different for an alternate version of the riddle: a mother is killed, her daughter sent to the hospital, and a nurse declines to attend to the patient because “that girl is my daughter”; few people guessed that the nurse might be the child’s father.)
The genesis of the research was Belle’s 10-year-old granddaughter, who was given the riddle by her mom. “She thought for a moment,” Belle says, “and she said, ‘How could this be? Well, he could have two fathers.’” The child couldn’t muster any other explanation. Nor could several of her friends. “This piqued our interest,” Belle says. When she and Wapman posed the riddle to kids in the UROP study, some of the answers stretched the bounds of inventiveness: the surgeon was a robot, or a ghost, or “the dad laid down and officials thought he was dead, but he was alive.”
The results are all the more surprising considering that college students and participants in tony Brookline’s summer programs likely hail from higher income and educational backgrounds than the general population. “These are two populations that we would expect, if anything, would be in the avant-garde,” Belle says. Yet, for example, BU students theorized the “father” in the car referred to a priest, or the surgeon was “horribly confused,” or, à la the old Dallas TV show, the whole scenario was a dream.
What made imagining a surgeon mom so difficult? Gender schemas—generalizations that help us explain our complex world and “don’t reflect personal values or life experience,” says Wapman. (So having a surgeon mother doesn’t necessarily mean you’ll propose that as the riddle’s solution.) “Schemas are very, very powerful,” Belle says, adding that the studies’ results and the endurance of gender stereotypes would not surprise Virginia Valian, a Hunter College psychologist who has noted how people presented with the same CV for a man and a woman typically assume the man is more competent.
Valian “argues that schemas are formed very early in life,” says Belle, “and that when it comes to gender, we fixate on women’s reproductive functioning, and we sort of allot competence to men. Experience can have some effect in our schemas, but much less than we might anticipate.” Valian has also noted that schemas are identical in our culture for men and for women—which is exactly what the BU survey found.
That bias against women, Wapman believes, shows the significance of schemas, “this silly riddle” notwithstanding. Stephanie Coontz, who teaches history and family studies at Evergreen State College in Washington state, cited the BU duo’s work in a New York Times column on the problems facing mothers in the workplace.
The solution? “Having people understand that they hold this bias,” says Wapman, “and when you look at job applicants, keep that in mind.”
“Eternal vigilance, I think, is the only solution,” says Belle. “These schemas do change over time”—she points to other countries with greater gender equity—“but the pace is glacial.”
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