Tuesday, August 21, 2012

Culture of blame: how we perceive certain diseases


In her article "Scandal of Underfunded and Undertreated Cancer" [1], Linda Geddes describes the heart-breaking struggle of a non-smoking mother-of-two against the ravages of lung cancer. The purpose of the article was to point out the disparity between research funding and number of deaths for the various cancer types. Leukemia and breast cancer draw from huge sources of public and private funds, receiving much more than their deaths : research-dollars share. There are more deaths from lung cancer than from breast cancer or leukemia, but the funding for lung cancer research is pathetically small. Part of the reason for this is that many family physicians view lung cancer as untreatable--a diagnosis of death--so why fund research into an untreatable disease? But, after all, how are we to learn how to treat the disease without research? And how shall we perform research without funding? 

The article suggests another alarming reason for this funding disparity as well: many people, consciously or unconsciously, believe that lung cancer is the fault of the victim. If they hadn't smoked, after all, would they be in this situation? Shame on them! And they're endangering us with their second-hand smoke as well! But what about non-smokers who get lung cancer? (After all, that second-hand smoke is going somewhere, isn't it?) And what right do we have to blame the victim of a disease, anyway? Is a person's death less tragic because he was a smoker? Trust me, I fall prey to those adverts of children with leukemia...I want to send them money, too. But does our culture of blame induce us to spend money on those we consider "deserving" but not on the "undeserving?" Are we ok with that? 

I think a good example of our society (and the world) overcoming a prejudice against a culture-of-blame disease is our relative success with suppressing the dreaded AIDS epidemic. Many a politically-incorrect statement about AIDS victims was bandied about when I was younger...but now, I think, those negative connotations are mostly remembered only by older members of society. And although we haven't successfully "cured" or fully protected against AIDS, we can now suppress it with anti-viral drugs--the result of well-spent research funding. Perhaps we can take a good lesson from our success with AIDS. Perhaps we can see lung cancer for what it is--a tragic disease that steals the lives of tens of thousands of people in the US every year*. Perhaps we can bring a halt to our culture of blame.

Geddes, Linda: Scandal of Underfunded and Undertreated Cancer. New Scientist issue 2871. 28Jun, 2012.

*This number was 35,000 deaths in the UK in 2010 according to Geddes' article.

5 comments:

  1. Hey Rachel

    This is a great post on an issue I had never considered (though it now seems to self-evident).

    It also raises an alarming problem regarding charitable donations to cancer research. Correct me if I'm wrong, but treatment for breast cancer has changed drastically little since its inception (I remember reading about this in Barbara Ehrenreich's book 'Smile or Die'), so where do all our well-meaning charitable dollars go to?

    I read this article a few months ago and found its observations quite startling.

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  2. PS: Of note is Dana Reeve, late-wife of the late-actor Christopher Reeve. A non-smoker, she died from lung cancer.

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  3. Great post.
    I wonder is it something to do with blaming tobacco, and the tobacco industry, in the first place? It's the whole find fault with the sin not the sinner argument that is very difficult (and has been stolen by the anti-gay brigade).

    I do remember the *good* Aids vs the *bad* Aids, was that on South Park? Horrible horrible idea.

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  4. CME de Oliveira: Wow, that was an interesting article. I had no idea how sketchy breast cancer charities can be...but I guess they're like any other charity--you need to know who you're giving your money to.

    Treatment for breast cancer changed quite a bit over the years, yes. Women used to get "radical mastectomies" where not only the breast but much of the tissue underneath was taken in a deforming operation. Now, we mostly do "lumpectomies," which just take a small bit out. But the effectiveness of that treatment is being questioned now. In a blog post a while back I briefly mentioned this article: http://www.newscientist.com/article/mg21428700.300-cruel-cuts-is-all-breast-cancer-surgery-necessary.html

    It points out that the rate of breast cancer occurrence hasn't exhibited the expected drop when we started giving lumpectomies after preventative mammograms.

    Fence: HA! Well, I haven't seen that episode, but it sounds like I'm better off without it. ;)I'm not sure who gets blamed more, the tobacco companies or the smokers, but there certainly is a lot of mud flying around and it hits a lot of people!

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  5. How correct you are. I remember the landscape in the early 90's when I was in an academic environment. The joke was that any grant could get funding if the project could be attached to AIDs. The big advances in breast cancer have come not so much in cure rates, but more conservative treatments. Halstead, the surgeon who began the radical mastectomy trend, believed that removing lymph nodes to which cancer had spread improved survival. We now know this to be incorrect, but we use lymph mode positivity to guide post operative treatment with chemo.
    Fred F

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