Commenting on Steve’s post “Cutting Medicaid; Breast Cancer and Cervical Cancer”, I mentioned the disparity between the attention given to breast cancer and that given to prostate cancer.
In response to my comment, Janice said, “Early detection and treatment of breast and cervical cancer saves lives, not true of prostate cancer.” Janice is correct, and this post is not to denigrate Janice, but to highlight a bias in our society.
That fact that early detection and treatment of prostate cancer does not save lives may be due several reasons, or a combination of those reasons. Prostate cancer may be easily treatable, therefore later stage prostate cancer can be easily and successfully treated. Prostate cancer may be particularly virulent and treatment rarely succeeds no matter what the stage. Prostate cancer grows slowly but the medications and techniques to successfully treat prostate cancer are not yet known, thus early detection doesn’t help significantly. There may be other reasons, but these will suffice for the moment.
According to this “Cancer Facts & Figures” (2010) from the American Cancer Society, more men die from every category of cancer except breast cancer (390 males, 39,840 females), the other female specific cancers and endocrine system (1,140 males, 1,430 females). Overall, males die from cancer more than females. (299,200 males, 270,290 females). But, how is the funding for cancer research distributed? Not very evenly.
For the National Cancer Institute’s budget the numbers broke down like this:
Among the big cancers, breast cancer receives the most funding per new case, $2,596 — and by far the most money relative to each death, $13,452. Notably, prostate cancer, the most common cancer, receives the least funding per new case at just $1,318. But on a per-death basis it ranks second, with $11,298 in N.C.I. funds.
Here’s a look at the N.C.I. cancer funding based on 2006 death rates and incidence rates for some of the most common and deadliest cancers.
| Cancer (Deaths) | N.C.I. Funding per Death |
| Lung (162,460) | $1,630 |
| Colon (55,170) | $4,566 |
| Breast (41,430) | $13,452 |
| Pancreas (32,300 ) | $2,297 |
| Prostate (27,350) | $11,298 |
| Cancer (New cases) | N.C.I. Funding per New Case |
| Prostate (234,460) | $1,318 |
| Breast (214,640) | $2,596 |
| Lung (174,470) | $1,518 |
| Colon (106,680) | $2,361 |
| Pancreas (33,730) | $2,200 |
In the Cancer Facts & Figures, we see 207,090 new cases of breast cancer in females in 2010 and 217,730 new cases of prostate cancer. We’ve seen how the funding numbers look per individual case and death, how about overall? From the National Cancer Center:
| Cancer Type | 2008 Spending (in millions) |
2009 Spending (in millions) |
2010 Spending (in millions) |
| Lung | $247.6 | $246.9 | $281.9 |
| Prostate | 285.4 | 293.9 | 300.5 |
| Breast | 572.6 | 599.5 | 631.2 |
| Colorectal | 273.7 | 264.2 | 270.4 |
| Bladder | 24.1 | 25.9 | 22.6 |
| Melanoma | 110.8 | 103.7 | 102.3 |
| Non-Hodgkin Lymphoma | 122.6 | 130.9 | 122.4 |
| Kidney | 43.4 | 45.2 | 44.6 |
| Thyroid | 14.6 | 14.7 | 15.6 |
| Endometrial (Uterine) | 17.1 | 18.0 | 14.2 |
As you can see, breast cancer research receives more than double the funding than any other form of cancer, including the number one killer, lung cancer, 157,300 deaths vs 72,280 for breast and prostate cancer using the ACS figures.
I’m going to posit that the reason Janice’s statement, “Early detection and treatment of breast and cervical cancer saves lives, not true of prostate cancer,” is true is the third reason I listed, “the medications and techniques to successfully treat prostate cancer are not yet known, thus early detection doesn’t help significantly.” It seems quite likely that, had the same funding and emphasis been put on prostate cancer over the past few decades as has been to breast cancer, early detection would save lives.
But, as we’ve seen more and more in our society, men matter less and less. Men seem to be in the position of group A in H. M. Stuart’s post, Politics and the English Language. Feminism has wielded a heavy hand over the past few decades. Trouble is a lot of men don’t care about men either, that doesn’t improve the odds of them getting laid.
If we were to distribute funds based on the impact of a disease on total society, Alzheimers/dementia would get more that all the cancers together. It is the second highest cause of death in US society. In addition, it causes death after several years of progressive debility and costly care. Yet, in the NIH budget, dementia does not even have its own heading but is included under neurological disorders.
Prostate cancer is a pretty complex disease. A percentage of persons with this disease do very well with no treatment at all and live a normal life and die of causes unrelated to the cancer. We do not have technology at this point to determine which ones are of this variety. The problem with vigorous early detection programs is that we find a number of these tumors and they are subjected to aggressive care. When one factors in the complications and deaths from treatment, there is little or no benefit to the population of men as a whole. Put differently, as much harm as benefit is done.
All that said, clearly the women’s lobby has been very effective in beating the drums of breast and cervical cancer. Those of us with close relatives who have suffered the devastation of dementia might do well to push for similar lobby actions.
Most family caregivers of people with Alzheimer’s are too busy and exhausted to do any lobbying.
To second Ed, detecting prostate cancer early does not lead to better outcomes. Breast cancer also affects a goodly number of younger women. Still, it seems likely there are other reasons. I think the women’s lobby is a factor. I also think that politicians from both sides of the aisle pander to the women’s vote this way.
Steve
Women, of course, despite being 53% of the population except in China and India, are a “special interest group.”
Prostate cancer varies in its virulence based on age. Perhaps breast cancer does, as well, though that seems less clear.
Without question, the younger a male contracts prostate cancer the LESS likely there is of a “good outcome.”
Frank Zappa died within a year of contracting that disease in his fifties. None of the firefighters I’ve known who came down with that disease young (50 and under) are around today.
Older men tend do have better outcomes. Some oncologists have indicated they believe this is due to lower hormonal levels in older people. My father contracted prostate cancer and caught it later (he was 66 y/o) when he was diagnosed. He lasted 6 years, all but the last one, in which he was on some experimental treatments that didn’t work for him, but helped with studies being done to benefit future patients, were relatively decent quality of life years.
My mother contracted breast cancer at around the same time (in her 60s) and she fortunately caught it earlier than my Dad did his. She’s still alive today, over 25 years later.
Perhaps age is a factor in both cancers.
The problem with focusing on groups (ie. races, or genders) is that most educated people and even more very educated tend toward a fair amount of “sloppy thinking,” or over-generalization. Our educational methods teach us to generalize that “if it’s true in this case, it should be true in all others.” And indeed, the laws of math and physics don’t change and they can be used to explain results across all fields. However, many of even the most educated among us tend to make generalizations, forge opinions and come to conclusions without taking into account enough of the many variables presented. That kind of lazy/sloppy thinking is also inculcated in higher education, as most advanced math and physics questions begin with “assuming a perfect vacuum,” precisely so that the many and “extraneous” variables can be overlooked.
The fact that black men, for instance, contract prostate and other cancers at a significantly higher rate than white and Asian men for instance is NOT an “issue,” but merely a interesting aberration. Issues, bring about progress on the overall disease, aberrations, merely deliver a narrow focus on a small aspect of that disease and generally do very little in the way of leading to a better overall understanding of that disease.
COULD and perhaps SHOULD the potential reasons for such disparities be looked at? Differing dietary and other habits, perhaps?
Sure, so long as they are NOT coupled with well-intentioned attempts to control the behavior of groups who have those higher disease rates.
For instance, if it were shown that perhaps the African-American diet might have something to do with the higher disease rate, our system of enshrined individual liberty allows for education (suggesting that people change their more self-destructive habits) BUT it does NOT allow for us to look to directly interdict or even make these choices more difficult/expensive for them.
The same is true for women and lung cancer. Women now lead men in contracting lung cancer and last I looked there had been a greater increase in women smoking coupled with a decrease in men smoking. That too is but an “interesting aberration,” NOT an “issue” surrounding lung cancer. That interesting aberration does NOT appear to justify more funding for “women’s lung cancer,” although it could be a basis for more anti-smoking education and outreach geared toward women.
Perhaps many women saw lung cancer as “a man’s disease” and not just a smoking-related one. THAT is an education issue NOT a cancer issue.
ETH is correct, that IF we funded diseases based on rates of contact and the devastation caused, then Alzheimer’s & Parkinson’s disease would get far more funding. . .ACROSS-the-BOARD and NOT geared only to certain population demographics.
I don’t understand why supporting the cause of breast and cervical cancer research is equated with pandering. Yes, many women’s groups have advocated for this funding. I think women have embraced this cause partially because so many have seen family and friends suffer and also because of the ways women have been treated in the past by doctors. There was a big push for women to take control of their healthcare by questioning doctors and pushing for funding. For a long time medical studies primarily studied men while ignoring women and many doctors had a paternalistic “I know best” attitude. Women finally responded by advocating for themselves.
Where are the men advocating for prostate and other cancer research? Every year I am approached in person and on Facebook by friends and co-workers running and walking marathons or raising funds in other ways for breast cancer research and awareness. No one has ever asked me to support prostate cancer research.
By the way, men can get breast cancer too.
I mentioned that: more men die from every category of cancer except breast cancer (390 males, 39,840 females),
“I don’t understand why supporting the cause of breast and cervical cancer research is equated with pandering.” (ST)
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Since I didn’t mention vote pandering (others did) I can pretty much guess that it’s because breast cancer is funded at more than double the deadliest cancer in the U.S. (for men & women). . .lung cancer. . .and 2nd deadliest (colo-rectal cancer) and more than 6X as much money per death is spent on breast cancer ($13,452) than is spent per death on pancreatic cancer ($2,200) which little progress has been made and which remains a veritable death sentence.
When you look at the outcomes and the number of cases contracted, there’s certainly a politicization of cancer funding, given that lung and colo-rectal cancers are so woefully underfunded (especially relative to their deadliness) compared to breast cancer.
I think the response you might be looking for isn’t so much “WHY is that pandering,” (since it is), BUT “Well, just about everything that government funds in America has been politicized.”
Out of curiosity I looked up definitions of pandering. There were several (see the more sex-related ones at: http://www.thefreedictionary.com/pandering). The closest that comes to the way I think it was meant in the comments above is:
“to provide gratification for others’ desires <films that pander to the basest emotions" and “to facilitate the fulfillment of others’ or another’s desire, especially one of questionable appropriateness or morality.”
“When you pander to people, you cater to their needs because you want something from them. A good example is a politician who says what the voters want to hear, to get their votes–politicians pander to voters. The verb pander is used in a negative way to denote the behavior of someone who has ulterior motives or just wants to indulge the person to whom they are pandering.”
I don’t think that at all describes what has happened with breast and cervical cancer research. Charities and groups of women put forth an unprecedented effort for the past 30 years to get more funding and research for these cancers in part, as I said above, because of the long history of having their needs ignored. If finally the “powers that be” started spending more money on this research because of their efforts, well then good. We live in a representative democracy and enough people felt strongly enough about this issue to push their representatives to do something about it. Just because it was women pushing for it doesn’t make it pandering or the results of questionable morality.
I’m not sure how to explain the discrepancy in the numbers you’ve just listed and the ones I found on the American Cancer Society website. According to the ACS, more women than men have colo-rectal cancer and those numbers combined are less than half of the women with breast cancer (men make up .5% of breast cancer).
http://www.cancer.org/Cancer/CancerBasics/cancer-prevalence
If I seem annoyed it is because 2 of the 3 comments above included jabs about feminists, which is all the more ridiculous given the most well known and largest organization pushing breast cancer awareness and research is the Koman foundation which has recently outed itself as clearly not part of the great Feminist Cabal.
Not sure why that’s all in italics. ???
As I noted, I didn’t use the term “pandering,” although it’s certainly appropriate, as that’s what’s been done.
AND there’s NOTHING innately wrong with “pandering”. . .for votes, or anything else.
Corporations today are partnered with government – they control the media and filter the news/information people get, they control the grant process via their own and government grants – people are rewarded for views that are in-line with what that Corporatist partnership wants.
Now there’s NOTHING innately wrong with that either. . .it can only accurately be said that, “Such a partnership is perhaps too powerful and influential and is very much rife for abuse.”
Still, the reality is that for better or worse, ALL such funding is “political.” It IS what it is.
Breast cancer is LESS deadly (that is fewer people are stricken and die from it) than lung and colo-rectal cancer.
SEE: http://www.msnbc.msn.com/id/39102353/ns/health-cancer/t/top-deadliest-cancers-why-theres-no-cure/#.T0reHVHYTeU
Lung Cancer: 792,495 lives lost
Colo-rectal Cancer: 268,783 lives lost
Breast Cancer: 206,983 lives lost
But HIV impacts far fewer people than do Parkinson’s and Alzheimer’s, and yet far more money’s been spent on HIV research. It IS what it IS.
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The idea of “women as victims” is something I’ve never really considered. . . I’m very serious about that.
Are you saying that Feminist groups oppose long-standing traditions like “Women and children first?”
Or being dissuaded from working outside the home in past generations, and often given that option today?
I’ve honestly never heard such claims.
I know that no one can say anything like, “The concerns of women have traditionally NOT been listened to” at least not with a straight face!
For even BEFORE women had the vote they had the influence to get the most ill-conceived, misguided and anti-freedom Amendment (The 18th Amendment) or “The Volstead Act” that ushered in prohibition. You COULD SAY, “Yup, just like a bunch of women, to push the ONLY Amendment to ever restrict individual liberty,” without being all that ironic. Certainly lots of women also opposed it and some men supported it! Still, it’s primary impetus came from women’s groups.
Women have been a LOT of things, but “victims” hardly describes the historical state of most women in America or the West. They don’t appear to have been “victimized” any more than any other group (ie. males, the Irish, blacks, Jews, gays, etc.).
Ironically enough, one of the worst atrocities ever committed on this planet (The Irish Slave Trade) DID indeed impact women every bit as much as men, BUT you rarely ever hear it mentioned. Is it just an “inconvenient bit of history? For after the Irish backed Charles I (a Celtic Scot) Oliver Cromwell was unleashed in retaliation and his genocidal campaign against the Irish Celts reduced the population of Ireland from 1.6 MILLION to around 500,000 in a relatively short order! Hundreds of thousands of Irish (many women and children) were “kidnapped” (that’s where that term was first coined) off the streets and sold into slavery (NOT “indentured servitude”) in “the Americas.”
Until 1705 there were more Irish slaves in the Americas than blacks.
Unlike the African slave trade, the Irish never sold their own into slavery. In Africa, the Zanzibar slave trade (between the Arabs and sub-Saharan Africans) had existed since the 8th century and continued long beyond the (self-initiated) end of the European slave trade in the mid-19th century.
No other group was subjected to anything close to the genocide the Irish were. In fact, on slave ships, when cargo had to be cast off as “ballast,” the Irish slaves (which were gotten for free) were always thrown overboard before the slaves the slavers paid for.
In the “New World” (especially in the West Indies/the Caribbean) Irish females were often bred with black males to create slaves that generated a higher price on the slave market for their owners. In THAT regard, Irish women were abused differently though not so much worse (what can be worse than torture and death?) than Irish males during that long attempted genocide.
That’s a bit of history worth taking a second look at.
SEE: http://www.amazon.com/White-Cargo-Forgotten-History-Britains/dp/0814742963/ref=sr_1_1?ie=UTF8&qid=1330313798&sr=8-1
AND: http://www.amazon.com/Irish-Slaves-indenture-Contract-Immigrants/dp/145630612X/ref=pd_sim_b_2
AND: http://www.amazon.com/They-Were-White-Slaves-Enslavement/dp/0929903056/ref=pd_sim_b_4
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And yes, I know what they say, “This kind of victimology is all fun and games UNTIL someone loses an eye!” It’s just that so much of what is taught as “history” today, just really isn’t so.
I don’t really understand what the last half of this has to do with anything. That women pushed for Prohibition has zip to do with current cancer research.
I know that no one can say anything like, “The concerns of women have traditionally NOT been listened to” at least not with a straight face!
I can say that with a straight face. Particularly when it comes to the medical establishment of yesteryear.
Women’s successfully pushing for the Volstead Act proves that “women’s concerns have long been taken seriously”. . .even the misguided ones (like prohibition).
Indeed, Margaret Sanger DID bravely pioneer eugenics via “reproductive services for women” (Planned Parenthood) and I commend her for that. TODAY poor women avail themselves of such services at an absolutely astonishing rate. I believe I noted elsewhere that in NYC over 80% of black pregnancies end in abortion and nationwide that 12% of the female population accounts for over 35% of all abortions.
YES, anti-eugenicists DID (and still do) oppose that, but the strides Sanger made were NOT at all due “to men not taking women’s concerns seriously,” but rather that pesky (earlier) association of eugenics with racialism. . .an association that Margaret Sanger (by the way) did little to ameliorate.
The above source indicates that breast cancer lags far behind lung cancer and significantly behind colo-rectal cancer in terms of deadliness, but overwhelms them both in terms of funding. That can be attributed to “pandering,” but again, ALL such funding is “political.”
if it weren’t, HIV/AIDS research wouldn’t be so much better funded than the far more far-reaching and devastating Parkinson’s & Alzheimer’s research.
It IS “pandering”. . .it IS “political”. . .BUT virtually ALL funding today is enmeshed in BOTH those things. That fact shouldn’t vex you so much.
Here’s another question worth thinking about. Is it that there has been a static amount of money for cancer research which breast cancer research has been taking more and more of, or has the amount of money increased with funding specifically aimed at breast cancer?
[...] went and found the referenced pages in the articles, despite there being links to them. Article – http://www.aleksandreia.com/2012/02/25/the-unfairness-in-cancer-research-funding/ Accompanying article (linked in original) Cancer Funding: Does It Add Up? – NYTimes.com [...]
[...] Posted by prohobo;1594773[FONT=" [/FONT]] Article – http://www.aleksandreia.com/2012/02/25/the-unfairness-in-cancer-research-funding/ Accompanying article (linked in original) Cancer Funding: Does It Add Up? – NYTimes.com [...]