Just minutes
after rocker Melissa Etheridge posted notice on her Web site
October 8 that she was being treated for breast cancer, her
message board was bombarded with hundreds of
supportive notes from fans. "Wow, I didn't
see this coming," the singer responded, writing about
her diagnosis on the site. "What an unexpected
journey this is."
In an instant, Etheridge had brought cancer into
the nation's headlines. What impact her
diagnosis will have on the health of lesbians remains to
be seen, but the news came as a shock, particularly since
Etheridge is only 43. (Still recovering from surgery,
Etheridge had granted no interviews at press time, but
she did approve of the use of her image with this story.)
"Hearing about Melissa's diagnosis
gave me a jolt, as I'm sure it did to a lot of
lesbians," says Alison Bechdel, author of the
"Dykes to Watch Out For" comic strip,
which features a lesbian character with breast cancer.
"I think we tend to be pretty much in denial about
breast cancer until it touches our lives directly.
Even among the out activist lesbians I know who are
very educated about breast cancer and prevention,
it's a threatening topic. So I think the fact
that everyone knows Melissa will definitely get us
talking more and, hopefully, dissipate the fear and
denial a little bit."
Adding to many lesbians' fears is the
fact that they've come to believe their risk of
developing breast cancer is much greater than that of
heterosexual women. It is true that studies have found that
some risk factors for breast cancer--such as
being overweight, smoking, and not having given birth
or breast-fed--are more common among lesbians. But a
recent study that compared differences in risk factors
between lesbians and their heterosexual sisters did
not find much disparity at all.
"What we found was that the risk was
about 1% higher in lesbians," says Suzanne
Dibble, cofounder of the Lesbian Health Research Center at
the University of California, San Francisco, and a
lead researcher on the study. But even if the risk is
higher, that doesn't mean more lesbians will
get breast cancer, she notes. Women with many breast cancer
risk factors don't always get the disease,
while some women who have none of the known risk
factors do.
Noelle Mayhew was diagnosed with breast cancer
in July 1999 at age 32 and "was totally blown
away," she says. Mayhew had gone to see her doctor
after she began experiencing pain in her right breast and
"thought of cancer as an old ladies'
disease. Also, when you hear 'cancer,' the
first thing you think is, I'm going to die."
Following her diagnosis, Mayhew had a modified
radical mastectomy followed by chemotherapy and
radiation. Over the next several years it appeared her
cancer was gone. Then in May she learned that the cancer had
returned and spread throughout her body. But even that news
hasn't dampened her spirit. Mayhew, who is a
buyer for an arts and crafts paper store, is grateful
for the support of her family and friends. In fact, on
the day that she spoke to The Advocate, her mother threw her
a surprise party at work. She mentions that she is
single but is dating. And she's now in an
18-month clinical trial that is designed specifically for
women with metastatic disease that is testing a new
way to treat cancer. She says, "I don't
plan on going anywhere."
"You have breast cancer" are
undoubtedly four of the scariest words a woman can
hear from her doctor. And about 216,000 women in the United
States will receive that news in 2004. All women are at risk
of developing breast cancer; statistics indicate that
the older a woman gets, the greater her chance of
developing the disease. Approximately 77% of
incidences of breast cancer occur in women 50 and over. It
is estimated that 40,110 U.S. women will die of the
disease this year.
"We need to get lesbians into routine
screening because when a woman is diagnosed early her
chances of surviving are much higher," says Ellen
Kahn, director of the Lesbian Services Program at the
Whitman-Walker Clinic in Washington, D.C. "At
this point, everyone knows someone who has or has had
breast cancer. It's not a foreign or intangible
reality. Yet there remain lots of personal reasons why
folks delay mammograms or don't do breast self-exams."
The good news is that more women are now being
diagnosed early, when the disease is more easily
treatable; options for treatment have improved; and
many more women survive breast cancer than die from it.
"We cure two thirds of breast
cancer," says openly gay breast surgeon and
women's health activist Susan Love. "And when
I say 'cure,' I mean that most women who
have had breast cancer will not die from it. Further, even
once breast cancer has spread to other parts of the body,
women can live for a long time with the disease.
"There has been more research on breast
cancer than probably any other cancer," Love
continues, "and that, in part, is thanks to the
efforts of many women. We've made a lot of
progress in treating breast cancer, but what we really
need to learn how to do now is to prevent breast cancer
from happening."
Another important
factor that determines whether women will be diagnosed
early, when the disease is most treatable, is access to
care. But research shows that lesbians are often
worried about encountering homophobia in the
doctor's office; they are also less likely to have
health insurance. And not having regular access to care,
which keeps women from having annual mammograms or
clinical breast exams, can delay a breast cancer diagnosis.
Annie Shaw, a 57-year-old lesbian, knows this
firsthand. Shaw's mother and three maternal
aunts all have had breast cancer. And she works in the
Lesbian Services Program at the Whitman-Walker Clinic. But a
negative experience with getting a mammogram in 2001
when she didn't have health insurance kept her
from getting the routine care she knew she needed.
"Even I, who knew better, couldn't
call and make the appointment," says Shaw.
"I even have a partner who was going to a breast
surgeon every six months" because she had had a
suspicious biopsy. "So I should have been first
in line. But the reality was, my own fears or my own shame
kept me back."
Shaw finally went for that mammogram in August.
She had breast cancer. She had surgery to remove the
two tumors that were found, and she will soon begin
chemotherapy and radiation. The diagnosis has been hard, but
Shaw says she's pleased that she found a
lesbian-friendly surgeon who put her at ease by
expressing concern for both her and her partner. "My
doctor told me that she thinks a breast cancer diagnosis is
harder on female partners than on a husband,"
Shaw says, because "it puts partners in touch
with their own fear of having breast cancer. And for my own
partner, that has been true."
How individual lesbians view their breasts can
also affect how they handle a cancer diagnosis.
"I've heard plenty of butch lesbians
who've had breast cancer or are at high risk
for breast cancer say that they are more than happy to
have their breasts removed because they don't want
them and never wanted them," says Jessica Halem,
executive director of the Lesbian Community Cancer
Project in Chicago. Yet, she notes, there are other
lesbians--butch and femme alike--who feel their
breasts are an important part of their sexuality and
who choose treatments that will allow them to keep
their breasts or who decide to have reconstructive surgery.
"I still have both of my breasts. and
whether I will keep them is a bridge I have to cross
later," Etheridge wrote to fans in the days after
her surgery. "They took out the tumor and a few lymph
nodes, only one of which was positive...the
sentinel node (for those that know breast cancer-
speak). After that my margins are clean!" At press
time, the singer was home recovering with wife Tammy
Lynn Michaels, who has also declined to speak to the press.
Etheridge's diagnosis came after she
discovered a lump in her breast. For Vernita Gray, it
was a friend's insistence that she get a mammogram
that might have helped save her life. She had a family
history of breast cancer--her mother,
grandmother, great-aunt, and cousins had all been
diagnosed with the disease--but had not had a
mammogram in over a year. When she did, in November
1995, at age 47, she was diagnosed with cancer in her
right breast. Over the next eight years, it appeared that
her cancer was in remission. Then in September 2003
another mammogram showed that she had a tumor in her
left breast.
Gray decided to have both breasts removed and to
have immediate reconstructive surgery. Initially she
wasn't going to have the reconstructive
surgery. "It was a challenge for me as a butch
lesbian," she says. "But I'm glad
I did it. I swim a lot, and I feel comfortable wearing
a swimsuit. And that's important to me."
It's been a year since Gray's
surgery, but she still needs to have two more
surgeries on her breasts--which she calls "my
new girls"--before the process will be
complete. "It's been a long and incredibly
painful process," says Gray, who is the GLBT
liaison in the Cook County state's
attorney's office in Chicago, "but I've
been an activist for 35 years, and I'm still
doing my work in the community."
Gray's
second diagnosis led to myriad other changes in her life as
well. "My breast specialist said to me,
'Let's take a look at your lifestyle,'
" says Gray. So she did. Soon she was working out
regularly, had changed her diet, and was no longer the
bar dyke she once was. Now, she says, on Friday
nights, instead of sitting at the bar breathing in other
people's cigarette smoke, "I'm at
my local health food store buying tofu and
nitrate-free bacon and then heading home. I hardly recognize myself."
Health advocates would like to see more lesbians
adopt such overall lifestyle changes. They hope
Etheridge's diagnosis not only draws attention
to breast cancer but increases awareness about broader
health issues. "It's more complicated
than just saying, 'Go get a mammogram.' We
need to talk about health as a way of life," says
Halem. "We have moved to a place where our
loudest cry is for every person to have a strong,
positive relationship with a [health care] provider."
Mary Dzieweczynski, executive director of
Verbena, formerly the Seattle Lesbian Cancer Project,
agrees. "My concern," she says, "it
that we take a specific incident such as someone like
Melissa Etheridge being diagnosed with breast cancer
and put it in the larger context of health disparities
and health justice and how that plays out" among
lesbians. She and her group want women to understand
that wellness is pride, she says: "We want gay
pride to be connected to taking care of yourself."
In the short term, though, when people think
about Etheridge they are undoubtedly going to think
about her struggle with breast cancer, and her fans
are already trying to move that awareness into action.
Virtually overnight a group of women who met on the
MelissaEtheridge.com message board organized a
fund-raising campaign called the Pink Bracelet Fund.
Taking inspiration from the hugely popular yellow live
strong bracelets sold to support the Lance Armstrong
Foundation, the pink bracelets feature the breast
cancer ribbon and say BE STRONG--mle . As of October
20 approximately 13,000 bracelets had been sold worldwide,
and coordinators of the fund-raiser report the
bracelets continue to sell at a rate of 1,500 to 2,000
per day. At Etheridge's request, all of the
proceeds raised will be donated to the Dr. Susan Love
Research Foundation.
Lesbians who have had cancer say they hope that
Etheridge will continue to be an active voice.
"I know if Melissa speaks out, it will really
help," says Shaw. "Especially if she were to
say, 'If you enjoy my songs, go get a
mammogram.' Sometimes it takes someone famous to get
you beyond your own inertia or fear."
Seven days after announcing that she had cancer,
Etheridge posted a second letter on her Web site,
letting her fans know that she is recovering from
surgery at home in Los Angeles and thanking them for
their concern and activism. "Thank you for organizing
and making those bracelets. I am humbled by your love
and caring," she wrote. "I will be
entering the phase of chemotherapy next. Who knows what that
will bring. I will be writing songs for the greatest
hits album and after...(the Pink album, maybe?) I
will be working on the pilot for ABC and hanging with
Tammy and the kids. I imagine you will see me again around
the beginning of the year."