I’m not gonna lie, I just drank some bourbon and I’m already wound up with the onslaught of pink when it isn’t even goddamn Labor Day (I am so sorry, childhood and gynecological cancer peeps, it sucks that Pinktober is eating your awareness month). So maybe this will be even more rangy than my usual feminist breast cancer rant, but I’m not even remotely sorry about that.

I am so fucking sick of the pink awareness machine convincing everyone, especially early stagers, that breast cancer is cured when treatment for early stage disease ends. We don’t know how many people who have early stage disease will later develop metastatic disease, but it may be as many as 36% within 12 years of ending treatment. However many it is, it’s TOO FUCKING MANY. And too many women who have early stage disease think they’re cured, when they are still at risk of developing metastatic disease. 

Why does this happen? I personally think it’s partly a gender issue, and partly a marketing issue. Let’s delve into the gender issue first.

It’s been a thing since time immemorial to treat women like they’re too fragile or stupid or incompetent or whatever to be handle the truth. We’re delicate flowers, you know, so if you tell us that something scary might happen, we’ll probably have some hysterical (did you know that word has the same root as hysterectomy? Because doctors thought our uteruses made us cray-cray) reaction and never recover. So the solution was, just don’t tell women what’s happening to them. 

What. The. Fuck. I mean, WHAT IN THE ACTUAL FUCK, amiright? Except we still do that now. We don’t tell early stagers that their cancer might metastasize because we don’t want to scare them. Why don’t we want to scare them? Is it because we worry their poor little female brains can’t handle it and they’ll start running through the streets screaming and pulling out our hair? For the love of pete, could you all please just stop infantalizing us for five minutes? Women have a right to know what can happen to their bodies. We are not pussies. We’re strong and powerful and we handle horrible shit all the fucking time.

Then there’s the’s the marketing thing. Take a look at practically any marketing for any cancer center, cancer charity, or cancer anything, and you’ll see it’s about selling hope. Hope for life, hope for a cure, hope for never having cancer come back. How can you convince people to hire a doctor or donate money if there’s no hope that they’ll be cured? I mean, if the marketing said “We’ll do our best but 1 in 4 of you will develop terminal breast cancer anyway” they’d never convince anybody to part with their hard-earned dollars, now would they? The truth can be mighty inconvenient, so it’s easier to just focus on hope.

The thing is, though, if women don’t know that their cancer could recur, they don’t know what signs to look out for. They don’t know that unexplained bone pain is something they should mention to their doctors, because it might be bone mets. They don’t know that that headache they just can’t shake should result in an MRI. They don’t know that the tamoxifen they’re on is really fucking important and if they stop taking it, they may be risking their lives. Because nobody told them the risks, because nobody wants them to worry their pretty little heads.

This shit is fucked up. Patients have a right to know that their cancer could come back, that it could become life-threatening. We should respect them enough to trust that they can manage their fears in the face of the facts. We should treat them as adults and tell them the truth.