October Reflections on Breast Cancer

There are actually numerous kinds of breast cancer--ductal carcinoma in situ, hormone-sensitive cancer, triple negative cancer unrelated to hormones, and inflammatory cancer, to name a few. While the disease occurs primarily in women, men can have breast cancer, too. The extent of the disease is important to developing the right treatment plan. There is similarity in the general types of treatment offered, surgery, chemotherapy, radiation. But there are also significant differences. Newer types of treatment include hormone therapies, targeted therapies, and precision medicine. The choice and order of treatment options depend on the circumstances and pathology of the case. For example, patients with hormone-sensitive tumors may continue with medication for five or ten years following their initial treatment, while patients with triple-negative tumors do not.

Early detection and treatments for breast cancer have come a long way. From 1975 through the 1980s, the rates of patients dying from breast cancer rose slowly. But from 1989-2014, deaths from breast cancer decreased by 38 percent. That translates into about 300,000 patients who have been diagnosed with the disease and not died from it.¹ Breast cancer research has benefited tremendously from an outpouring of charitable contributions, a large amount of which has been generated by the Susan B. Komen organization and its multiple chapters around the country. And the research has resulted in new and improved treatments that benefit patients.

Unfortunately, while detection, treatments, and prognoses have improved for breast cancer patients, the incredible disruption of a cancer diagnosis and treatment may not have. Many patients and their families have questions about or even face problems with insurance benefits, employment, ex-spouses and custody, or medical decision-making. They do not know their rights or how to protect them. The ABA Breast Cancer Task Force was developed to help patients with such legal issues. The ABA Commission on Women in the Profession started the Task Force in 1993 with an educational program on how lawyers could help patients with these legal issues. During the 2000s, the Health Law Section became involved and ultimately took on the Task Force and its work. Now called the Breast Cancer Initiatives Interest Group, it continues with education and outreach efforts. And while the Interest Group’s genesis and initial focus has been on breast cancer patients, the legal issues that patients may face are shared by people fighting all types of malignancies.

The Interest Group maintains and regularly updates a cancer advocacy guide that covers key legal issues and the applicable laws. The Interest Group’s Executive Committee has a webpage that it is continually updating to provide information, resources, and links to cancer patients and their families, and to lawyers wanting to help cancer patients. The Interest Group continues to present occasional in-person half-day workshops to educate lawyers on key issues and legal rights so they can help cancer patients and perhaps even volunteer to participate in support organizations operated by state and local bar associations or by nonprofit organizations. One of these workshops is typically presented in conjunction with the Emerging Issues in Healthcare Law conference (EMI) and is made available to lawyers in the community regardless of whether they are attending EMI. The Interest Group has helped with clinics to provide services to patients. The Interest Group periodically presents webinars on various topics, and several are posted on its webpage. Finally, the Interest Group is enhancing materials that local organizations can use to develop and present their own educational workshops or clinics. The webpage is available at: https://www.americanbar.org/groups/health_law/interest_groups/educational_outreach/breast_cancer.html.

So, this month I reflect on and celebrate the progress we are making in our national fight against breast cancer; my personal victory in overcoming the disease; and the wonderful work being done by the Section’s Breast Cancer Initiatives Interest Group. Onward and upward!

1.  Ww5.komen.org/BreastCancer/Statistics.html.