1. Drescher, Fran


Let's detect cancer early, when it's most curable.


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I am a cancer survivor. Little did I know more than a decade ago, when I first noticed symptoms, that I was about to embark on a two-year, eight-physician odyssey before receiving a diagnosis of uterine cancer. As I've often said, I got in the stirrups more times than Roy Rogers!!


At first the physicians had any number of explanations for my symptoms: I was "too thin," "eating too much spinach," you name it. And all the while they prescribed hormones I didn't need, neglected to see obvious signs, and failed to order the right diagnostic tests. Finally, an endometrial biopsy confirmed my worst fear: I had uterine cancer.


I wouldn't be alive today if not for my sister, Nadine, a nurse who, after my diagnosis, when I didn't know where to turn, became my medical compass: a guide through the labyrinth of laboratory tests, biopsies, and second opinions that led me to a more aggressive treatment. She urged me to go to my physician with a list of questions about my tumor and have my surgeon conduct her own tests. My sister's willingness to educate me saved my life.


My cure came in the form of a radical hysterectomy-painful for any woman but especially so for me, someone who'd never had children. I felt betrayed by my body and the medical community. I didn't want what happened to me to happen to other women, so in 2002 I wrote Cancer Schmancer. After it was published, I spoke with women around the country and found out I wasn't alone. Thousands of women every year are misdiagnosed or receive diagnoses too late. Their stories made me realize that women's health care must change. It's now my life's mission.


Many researchers are focused on finding a cure for cancer, and I sure hope they do. But we have another option: equipping every woman with the information she needs to prevent cancer and detect it early, when it's most curable. With so many screening tools available, many cancers can be identified earlier than they often are, enabling better patient outcomes and higher survival rates. Papanicolaou tests, for example, have dramatically reduced death rates from cervical cancer in the United States.


Still, screening is a hot topic. On July 16 the New York Times published "In Push for Cancer Screening, Limited Benefits," an article claiming that routine screening for many cancers offers little benefit. I say: no matter what the cost, women have a right to know what tests are available and, in consultation with their physicians and nurses, to choose a test that could save their lives. Yes, it's true that not every test is appropriate for every woman. But I sure wish I had known that a simple procedure like transvaginal ultrasound could have diagnosed my uterine cancer. That's two years of my life I'll never get back.

Figure. Fran Dresche... - Click to enlarge in new windowFigure. Fran Drescher

Patients interact with nurses more than with primary care physicians. Nurses, please, talk to all patients about the benefits of screening and urge them to take responsibility for their health. Many Americans aren't aware of their risk factors or the early warning "whispers" of certain cancers. Women with ovarian cancer, for example, are often misdiagnosed with irritable bowel syndrome, and most find out they have cancer when it's in the late stages. But if all women knew that bloating and feeling full when eating might be early warning signs of ovarian cancer, they could be more proactive, asking for a transvaginal ultrasound or a cancer antigen-125 (CA-125) blood test when such symptoms appear.


You can lead the way in transforming passive patients into active medical consumers. Encourage women to ask questions and get answers and to understand their risks and the benefits of screening. Not everyone is lucky enough to have a sister like Nadine. But every woman deserves the guidance of clinicians who can empower her to be her own best advocate in leading a healthy, cancer-free life.