Navratilova's cancer: why the media failed to score

The announcement this week that legendary tennis champion Martina Navratilova is undergoing treatment for breast cancer has made headlines in practically every newspaper and website.

On checking the front pages of the national newspapers and web-based reportage yesterday I couldn't help noticing almost all of them used cliched words such as "battle", "struggle", "suffer". This is exactly the kind of vocabulary my sub-editing tutor advised us not to use, as they risk portraying a disease as something more dreadful than it may actually be.

Yet this is how some of the nationals headlined the story on 8th April:

Headings scream

The Daily Express: Martina fights breast cancer

The Daily Mail: Martina's breast cancer battle

The Daily Telegrpah: "I will win cancer fight, says Martina."

The Indie: Navratilova's new battle

It is easy for a story to end up magnified in the media when it is linked to a famous person, such as Martina Navratilova.  But looking at some of the more sensationalist headlines made me question what the best and correct way of reporting the story of someone's serious disease might be. 

Red lipstick gone wrong
At at time when newspapers struggle with a falling readership, 'bigging up' a story to make it more saleable might even fall within the forgivable remit of a sub-editor's stylistic licence. But an Antipodean news website had the bad taste of calling Navratilova a "cancer victim", even when prognostics of a complete cure for her early-stage, not invasive ductal carcinoma in situ (DCIS), confined to the milk ducts, has been reported to be "excellent". 

Do journalists really think all cancer patients consider themselves to be cancer victims? It concerns me that language better suited to obituaries end up being used in headings to announce someone is merely ill.

As a loyal Guardian reader, I felt proud that its subs had chosen the heading" 'My 9/11' Navratilova's cancer" – understated and to-the-point, yet still emotive, with Navratilova's quote providing just enough dramatic impact.

The Guardian: Navratilova's cancer

Headlines and captions must grab the attention of the reader, of course, but try too hard and it turns into that dangerously bright red lipstick that makes a woman look more like a hooker than a sex goddess.

Tragedy vs. tragic words

Examples of headlines that scream tragedy and scandal at the reader abound in our papers. I happened to pay particular attention to Navratilova's cancer news because a) I have experience of breast cancer myself, b) I have always admired the tennis champion. 

Navratilova says she cried on receiving her diagnosis. Who wouldn't? The calmest, most self-controlled people in the world lose their cool when the C-word comes out of the doctor's mouth. I too cried, and how. In the consultant's room, I felt the ground beneath me crack open, and, in an instant, I was falling head first into a dark abyss. 

But Navratilova's cancer, like mine, was caught early enough that a lumpectomy (as opposed to a mastectomy) and a few weeks of radiotherapy with no chemo will suffice to guarantee high chances of cure and non-recurrence. 

Cancer is a painful personal tragedy to be dealt with. But depending on how you see it, it can also bring fantastic positive changes and insightful discoveries into your life you would never have come across otherwise. 

While it is not untrue to say a cancer patient does have a fight, or battle, to win against a deadly enemy, I believe the only ones with the right to say they are "suffering" are the patients themselves. 

Suffering is a relative, abstract sentiment. What a reporter might describe as someone's "suffering" might be perceived by the "sufferer" as a mere challenge, akin to for instance, running a marathon.

Isn't labelling someone a "victim" tantamount to admitting their defeat, when they might be winning from the start?

The woman who is thrown out of the vehicle, which crashed into another, and is splayed on the pavement like a roadkill, hemorrhaging from her wounds, is a victim. A woman who has been diagnosed with breast cancer, and is almost certainly going to be cured of it after surgery and some radiation treatment, is  the lucky driver in the car ahead, who missed the collision by seconds. 

Awareness, not fear

Talking to ABC News in the USA, Navratilova says she had not wanted to come public about her cancer but she realised doing so could help raise awareness to the importance of having regular mammograms. 

I do not believe it was ever her intention to solicit our sympathy or commiseration for her personal plight. The message was not that cancer is trying to kill a tennis legend and may be coming to get you next.  The lesson to be learned was that through simple preventative measures, such as self-checks and mammograms,  a rottweiler of a disease can be tamed into an annoying but much less frightening yappy dog.

Listen to her interview till the end. Notice how her fighting spirit underlies every single aspect of her life, including her "battle" with cancer. Notice how she refuses to be a "victim"or show any overt signs of suffering, despite admitting to emotional turmoil. A winner through and through.

Martina vs Media: 40-love

The not-so-sunny side of positive thinking

I have always believed in the power of positive thinking as a propelling force in life. But Andrew Marr's interview on Radio 4 with an anti-positive thinking writer last week made me stop in my tracks and review my position on where to draw the line between healthy optimism and sheer delusion.

Barbara Ehrenreich (above), author of Smile or Die: How the Relentless Promotion of Positive Thinking Has Undermined America ('Bright-Sided' in US edition) argues the ever so profitable positive thinking industry in America (remember The Secret?) has created such a deeply ingrained culture that 'positive' became "not only normal but normative – the way you should be," as Janice Harayda says in her excellent One-Minute Book Reviews.

Lucy Ellmann, in her Guardian review, says:

"Americans aren't happy, they're just trained to look as if they are. It's fake orgasm on a grand scale, and we're almost deafened by the din."

Barbara's journey
When diagnosed with breast cancer in 2001, Ehrenreich was appalled by "the constant exhortations to be positive, to be optimistic at all times to the point of embracing the disease as a gift." The sites she found while searching for information about the cancer referred to it as an almost spiritual experience, at the end of which one would come out more "evolved", a better person even.

The associated implication was that:

"if you didn't get better, you weren't a positive thinker"

even though subsequent studies could establish no connection between a patient's attitude and mentality and cancer survival rates.

"It's not some kind of harmless encouragement. This seems like a burden."

she says on Marr's programme. On top of having to deal with the stress of the treatments, patients have the double burden of feeling pressured to think positively and have only themselves to blame for in case treatment was unsuccessful.

For the full version of Barbara Ehrenreich's fascinating interview on Radio 4, listen to the podcast below: (Ehrenreich comes on at about 11 min):

Kehoe's Mind Power
The same logic can be applied to the unemployed during the current economic downturn. If anyone is made redundant or the job they have been positively "visualising" didn't materialise itself, are they to blame for their failure to eschew 'negative' thoughts?

I too have often fed a few quid into that multi-million-dollar feel-good industry by purchasing self-help books, videos, workshops and talks, hoping against hope that if I can manage to will my mind to think only thoughts of health, wealth and success, I may just about land that dream job, which will fulfill my professional aspirations, banish all 'red' figures from my bank balance and fill my life with such joy I will boast abundant health forever.

When I took my four-week Mind Power course last September, which advertised itself with the tagline "Transform Your Life", I was told by the tutor: "You will get out of it exactly what you put in it." Every week he reminded us: "You must do the mind power exercises every single day." "Persevere." "Remember: stop reacting to external circumstances, you must create your own reality."

Mind Power, as a form of enforced positive thinking, can be exhausting in that its exercises are like drills one does when learning a foreign language, repetition being the key to mastery. I was utterly terrified of missing my exercises and spoiling my "breakthrough moment", as John Kehoe, the founder, calls it.

Although the drills temporarily lifted my mood, I could not help but feel a pang of guilt when I failed to get a job I had been interviewed for before Christmas, and about which I had done hundreds of daily positive affirmations. Had I not done enough? Did I let self-doubt seep in and cancel my positive thoughts? I must have brought it upon myself, was my thinking.

To be honest, after more than a year out of work, I really didn't need another reason to feel demoralised.

God is capitalist
In Smile or Die, Ehrenreich goes as far as suggesting that the positive thinking culture was responsible for the recent collapse of American banks – a result of Wall Street bankers following the "prosperity gospel" of "God wants you to be rich", the title of one of the chapters in her book.

In fact, while doing my own motivational course, my tutor said we should "seed" (=feel within) the vibration of success, and if we didn't know what that felt like, we should "go sit at the lobby of the Hilton Hotel", which supposedly was brimming with the right type of vibes.

What disturbed me was the assumption that success can only be achieved through material wealth, that the lifestyle of guests at four and five-star hotels was to be emulated. There is nothing wrong with the desire to own money – I do like money and comfort myself – but I disagree with that perception that happy = rich. Did we import that concept from America too, or is it a natural product of our capitalist society?

If positive thinking is as effective as the gurus say, why do Americans – voracious consumers of that culture – need to "consume two-thirds of the world's antidepressants" in order to have a nice day? asks Christopher Hart in The Sunday Times.


Creating my reality
After the course I purchased Kehoe's Money, Success and You. With Christmas coming up, I was feeling decidedly poor, with job applications disappearing into black holes and my bank account nearly overdrawn. I wanted to create a new reality in which there was a secure job and no more financial worries.

I found the first half of the book inspirational, especially the chapter where Kehoe says with every 'no' we hear, we are one step close to a 'yes'. To a desperate jobseeker like myself, those words felt like a soothing balm. Unfortunately, the latter half read like a business manual for salespeople: the 'a-ha' moment of successful entrepreneurs, how to get your customers to buy from you, how to keep their loyalty... All very well for a man who made his millions on the back of his positive thinking parlance, but not all professions are about selling, and not all success can be measured in monetary terms.

If we can realise all our dreams just through thinking about them everyday for half an hour, we can all be masters of our destiny. That's what positive schools of thinking claim you can do. But then is there no room for serendipity in this life, for twists of fate and unexpected happy endings that were not written in your own script but turns out to be a more suitable outcome than the one you had envisaged?

Ironically, not knowing what tomorrow may bring is at once our most feared uncertainty and the most treasured joie de vivre.



Charlotte's choice
But surely there are moments and people for whom positive may not be an option? The words Haiti and earthquake come to mind...

On Saturday I read the story of Charlotte Raven (Charlotte Raven: Should I take my own life?), who seems to fit that profile. The 40-year-old Raven has tested positive for the incurable and degenerative Huntington's disease. In the Guardian weekend magazine Raven courageously talks about the shock of her diagnosis four years ago, her contemplation of suicide and an early end at Dignitas, and how that would affect her husband and young child.

Astonished to find out that as much as three quarters of people with HD did not choose to end their lives but carried on, she travels to a fishing village in Venezuela where Huntington's had become endemic, seeking answers, meeting HD carers and patients in advanced stages of the disease, only to choose life in the end. This despite the knowledge of the suffering and indignity, which will inevitably come one day. Raven concludes:

"Registering the discomfort of existence, I felt a great wave of self-pity, the first since my diagnosis. I felt worthy of being cherished and knew I'd do whatever it took to survive. [...] Suicide is rhetoric. Life is life."

The discomfort of existence
A couple of weeks ago, as I walked my dog in the local snow-clad park, observing the white landscape, noticing the profound silence everywhere interrupted only by the low squeak of my boots, I was overcome with an overwhelming feeling of peace. Absence of colours and absence of sound: peace could not have been more complete.

I could not bring myself to practise my positive affirmations nor entertain morbid thoughts on unemployment and poverty. Strangely, my thoughts, inside a brain that is normally a chatterbox, came to a complete halt. It was like going into a meditative state, finally reaching a place of complete stillness and comforting knowledge that everything will be all right.

Charlotte Raven must also have found her inner peace in the midst of pain and chaos. Her total acceptance of the now, whatever that may be, brought her the strength to embrace life for what it actually is: a delicate blend of dark and light.

Maybe then positive is not all about refuting negatives and aiming for an opulent lifestyle, not even enjoying perfect health all the time. Maybe a more lasting positiveness can be achieved through learning to tap into that magic space, where thoughts, and therefore emotional reactions and judgment, cease to exist.

René Descartes said "I think therefore, I am." But does our existence dependent on our thinking all the time? My own view is that there is a thinking self and a knowing self, but the latter can hardly ever get a word in edgeways because the former is so loud.

If we debated less frequently with ourselves, if we actually stopped using our minds to label every circumstance in life as positive or negative, wouldn't life become altogether more tolerable, and as a result more positive? And yet, in a world where so few are enlightened enough to live that way, perhaps positive thinking techniques needs to remain, for the foreseeable future, a necessary evil, an opium of modern society.


Here's an excellent video of Ms Ehrenreich giving a talk about her book:

Related links:
If you are interested in finding out more about Smile or Die, read the following:

• One-Minute Book Review by Janice Harayda (recommended)
• The Sunday Times review by Christopher Hart
• The Guardian review by Lucy Ellmann
• The Observer review by Jenni Murray

Why breasts on show miss the point of breast cancer campaigns

Another October, another breast cancer awareness month. Besides the ubiquitous pink ribbons and charity goodies on sale everywhere, I could not help but notice the number of bare breasts that started appearing everywhere in the name of cancer awareness.

Last month Britain's Got Talent judge Amanda Holden stripped down to a pair of leopard print knickers and was photographed with only a pair of silver stilettos to cover her modesty. The London Evening Standard reported this was part of a charity campaign to raise funds for research into women's health issues.

This week some women on the social networking site Twitter started uploading photos of their cleavages, while tweeting the hashtags #BreastCancerAwareness and #BCAwareness to turn them into trending topics.

While a handful of good-humoured twitterers opted for publishing images of two watermelons, fried eggs, or man boobs, a few ladies replaced their normal avatars with images of their exposed bosoms – to the delight of the male Twitterati.

Below are some of the avatars available on the site as of today. Happy viewing:

Interestingly, all breasts on display were perfect, healthy-looking ones. Not a single mastectomised boob.

Put 'em away, love

It always floors me how women with no experience of breast cancer can think that exposing their bosoms in public can in any way promote awareness for a serious disease, which affects one in nine women in the UK.

The majority of women diagnosed with breast cancer will undergo surgery, either a lumpectomoy, removing the cancerous lump, with some of the healthy cells around it, or a mastectomy, in which they will lose one or both breasts.

Breast reconstruction is possible post-mastectomy, but as I mentioned in a previous blog, it is not a straightforward process, involving skin grafts and separate operations for adding nipples. And despite advances in plastic surgery, they will never look the same as real breasts.

As the mutilation affects one of the female body parts most closely associated with sexuality and femininity, losing part of a breast, a full one, or both breasts can have long-term devastating psychological effects on the patient.

I speak from experience – I am a breast cancer survivor myself. Although I only needed minimal surgery for an early stage cancer, my relationship with my body has never been the same since.

The gratuitous breast exposure samples on Twitter infuriated me because they do not take into consideration the feeling of those women who have lost their breasts, or whose breasts were deformed due to breast cancer treatment. It is not my business what part of her body a woman decides to expose on the Internet, but if their aim is to help breast cancer patients, I would borrow the words of a gay friend and say:

"Darling, put those tits away."

Publicity ...for whom?

Making one's avatar into one of a beautiful cleavage may excite men and raise...erm...alertness of a certain type, but it does zilch towards helping the cause of preventing breast cancer, nor of improving treatment and the patients' chances of survival.

At the risk of causing offence, I will go as far as to say it is a meaningless narcissistic act, which demeans the plight of breast cancer patients and trivialises the importance of a serious health issue.

If anyone thinks I am being extreme, I would invite them to go visit the breast care unit of a hospital and ask to be shown a mastectomised chest, speak to patients undergoing treatment whose hair, eyebrows and eyelashes have fallen out due to chemotherapy, patients experiencing acute menopause symptoms because they are on Tamoxifen. I challenge them to go round the ward in a low-cut top, flaunting perfect cleavage, when these women's are being butchered.

Breast cancer does need as much publicity as possible. The more aware women become, the sooner the cancer is diagnosed, the less radical the treatment will be, the higher the chances of survival. Taking one's kit off, especially in the case of celebrities, may help fill the fundraising kit-ty faster. But it must always be done with care and sensitivity, and never be used in a self-serving manner.

If you want to genuinely help fight breast cancer you can:

a) start a campaign yourself

b) help promote self-examination in women

c) make a donation to a breast cancer charity

d) participate in a fundraising event

e) volunteer your time to a charity

Below are some breast cancer charities in the UK worth supporting (click on links to find out more). I am personally hugely indebted to Breast Cancer Haven, so I have listed them first. Please feel free to leave me comments with further suggestions, and I will add them to the list

• Breast Cancer Haven
• Breakthrough Breast Cancer
• Breast Cancer Care
• Breast Cancer Campaign
• Walk the Walk
• Pink Ribbon Foundation
• Cancer Research UK
• Macmillan Cancer Support

Why Facebook's boob is larger than Sharon's

The news about Facebook removing the post-mastectomy photos of 45-year old breast cancer patient Sharon Adams allegedly due to its "sexual content" and "nudity", brings me to my favourite topic: boobs and why the world is so obsessed by them.

This is not the first time, and it won't be the last, the sight of a woman's bare breasts causes public outcry when the last thing she had in mind was to use them as a sexual weapon, to provoke or to shock.

No breastfeeding please, we are British
Women being cautioned or expelled for whipping their boobs out in public places for no other reason than to feed their babies, seems to be a common occurrence in this country. Below are some clippings from the British press:


Woman asked to stop breastfeeding her baby at Job Centre

Woman thrown out of Job Centre for feeding baby

Woman told to stop breastfeeding in a leisure centre because "there are children present"...

One Birmingham mother found the constant disapproving stares so disturbing that she went on to invent a product called Mamascarf, which can be tied around the feeding mother's neck thus shielding both baby and boobs from intrusive eyes.

For a nation of men and women who are obsessed with breasts, it is ironic that their sight in the context of baby feeding can cause such controversy.

Breastfest
Breast images seem to bombard our daily lives whether we want it or not. All one has to do is to step out into the street, especially now that the weather is getting warmer, to see ladies of all ages sashaying in tops and dresses that hardly cover their modesty. Women wear them with pride, knowing men are going to stare. For those ladies craving attention, it is a tried-and-tested attention-grabber – if you don't mind men having conversations with your breasts, that is.

Women say high heels give them confidence; it makes them "stand tall" both literally and figuratively. But breast exposure can be used even more effectively as a confidence booster. Often women addicted to breast augmentation surgery turn out to suffer from very poor self-esteem. They confuse their need for love, self-love, with a need for larger breasts.

An example that comes to mind is that of Sheyla Hershey, a Brazilian woman who has the record of the largest breasts in the world at a 38KKK bust. She has had a total of 18 plastic surgeries done, mostly to her breasts. She wants to be even larger, and her surgeon will not refuse her further augmentations, even though, with one gallon of silicon implanted, her life is already at risk. "I just want to be happy," she pleaded, as she wept to the reporter interviewing her. "No one will stop me from being happy."


Extreme cases aside, sights and photos of breasts abound in real life as well as in page 3s and glossy magazines. In Britain, as in many other Western countries, flaunting one's "assets" is generally accepted and seen as positive. The celebrity culture only seems to underline this perception. No reader seems to consider offensive a photo of singer Jordan (Katie Price) with her "silicon valley" spilling out of her dress splashed across the front page of a tabloid. In fact, papparazzi are paid handsomely to take photos of glamorous topless celebs on the beach or private yachts, or wearing bikinis of the type Brazilians appropriately call "fio dental" – or dental floss.

It takes one quick browse of a social networking site such as Facebook or MySpace for one to find that a large number of ladies post profile photos of themselves taken from such an angle that it gives ample view of their breasts. I have been on any Internet dating site before and was amused to discover that the de rigueur ID photo for women is one that makes your potential suitor feel like they are naughtily looking down your bosom. It makes you wonder if men are even interested at all in anything above the bra line.

And yet, these are considered, normal, natural, completely healthy behaviours by both sexes...

Double Standards
Facebook has now allegedly apologised to Sharon Adams for having censored her mastectomy pictures. A group called GET SHARON ADAMS PICTURE BACK ON FACEBOOK FOR BREAST CANCER has now been formed to protest against the removal of the "offensive" photos. The fact that the reason for their removal was the partial nudity and their "sexual content" just shows how warped our attitude towards human bodies are.

Why is it acceptable for us to ogle at breasts owned by celebrities and models but not at the butchered breast, or the absence of one, in a woman with breast cancer? Needless to say, unless you have kinky tendencies, the sight of a mastectomised breast is not exactly one to provoke sexual arousal. In fact most women I have met who have lost their breasts this way, were concerned about how this will affect their relationship with their partners, or, if they were single, whether any man would ever want to be intimate with them again. One divorced woman who had had mastectomy once said to me, "Will I ever be able to get naked in front of a man?"

What an irony it must have been for Sharon Adams to receive a message from Facebook saying, "we are removing your boob pictures because we don't allow pictures of sexual content" when the last thing she must have been feeling was sexy or sexual.

Because the disease affects a part of a woman's body that is so closely linked to her sexuality and her identity as a woman, mastectomy is an operation that can bring serious psychological consequences to the patient. Elderly ladies are often better at shrugging it off saying, "My husband knows I am feminine; I don't need my breasts to prove it to him." But younger ones understandably prefer opting for breast reconstruction post-mastectomy.

Not exactly bionic woman
Breast reconstruction is not nearly as straightforward as a "boob job" is. It requires taking skin and fat from elsewhere in the patient's body and transferring it to the breast area, and, surprise surprise: the new breasts come with no nipples.

Nipple and areola reconstruction is an optional, usually separate, operation. A reconstructed breast cannot be used for feeding babies so the addition of a nipple is an aesthetic choice, one could almost say sheer vanity. It is no laughing matter: the general shape and look of the breast can be restored through surgery, but there is little sensation on the new breast because the nerves will have been cut off. Think "cyborg" and his bionic arms and legs, i.e. it looks like the real thing but it is not.

Let's put it this way: it is not something any woman wants to go through. Whereas in cases of early detection, less radical surgery is required, it is still a traumatic experience that affects women not only physically but psychologically and sexually as well. Scars eventually subside, but a breast cancer patient's relationship with her body is forever changed by the experience.

Good boob bad boob

So what is the turning point of a good boob image into a bad boob one. What is the difference between, for instance, sex symbol Angelina Jolie stripping off her top to reveal her bosoms to the world and a mother momentarily exposing a breast to feed her baby in public. Or a breast cancer patient deciding to show her scars on Facebook to raise awareness.

Isn't it more honest to say that a breast image that does not offer a direct mental association with sex, either because it has been disfigured or it comes with a suckling child hanging at the end of it, is what people consider "offensive"? What we are really saying, when we tell breastfeeding mothers and breast cancer patients to cover up is, save us from the horror of boobs that do not make men immediately want to grope or sexually fantasise; or worse. Because somewhere in our psyches there is a deeply embedded belief that is what breasts are for: an aphrodisiac for men and a sexual hook for women who desire to ensnare men.

Nothing wrong with that, mind. Males and females of all species in the animal world are conditioned by nature to mate, reproduce and die. Humans are no different, and if shoving one's breasts in the general direction of eligible males is what it takes a woman to ensure progeny, so be it, though the moral stance on this may differ in each culture.

Reality check

Facebook's reaction to Sharon Adams' images may have been a genuine administrative mistake, and they have now rectified it by apologising and allowing her to re-upload her photos. But it is symptomatic of society's warped attitude towards breasts and human sexuality.

If Facebook is to impose codes of public decency on its site, perhaps a more wholesome, if somewhat draconian, measure would be to censor images of healthy-breasted women displaying any cleavage while freeing up someone like Sharon Adams to showcase her lack of one, post-surgery.

Maybe women have got their focus wrong by trying too hard to expose their breasts to the admiring eyes of the viewing public. Perhaps the message Sharon Adams was trying to get through was: pay attention to your boobs yourself. Before you let men touch them, touch them yourself and check for any suspicious lumps.

One in nine women in the UK are diagnosed with breast cancer every year. Even though survival rates for breast cancer after five years are high and increasing due to improved treatments and earlier diagnosis, it is still a nasty disease that can maim and kill.

For Sharon the decision to allow the entire Internet world to view her scarred chest so that fewer women have to lose their breasts to cancer was an act of immeasurable courage.

Facebook administrators fell into a big no-no of a booby-trap.