I had the privilege to listen to a keynote speaker this weekend at a breast cancer symposium sponsored by my hospital. It was the last talk of the day after our specialist physicians spoke about the latest in surgical, imaging, and reconstructive options.
From the corner of the room, our speaker, Joni Eareckson Tada, wheeled herself to the stage and began to tell us about the diving accident that left her a paraplegic at the age of 17. For a long time, she was depressed, suicidal, and in a "tunnel of despair."
Two years ago, when she was diagnosed with breast cancer at the age of 60, she thought she might go into that dark place again… but she didn't. She now heads a worldwide ministry to assist others with disabilities. She paints beautiful art with a brush between her teeth, and she has served several presidents on various boards. The room was hushed as this vibrant, energetic, and thoughtful individual gave us a glimpse of her journey.
In the United States in 2008, women with disabilities aged 50-74 reported a lower rate of mammography use than women in the same age range without a disability (78.1 percent vs. 82.6 percent).1 Studies also show higher rates of death related to breast cancer among women with a disability, even when they are diagnosed at the same stage as women without a disability.2
The CDC has written some things about women with disabilities. There is not much written on the subject of women with disabilities and breast cancer, but early detection should not be overlooked because of any physical limitations.
A survivor whose mammogram identified her cancer wrote the following:
My final words to women with any type of physical disability are that you've come this far and it hasn't been easy. You've overcome what you had to overcome, you're still alive and you're still functioning. And that in itself shows you that you have the strength to do what you have to do for yourself. You have to take that strength or dig deep inside and find the strength to really take care of yourself. You know you deserve this. We deserve this. From where I'm sitting breast cancer screening is the key to living.3
Tips for women with disabilities2
A woman living with a disability might face a number of challenges that make it difficult to get a quality mammogram and clinical exam. Here are some questions that should be considered when scheduling a mammogram:
- How do I prepare if I use a wheelchair or a scooter?
- Can the machine be adjusted so I can remain seated?
- How long is the appointment, and can I have additional time if I need it?
Let the scheduling staff, radiology technicians, or radiologist know that you can/cannot:
- Sit upright with or without assistance
- Lift and move your arms
- Transfer from your chair/scooter
- Undress/dress without assistance
Joni ended her talk with a delightful story that will stay with me for a long time. She talked about a wonderful pair of gold earrings she had received as a gift. One had fallen off her ear as she was speaking on the phone. Then her wheelchair rolled over it, making it distinctly different from the other one. She could not find a jeweler who could restore the earring to its original shape, but she did find someone who could hammer away at the other one to make it look the same.
The metaphor for me and for my patients: Damage may come into our lives, but that does not mean we cannot be beautiful and recreated into something just as worthwhile as others. That's a good lesson for all of us facing the challenges of disease and have the faith and strength to carry on.
- Breast Cancer and Women with Disabilities. Centers for Disease Control and Prevention.1600 Clifton Rd. Atlanta, GA 30333, USA.
- Disability and Health. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/ncbddd/disabilityandhealth/index.html.
- Joni and Friends. Available at http://www.joniandfriends.org.