PLENARY ADDRESS Danilo V. Meneses (husband of Rosa Meneses, founder of the Philippine Breast Cancer Network who died of breast cancer) 4th World Conference on Breast Cancer June 11, 2005 - Halifax, Nova Scotia, Canada As Rosa stood here before you six years ago, a woman with a bare chest, I now stand here before you, a man with a heart broken by breast cancer. If breast cancer were just a consequence of one’s consciousness, then her loss was the price to pay. I would not have at all bothered to pursue what she had started eight years ago. I would have just accepted her death, had bullets in the armed struggle against the Marcos dictatorship felled her. Recurrence is such a familiar word most feared by women living with breast cancer, yet the recurrence of the Philippine Canadian Embassy’s refusal of visas to participate in the past three World Conferences on Breast Cancer is undoubtedly one for the books! In 1999, when Rosa was a Keynote Plenary Speaker, five were refused visas. 1n 2002, when I first attended as a Concurrent Speaker and film presenter, conference organizers had to personally call the Philippine Canadian Embassy to allow Elvira Galang to attend. Again, Elvira who is now teaching in Japan was almost prevented from joining us here in Halifax. The PBCN’s nurse who is part of the conference program was refused a visa but with the intervention of the world community of breast cancer activists, will now be able to make her presentations. Allow me to give special mention to Breast Cancer Action Montreal for their pivotal role in resolving this recurrence. Wars are waged whenever a common enemy of society, such as poverty, drugs, terrorism and breast cancer threatens the general welfare of a people - yet the means to achieve a common goal most often always takes opposite perspectives. With breast cancer, military imagery and language has often been used, most particularly in 1971 when U.S. President Nixon declared War on Cancer, thus making it a public issue. Since then, the landscape of the so-called war on breast cancer drastically changed with the disease no longer confined to doctors and scientists. Activism was ushered in by the likes of Marvella Bayh, Babette Rosmond, Rose Kushner, Betty Rollin and Audre Lorde. In the previous decade, the silence had been broken with the formation of patient-based organizations such as the U.S. National Breast Cancer Coalition in 1991, the Canadian Breast Cancer Network in 1994 and the Philippine Breast Cancer Network in 1997. The historical background of a century-old tug-of-war eventually found print in Barron Lerner’s book, The Breast Cancer Wars published in 2001. Yet despite all the noise and rancor, the billions of dollars spent on decades of cancer research have not arrived at the cure. Frustrated, Andrea Martin set up The Breast Cancer Fund in 1992 in San Francisco and just last year, the Saunders-Matthey Cancer Prevention Coalition here in Canada was realized– both focusing on prevention with emphasis on the cause. Way back 1960, the World Health Organization had already concluded that the environment played the predominant role in causing cancer. In 1962, Rachel Carson’s book, Silent Spring warned of the dangers of pesticides and other synthetic chemicals on the lives of future generations. In 1995, Cornell University started the Program on Breast Cancer and Environmental Risk Factors. In 1997, Sandra Steingraber’s book, Living Downstream presented the growing body of evidence linking cancer to environmental contamination. Also in 1997, the documentary film Rachel’s Daughters investigated the causes of breast cancer with interviews of scientists in leading medical research institutions. Coincidentally, it was also in 1997 when Rosa was diagnosed and also when the 1st World Conference on Breast Cancer was convened. In the World Resources 1998-99 Report, Devra Lee Davis explained the vulnerability of all women to the proliferation of environmental xenoestrogens resulting in rising breast cancer rates. In 1998, Samuel Epstein’s book, The Breast Cancer Prevention Program elaborated on the avoidable risks of women. For sure, there have been many other initiatives that we may not be aware of. Yet, with three World Conferences on Breast Cancer that have been held since 1997, there has now been much more questions that needs to be answered. Confusions and controversies abound with studies, assumptions, observations and perceptions swinging wildly from both sides of the pendulum. During the Victoria Conference three years ago, a male Professor from Berkeley accosted me. He was very cynical of the PBCN’s pamphlet, telling me “Stop Breast Cancer? Are you a scientist?” On the other hand, Dr. Ana Soto in a documentary film interview stated, “I would not want a society run by scientists.” The question then would be whether continuing what one has been trained to do, regardless of its universal acceptance necessarily makes it the truth. Early detection supposedly equals early intervention. But can there really be early detection when it takes 5-10 years before the first symptom of breast cancer manifests itself? How then, can there be early intervention? Whether or not small tumors need invasive and toxic treatments - surgery, chemotherapy and radiation do need smaller tumors. The Danish study in 2001 questioning mammography has further fueled several claims in the past questioning its safety and reliability. With a margin of error of as much as 20-40%, the screening usefulness of mammography is now a raging controversy. A routine medical breast examination year in and year out, in reality simply makes a woman wait to be told that she already has breast cancer. Where here is the prevention? This abnormal fear of breast cancer has been fanned by periodic self-breast examinations in the hope of catching it early. Yet most, if not all cases are being treated aggressively to hopefully “cure” just a very few. Fifty years ago, the five-year survival notion had already been pointed out invalid as criterion of cure. From radical to modified to prophylactic mastectomies to lumpectomies to breast conservation, to what have you – women’s breasts have long remained a surgical domain. However, when the view shifted from being a local disease to a systemic one, breast cancer could no longer be considered solely a surgical disease. The rise of chemotherapy had now taken the helm from surgical proprietorship into the corporate boardroom of the pharmaceutical industry. While North America has the highest incidence of breast cancer in the world, the Philippines has the highest in Asia and reportedly the 10th highest in the world. For a woman to live in my country is already a premalignant condition. Yet our Department of Health does not have a National Breast Cancer Program – just a Breast Cancer Desk – literally, just a table! And as if by coincidence, the Secretary of Health recently resigned to attend to his wife who was diagnosed with breast cancer. Exactly 123 years have passed since William Halsted began to perform the radical mastectomy and yet his mindset has continued to prevail in the Philippines where more than 90% of surgical interventions are radical mastectomies. His loyal disciples abound. Most notable of whom is one considered the Surgeon Emeritus of my country's premier medical school who has stated in the past that the only way to prevent breast cancer would be the removable of the female breast upon birth. Just a few days ago, this supposed breast cancer authority was on national television and he even made matters worse - according to him, 70% of breast cancer cases are hereditary. I guess if the general public is made to accept his views, then there really is nothing that can be done. Breast cancer cannot be eradicated. One would just have to pray so hard and thank her lucky stars that she won't get breast cancer at all in her lifetime. But what do we see in the Philippines? Not why me? But why not me? Well for starters, there's the undisclosed presence of dioxin in former US military bases, the wide hormonal usage of Dipo Povera for contraception and Cytotec for abortions, the required annual chest x-rays of all government employees, the colossal garbage dumpsites, the continuous industrial waste contamination of bodies of water and the threat of further toxic mining spills. In 1996, a major toxic mine tailing of at least 1.5 million cubic meters spilled into the main rivers of Boac, Marinduque by Placer Dome Copper Holdings, a Canadian company. They simply closed shop right after, leaving a mess without any accountability whatsoever. Today, breast cancer has increased tenfold in that island. Then in 1999 gold mine tailings of cyanide spilled into 50 hectares of riceland in Surigao del Norte. This year, another Canadian company, Toronto Venture Inc. is set to extricate volumes of gold, silver, copper and zinc in Zamboanga del Norte. It is hoped that a revitalized mining sector will bring $9 billion of gross value and about 200,000 new jobs in the next six years. However, it has been correctly pointed out that our mining industry's two percent contribution to the gross national product would be minuscule compared to the amount of damage caused to the environment. The Philippines is fast becoming an ecologic disaster and our national government and distinguished legislators keep insisting on instant economic growth buffered by palliative public health and environmental remedies. For now, an irony exists wherein two countries such as Canada and the Philippines are both experiencing a breast cancer epidemic. Canada’s prosperity is threatened by the economic disadvantages of a rapidly falling birthrate compounded by the huge medical cost of breast cancer. Philippine migration to Canada is now welcomed more than ever, but what if the Canadian government is unknowingly importing potential breast cancer patients? Will they require all Philippine female immigrant applicants to undergo a mammography? On the other hand, breast cancer’s being the leading cause of death of Filipinos, without any cost at all to the Department of Health’s budget is propelling the population control program in the Philippines. Many women dying from breast cancer undoubtedly results in zero childbirths! Donating coffins by politicians are politically wiser than legislations against corporate environmental polluters. However with last Thursday’s decision of the Canadian Supreme Court opening the door to private health insurance, breast cancer research and action will surely suffer. When asked in my country why the World Conference on Breast Cancer was initiated and always held in Canada, I would explain that it is to the best interest of the Canadian government. Unlike in the United States, private healthcare system is the corporate American way and so the eradication of breast cancer can never be in their agenda. With Canada’s historical sacred trust of public-only medicine, a breast-cancer free population would definitely save the government tremendously huge amounts of money. So where else can a world conference seeking and addressing the causes of breast cancer take place but in Canada? Unfortunately, the very soul of this conference is now being threatened as breast cancer was made the example of the consequence un yesterday’s issue of The Globe and Mail newspaper, showing how money can buy the best treatment! The Canadian woman would have been dead had she not gone to New York and is now eleven years cancer-free. Doesn’t this sound like a paid advertisement? Whereas utmost environmental care is foremost for Canadian public health concerns, poverty and not environmental destruction is often if not always perceived as the cause for the deterioration in Philippine public health. A former Secretary of Health turned Philippine Senator would always say, “Given one’s poverty, it is forbidden to get sick. Take vitamins everyday so you wouldn’t miss a day’s work..” But I say, better to be poor yet healthy than to be rich and with breast cancer. Four months ago, a PBCN symposium on breast cancer for public school teachers was unceremoniously cancelled by a District Superintendent because their required annual chest x-rays would be questioned. To this day, the Secretary of the Department of Education has never even bothered replying, much less acknowledging the PBCN’s letter on the matter. I guess, the best form of state control is simply to ignore. How big a deal is breast cancer anyway to those who don’t have it? Do women with breast cancer only need to be given some kind of attention and a just a shoulder to cry on? Is losing a breast preferable to losing a right arm, or an assurance not to lose one’s life? Why must a woman lose her breast at all? Can anyone ever place breast cancer behind and “move on”? Can life ever be normal again just by looking good? Can they just be taught by psychologists how to cope and accept, to hope and forget? Every victim, even those who can buy a solution if ever there is, faces a lifetime of apprehension. Must we just find our place amongst our own kind and be thankful that however miserable, many others share in our predicament? Why is there breast cancer in the very first place? Should I just tell my children that life is too short and that whatever we do will not matter? That their mother fought a futile crusade? As people’s movements have waged revolutions against political dictatorships, breast cancer warriors are now revolting against corporate dictatorships! Contrary to those who maintain the lack of evidence, the link between the environment and breast cancer has been established. Yet governments continue to allow the presence of identified environmental risk factors produced by industry. What choice does one really have when what surrounds oneself is not between good, better or best for one’s health but what commercialism has deemed profitable. The war against breast cancer will not end until the multi-billion dollar cancer industry surrenders – but it never will. While using and producing carcinogenic chemicals, they are also produce the chemo drugs. They fund and support the scientific and medical community of schools, research institutions, hospitals and health insurances in order to maintain, develop and secure their multi-billion dollar marketplace of breast cancer victims. Are governments then elected for the welfare of its people or for corporate interests? Well, as for us here today, we all act for our families. We fight for the ones we love. It has been said that breast cancer advocacy will cease ten years from now because there will be a cure by then. However, finding the cure can never make breast cancer acceptable. The World Conference on Breast Cancer will no longer exist when the epidemic has been eradicated. Yes, my dear friends, the global situation of breast cancer, particularly in the Philippines is so pathetic. This is why I propose a gigantic leap forward by holding the 5th World Conference on Breast Cancer three years from now in the Philippines, thereby advancing the struggle beyond the borders of North America! As Rosa had in mind her three daughters when she first traveled to Kingston, I now have an additional personal reason to pursue global action for the eradication of breast cancer – my first granddaughter was born four months ago in New York City. Shortly before coming here, my 10-year-old daughter asked me, “Papa, what will happen to the PBCN if anything happens to you?” I answered, “I really don’t know, my dear, I really don’t know. We’ve just got to have faith.” A very dear friend of the PBCN quoted Goethe on its task ahead: “Whatever one can do or dream, one can begin it. Boldness has genius, power and magic. The moment one definitely commits oneself the Providence also moves. ” To love a woman is to end breast cancer! “Freedom from Breast Cancer Ann Fonfa is proud to claim friendship with Danny (and Rosa who died in 2000) Issues to be considered for future World conferences Breast Cancer Action, Montreal Breast Cancer Action, Montreal Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.