Abby Lippman

(This is a partial transcript of the animated talk that Abby gave at the conclusion of our 4th annual 'Prevention is the Cure' March on October 15th. We thank her for permitting us to put this into print for all our members. — J.O'L.C.)

In the Globe and Mail recently, Sandra Martin wrote about her lumpectomy using an ABCDiary for her experiences. In her piece, Martin used 12 letters of the alphabet to discuss her Diagnosis, her Side effects, her thoughts about Privacy and Weasel words, and so on. What I have done is adapt her approach, and use my own selection of letters of the alphabet to make some comments relevant to our walk today, to our position that prevention (and yes, that will be at least one of the "p" words) is the cure. If nothing else, doing this provides some order, an alphabetical one, for what might otherwise seem disconnected. As well, using this approach leaves you with space to fill in your own words for these and other letters, using words (or terms) that express what we are trying to say and do by our walk today.

A is for Activism. It's why we are here today — to get out our messages about prevention. About the need to stop cancer from starting.

I propose C for Coalitions as the next word for our lexicon. We need to link with other groups, to create synergies, to join in our efforts to prevent disease, since more and more we learn that the same harmful exposure that causes one problem likely causes others. For example, toxins that are carcinogenic may also be related to infertility and to other chronic diseases.

C is also to remind us that we are Citizens, and not consumers, when it comes to health and its protection. The health care we get must be based on need and not on wealth — or corporate greed. Here I should remind you of Madeleine Bird's excellent "Profits in Pink" report (on the BCAM website) showing how corporations are increasingly capitalizing on breast cancer.

C could also be a reminder that what is presented to us as "chemoprevention" is, as Sharon Batt put it, more likely to represent "disease substitution."....and certainly not the primary prevention BCAM seeks.

E This is easy: Environment. Or maybe Ecology, since I think there's a kind of dilution in the meaning of environment lately, and that we need to see breast cancer prevention within the framework of an ecology of health. As the converse of what I said above about the generalizability of toxic harms, it helps to recall that what may be protective against breast cancer may be good for us in other ways, too. (Think about having safe streets on which we can walk and be active, or a smoke-free environment.) Under this letter, too, we can remind ourselves that breast cancer is perhaps more akin to an environmental than to a genetic disease; perhaps we need to spend more of our energies mapping the environment, rather than mapping the genome, to find sustainable ways to prevent breast cancer.

F. Here I want to play with the letter, and use it phonetically, so that "f" is for PHarma... its influence on where research is focused, as well as on what we read about breast cancer in the media. We need to watch out for Pharma's promises of cures, the most recent of which comes with the letter...

H for Herceptin (although it could as easily be "H" for Hype). Herceptin is likely a Harbinger of things to come, and it is a reminder that we will need to have some Hard conversations about the place of Hugely expensive drugs of still-unknown effectiveness on our activist agendas. What is all this money for drugs really buying? Is this what we want on a public drug list? And we need to have these conversations from the perspective of our collective commitment to a public health system rather than on a strictly individual level ... which is why I call the conversations "hard."

J: for Justice — to ensure that the environmental risks are seen as differentially distributed in society; we don't all face the same hazards.

K brings me to Knowledge transfer, but not the kind government favours, which is to see knowledge made into some economic activity or product. Rather, it is the need for transferring the knowledge women have to researchers and policy makers to ensure that what they do is relevant and pertinent to women and women's health needs. It's also about getting — and keeping — our places at all the tables where decisions are made that will affect women's health. Women's experiential knowledge needs to have the same support as does that produced by biomedical researchers.

O could refer to One in 9... and how we need to work to change this fraction. Or it could be for Occupation, the jobs that women do that may increase their risks of developing breast cancer, We know, for instance, that shift or night work affects levels of melatonin in the brain and that, this in turn, influences risk of the disease. We could think, too, about how jobs are distributed unequally among women, and about how one's occupation allows (or doesn't) time for self-care.

P really needs no comments from me. You are all advocates for the Precautionary Principle; you are all aware of how we must Politicize breast cancer, since then we can address it with Policies that Promote health and Prevent disease. Only then will we have true Primary Prevention.

Q is remember to Question assumptions that things are safe; that the cosmetics we wear have been shown to be harmless; that the system can't change. Q is also for Quebec, and we need to think about what we can do locally to keep prevention on the agenda especially here where the province is in bed with the pharmaceutical and biotech industries.

R is for our goal of a Responsible, and Responsive society that lives up to its commitments to women's health as a human right, a society that is rigorous in acting on its responsibilities to protect our health and well-being. It's also about re-thinking our priorities: Do we want the "cancer control" policy announced by the federal government, or do we want governments to make "cancer gone?"

U: What we need is a U-turn in priorities and policies. We need the precautionary principle to have priority, and not take for granted that the absence of data about harms means there are none.

V could be for Vantage point. What you know, and what you want to know. because of your positions as women living with a diagnosis of breast cancer, or as friends and family of such women. It is also for our Voices — and the voices of other individuals and groups that are not "fronts" for those with commercial interests — that need to be heard. BCAM is, and has been since its start, in the Vanguard. We need to be Vigilant and ensure that BCAM endures as threats to the public medical and health systems increase in number and strength.

And this brings me to Y — the letter, more than the question — to end my informal lexicon.

Y is for YES. Yes, we can get things changed. And yes, we need to do this for ourselves and for the younger women we know. So, Yes to more activism, and Yes to celebrating ourselves and preparing for the next round of our activism. Thank you for inviting me and listening. The next set of words is for you to develop and to act on!