Fighting the stereotype

Breast cancer awareness month is upon us again and with it comes the usual tide of pink ribbons, fluffy bras and 5K runs. Women's magazines will run features on young, attractive, middle-class women who were diagnosed with breast cancer in their 20s and 30s and more recently, we'll celebrate the award of an honorary doctorate given to singer Kylie Minogue for her contribution to breast cancer awareness.All admirable stuff. But there is an invisibility here that often goes unnoticed and unchallenged. When I was first diagnosed with breast cancer seven years ago, I would meet other black women who were also going through treatment for this disease and would often hear the same comments. Many would tell me that they always thought of breast cancer as a 'white woman's disease,' that they didn't think they would ever be diagnosed with this illness.If we look at how breast cancer is portrayed in the mass media, we can see why they might think this way. The focus on Kylie Minogue as the current breast cancer pin-up girl is a typical example of the type of woman who normally fills our screens and newspapers. The tendency of the media to focus on the young, pretty, white, affluent breast cancer survivor at the expense of other groups has troubling potential implications, especially when it comes to racial differences.Although in general, breast cancer tends to be diagnosed less often in black women than white women, when it is, it tends to be more aggressive and diagnosed at a more advanced stage. For reasons that are currently unknown, black women have a greater tendency to be diagnosed with triple-negative breast cancer – this is an aggressive form of the disease that has no estrogen or progesterone receptors. It also doesn't have the abundance of HER2 receptors. This status means that hormonal and targeted treatments, like tamoxifen and Herceptin, will have no effect, with chemotherapy being the only option that can be used. If this wasn't enough, recent studies have shown that when black women are diagnosed with breast cancer, they tend to be diagnosed at an earlier age. One recent study even suggested that screening for black women should start earlier, from the age of 40.In addition to the media's stereotype of the typical breast cancer patient, there are a number of possible reasons why black women are less likely to run to the doctor at the first sight of a symptom. Here in the UK, we don't have the issue of a lack of medical insurance. The NHS offers a free service to all. But there still exists a taboo surrounding cancer among many older, black women from more traditional cultures, with many feeling that it is a fatal disease. This fuels a feeling that if you are diagnosed with breast cancer, then there's nothing that can be done. Added to this is often a distrust of the health system, in the way that there is a distrust of the criminal justice system, the educational system and mental health system. When miscarriages of justice are revealed along racial lines, it appears to cause a domino effect in all other areas.So what can be done? Perhaps we need to start acknowledging that there are differences among particular racial groups of women who are diagnosed with cancer. We need to put more money into research that looks at the reasons why women of West African origin are more likely to be diagnosed with triple-negative cancer, why black women are now being diagnosed at an earlier age, and we need to create awareness campaigns that challenge the stigma of breast cancer in black culture. We also need to change the current face of breast cancer – to one that incorporates women of all races and ages (incidentally, breast cancer is most common among those over 60). Until we do this, the prevailing image of a sexy, young, white breast cancer survivor will continue to exist and more women of colour will continue to die unnecessarily.Caroline Hunter is a photo editor and writer who lives and works in London. She was diagnosed with metastatic breast cancer when she had a recurrence in 2010, ten months after giving birth to her baby boy. She blogs about her experiences as both cancer patient and woman of colour. Read more from her at afrochemo.blogspot.com.