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Kay, Gwen, fl. 2007. "Review of Early Detection: Women, Cancer and Awareness Campaigns in the Twentieth-Century United States". In Collected Book and Web Reviews (Alexander Street Press, Alexandria, VA, 2005) pp. [N pag] [View document in context of full source text] [Bibliographic details]


Early Detection: Women, Cancer and Awareness Campaigns in the Twentieth-Century United States

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Early Detection: Women, Cancer and Awareness Campaigns in the Twentieth-Century United States

By Kirsten E. Gardner. (Chapel Hill: University of North Carolina Press, 2006. 304 pp. Cloth $55.00 cloth, ISBN 0-8078-3014-3; $21.95 paper, ISBN 0-8078-5682-7).

Reviewed by Gwen Kay.

Everyone knows someone affected by breast cancer. Most people know breast cancer receives publicity, funding and awareness unlike any other disease today. What most people do not know is that women have long been involved in the fight against cancer. In Early Detection: Women, Cancer and Awareness Campaigns in the Twentieth-Century United States, Kirsten Gardner seeks to re-position activists, organizers, patients and advocates. It is these women, she argues, whose efforts laid the groundwork for the feminist health movement. Using records of individual physicians and women, women's groups, cancer organizations, popular literature and film, Gardner persuades the reader that it is our memory, not the work of countless women, that is at fault in our misguided perception that health activism for, by or about women did not exist prior to the late 1960s.

Gardner moves through the twentieth century, highlighting people, funds, organizations, and strategies employed to educate women about female cancers, by which she means breast, uterine, ovarian and cervical. The first chapter, "Look cancer straight in the face," traces the involvement of women in the founding and development of the American Society for the Control of Cancer (ASCC). Messages about cancer emphasized early detection -- "if you find it, we can cure it." Implicit in this message, Gardner reminds us, was responsibility and guilt if the cancer was not found early (enough). Progressive-era women's organizations disseminated information to members, and those whom they aimed to help; their message promoted attention to warning signs and the value of early cancer treatment.

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In the 1930s and 1940s, women's networks grew, and these networks received and reinforced, rather than challenged, medical authority. "Expanding networks of women," the second chapter, examines the Amanda Sims Memorial Fund (ASMF) and the Women's Field Army (WFA). The former, based in Baltimore and named after a woman who believed in cancer prevention and early detection, encouraged women to have periodic pelvic examinations. The American Association of University Women worked with the ASMF in part because "health is a political concern" (63). Before ASMF monies were depleted in 1935, an alliance had been formed with ASCC. And the ASCC created the WFA, using women to reach and teach other women. The messages of the WFA were consistent with that of the ASCC: cancer could be cured; early detection worked; and necessity of periodic medical examinations.

During the war years, Edith Nourse Rogers introduced or earmarked congressional funding for cancer research. At the same time, Mary Lasker worked to (re)create the American Cancer Society (ACS). Lasker, with a background in advertising, knew the value of, and how to get, publicity. Lasker pushed ACS to put 25 percent of their budget into research, enabling ACS to sponsor clinical trials of vaginal smears in the early 1950s. As Gardner writes, "Lasker demonstrated that women could orchestrate changes in male-dominated medical societies. Moreover, she effectively established that the public could influence government appropriations for medical research by employing public relations tools" (95). The second half of chapter three, "From Awareness to Screening," examines two screening methods. The first, breast self-examination, needed to be taught. The cannister of the film "Life Saving Fingers" bore the label "To be shown only with a medical speaker present" (113). The second, on Pap smears, chronicles George Papanicolaou's study of vaginal discharge and the possibility that "preventive care through screening techniques" could dramatically alter the mortality rate of cervical cancer (122). When the public learned about the Pap smear, women clamored for it, and their demand overwhelmed capability. Gardner sees the ten year lag between women's demands for this preventive screening and the medical community's putting resources in place as an example of the limits of women's power and clout within the cancer world. They could educate and fund raise, but not force medical practices into place (p. 123).

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Women's stories about surviving cancer appeared in the late 1940s, just as public optimism about conquering cancer was growing. "Cancer survivors" (chapter four) examines the very real questions and concerns of women who had cancer. When Terese Lasser founded Reach for Recovery in 1954 some viewed it as "just" a group of breast cancer survivors. These women offered one-to-one support, instruction, and advice to other women. "The popular message of early detection continued to imply that women's individual behavior contributed to cancer outcome. As had been stated for decades, early detection would lead to a cure, while procrastination could lead to death" (162). There were important post-war shifts in public perception of cancer: a belief in science and technology lead to optimism about screening technologies; post-operative concerns and treatment were being discussed; and a network of cancer survivors helped themselves.

Then, things changed ... or so we've been led to believe. In reality, Gardner sees continuity between the activism and involvement before and after Betty Ford's and Happy Rockefeller's public announcements of breast cancer, and the Boston Women's Health Collective making breast cancer and women's health topical, political subjects. Mammography emerged as a powerful screening device, with the debate about its efficacy concealed from the public until the mid-1970s. Some patients and practitioners sought an alternative to the one-step surgical process of biopsy and immediate removal. Readers of Our Bodies, Ourselves were encouraged to learn about their bodies, and ask (or challenge) their doctors regarding health care options and treatment. The mantra "the personal is political" may have been new, but activism was not; instead, feminists carried on the legacy of women before them, about whom they, and we, previously knew very little.

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Gardner's book is a welcome addition to the literature on cancer and women's health activism. Written in an engaging style, it introduces a veritable army of women long dedicated to better women's health. Along the way, these women learned and taught others, and began to question assumptions about "responsibility" for cancers not detected "early enough." Women may have been used for their networks, talents and resources, but in the end, they themselves were empowered to demand more screening, better options for treatments, and continued research.

Gwen Kay, Associate Professor of History at SUNY Oswego, teaches U.S. women's history and history of medicine & science. She is the author of Dying to Be Beautiful: The Fight for Safe Cosmetics (2004), numerous articles, and book reviews.


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