October was Breast Cancer Awareness Month, an observance I have supported in the past but without a personal connection. That all changed this summer.
I went for my routine mammogram on Aug. 22. Shortly after, I received a call that I needed a follow-up mammogram. At that point, I wasn’t concerned because this had happened to me before and it turned out to be nothing. So on Aug. 28, I had a second mammogram and then an ultrasound.
As I was lying on the ultrasound table, it dawned on me that something was different this time. Something was up. When the radiologist came in, he recommended a biopsy. I pressed him for more information and he said it was more than 50 percent likely that it was cancer.
The biopsy was scheduled for Sept. 16. I spent the next three weeks waiting and worrying. I was paralyzed, sleepwalking through my life. On Sept. 18, the pathology report confirmed invasive ductal carcinoma — breast cancer.
I am now a month into treatment and received the first bill for the biopsy and care associated with it: $8,600. I have health insurance that covered most of the cost. I paid $84, as well as out-of-pocket payments for doctor’s visits and prescriptions.
The emotional toll of breast cancer took me by surprise. Just the amount of information you need to process is overwhelming. I can’t imagine what it would be like if I had to worry about the financial toll on top of everything else.
I’ve heard stories like this through my volunteer work at Planned Parenthood Maine Action Fund. I started volunteering there four years ago. It was personal. I had an abortion in the 1980s and was concerned about the direction that the government was taking. I wanted to fight back.
My support for Planned Parenthood is now personal in another way. If I hadn’t had good health care coverage for most of my life, would I have developed relationships with providers I trust and healthy habits, such as regular cancer screenings? If I didn’t have access to affordable care, would my cancer have been detected early? If I didn’t have health insurance now, how would I pay for my treatment?
My type of breast cancer is HER-2 positive. It’s very aggressive. But with treatment my survival outlook is excellent. Without treatment, it would be bleak.
My experience has made me more appreciative of Planned Parenthood of Northern New England and the critical care they provide in Maine — for many patients, the only health care they get.
For 50 years, Planned Parenthood providers have been part of the Title X program, the nation’s program for affordable reproductive health care. It helps ensure that people with low incomes can still access birth control, annual exams and, yes, cancer screenings such as breast exams. More than 4 million people, including more than 20,000 Mainers, count on care through the Title X program.
But in August, about a week before my mammogram, the Trump-Pence administration implemented a medically unethical gag rule on providers in the Title X program. The gag rule forced 900 health centers, including Planned Parenthood providers, out of the program.
The very month that a cancer screening likely saved my life, millions of people suddenly found their access to care in jeopardy.
Breast cancer is one of the most common forms of cancer affecting women. But it impacts us differently depending on our race, ethnicity or economic status.
Structural barriers, including racism, make it harder for women of color and women with low incomes to access care, including cancer screenings. As a result, breast cancer among white women is more likely to be diagnosed at an earlier stage, and death rates from breast cancer are 40% higher among black women than white women.
Half of Title X patients are people of color, and the Trump-Pence administration just made it harder for them to get the very care that could save their lives.
Politics is upending women’s access to health care, and it needs to stop. Next year, when we mark Breast Cancer Awareness Month, I hope we can see the end of this dark political time when our lives and health depend on our gender, race and ZIP code. We can say goodbye to the harmful gag rule and other policies making it harder for people to get the care they need, and hello to a future where health care is a right for all.
Sara Gilfenbaum lives in Portland and is a Planned Parenthood Maine Action Fund volunteer.