Every year, tens of thousands of women die from preventable cancers. Now, researchers are claiming that patriarchy is dominating cancer care, research and policymaking. The way forward? A feminist approach to cancer care.
The report, Women, Power and Cancer: A Lancet Commission, states that six in ten deaths could be avoided through earlier diagnosis and preventative measures being taken. And, that women aged 30-69 are losing their lives unnecessarily. Over 1.5 million deaths could be prevented by early detection and prevention, says the report, with 800,000 avoided if all women could access “gold-standard care.”
“Globally, women’s health is often focused on reproductive and maternal health, aligned with narrow anti-feminist definitions of women’s value and roles in society, while cancer remains wholly under-represented,” said Dr Ophira Ginsburg, co-chair of the Lancet Commission, to SkyNews.
Co-author Professor Nirmala Bhoo-Pathy added, “Women are often expected to prioritise the needs of their families at the expense of their own health, sometimes leading to the postponement of seeking healthcare.”
Across Europe, only one in two women will be checked for breast cancer, even though, according to the European Commission, breast cancer was “estimated to be the most diagnosed tumour among all cancer types and the first cause of cancer death among women” in 2020.
It’s clear that the stakes are high. But what is a feminist approach to cancer care? And, how accessible is this ideology for women at the margins of society?
A History of Inequality
The Lancet study recognises gender inequality and health inequalities are shaped by patriarchy and colonialism, explaining that both are reinforced by unequal power dynamics “to the detriment of women and marginalised communities.”
Calls have been made by other researchers to reorientate our social systems in favour of a more equitable and healthy society. One way to do this is to collect data on health issues of significance to women.
Women weren’t included in clinical trials until the 1970s — as until then, it was broadly believed that men were the dominant sex. And even then, because of the consequences of the Tholidimide trials, (a drug that was prescribed for morning sickness, but caused serious deformities in babies), pregnant women were seen as vulnerable. This led to single women, women whose partners had had a vasectomy and women using contraception being excluded from trials.
It wasn’t until the late 80s that the National Institute of Health introduced policies recommending the inclusion of women in clinical trials. However, it was in 1993 that it became federal law for women to be included in clinical trials. Twenty years on and period products have only just started to use blood to measure their efficacy. This was a surprising revelation, though perhaps not a shocking one, as menstrual blood wasn’t seen in advertisements until 2017.
But why is this important? Well, it demonstrates a historic and systematic omission of female-focused healthcare in modern medicine. This further reinforces evidence and the prevalence of health inequality — also known as the gender health gap.
Applying an intersectional lens to cancer treatment
As the Lancet report points out, to be able to provide adequate care for female cancer patients, the issues surrounding inequality need to be approached with an intersectional lens.
Intersectionality, first coined by Kimberlé Krenshaw, an American civil rights activist, as a feminist term that acts as ”... a metaphor for understanding the ways that multiple forms of inequality or disadvantage sometimes compound themselves and create obstacles that often are not understood among conventional ways of thinking.”
This means that feminist cancer care would seek to understand biological factors that put women at a disadvantage, but it also recognises “gendered socioeconomic, environmental, cultural, and political dimensions, gendered social structures and systems that shape the overall experience of women in relation to cancer”.
The report highlights how we can begin to help more women access the care they deserve by signposting which obstacles are proving insurmountable. It’s a call to action for change so that more women can live and not just make it out alive.
So, do we need feminist cancer care?
Yes, if the opinions of the British Medical Association (BMA) are anything to go by. According to an article published in 2022, the BMA has repeatedly asked the Government to improve women’s health. Their research paper, Cancer in Women – addressing unmet needs (which was published in 2018), outlines that every three minutes a woman is diagnosed with cancer. Soberingly, every seven minutes, a woman dies from cancer.
Women at the margins of society bear the brunt of inequality, as mortality rates are higher in deprived areas. Projections from the study show that by 2035, nearly 244,000 new cases of cancer will be diagnosed each year in women, an increase of 36%.
The BMA strongly recommend an overall improvement in diagnostic and treatment services, as well as calling on health professionals to educate and help women spot the signs early on.
But with a real-time cut of £ 4-9.5 billion reported in 2022, and the NHS workforce stretched to its limit, (following the 2023 spring budget announcement), we probably shouldn’t expect changes anytime soon. Even though, as it stands, the UK has the biggest gender health gap of any nation in the G20.