Carly's Cancer Warning
The new breast cancer advice “defies common sense,” says Carly Fiorina. The California Senate candidate and former HP CEO, still recovering from her own grueling battle with the disease, talks to Dana Goldstein.
Carly Fiorina, once the most powerful businesswoman in America and now a Republican candidate for the California Senate seat now held by Barbara Boxer, no longer sports her trademark, playful blond pixie cut. Fiorina learned she had breast cancer last February and underwent surgery in March. Just a month after finishing chemotherapy in early October, she announced her Senate run, hitting the campaign trail with a stylish buzz cut. So when the U.S. Preventive Task Force, a government-appointed panel of medical experts, announced Monday that it no longer recommends routine mammograms and breast self-exams for women under 50—and that even women over 50 should have the procedure only every other year—Fiorina, 55, had a lot to say. Had she followed those guidelines, “I’m not quite sure I’d be alive today,” Fiorina told The Daily Beast.
“I discovered my own lump two weeks after receiving a clear mammogram. So had I not been in the habit of self-examination I doubt I would have found it.”
The former Hewlett-Packard CEO, still recovering from her grueling nine-month battle with the disease, talked to The Daily Beast about how she found her own breast cancer through a self-exam, her strong opposition to the panel’s recommendations, and how it relates to the health-care reform battle in Washington. “It’s clear from my own experience and the experience of millions of other women that this new recommendation is not going to save lives,” she says.
What was your reaction to the new recommendations on mammograms and breast self-exams?
I was really shocked and disturbed because of my own personal experience. I discovered my own lump two weeks after receiving a clear mammogram. So had I not been in the habit of self-examination, I doubt I would have found it. And had I been following these recommendations, I would have waited a whole two years for my next mammogram, and I’m not quite sure I’d be alive today.
Following the outcry from many breast-cancer survivors after this news broke, Health and Human Services Secretary Kathleen Sebelius advised, “Keep doing what you have been doing… talk to your doctor about your individual history, ask questions, and make the decision that is right for you.” How do you interpret that, politically?
I think it’s a very confusing signal to send for women; for a task force that’s been pulled together by the government to come out and say one thing—which so flies in the face of everything women have been taught—and then, the next day, have the secretary of Health and Human Services say, “Oh, we’re not paying any attention to it.” At the very least, it’s confusing. At the very greatest, it suggests that this may be what happens when you have panels of so-called experts debating how to lower the costs of health care without considering what it does to the quality of health care.
Some people would say, “Well, these cancer screening tests are expensive, and they only save a very small number of lives in that 40 to 50 age range.” How can we balance concerns about public health costs while respecting the fact that many survivors feel they owe their lives to a mammogram?
Well, I guess what I’d say is that in my experience in business, the best way to reduce costs is actually to focus on quality. There are many things in a patient’s care—something I know a lot about, having just gone through breast cancer—that don’t improve care and are clearly costly, like repeating the same tests over and over again. I mean, when I was going to have my chemotherapy infusions, my blood pressure would be taken five or six times. That’s costly.
On the other hand, a test that clearly detects cancer and can save lives is something we shouldn’t be cutting out if we’re focusing on patients’ quality care.
And of course, beyond cost, this is a very emotional issue.
Well, one in six women now are diagnosed with breast cancer. You can’t tell me that diagnosis rate—and early diagnosis is key—hasn’t been improved by self-exams and mammograms. It defies common sense. It defies common sense to say that women shouldn’t be vigilant about their own health, through both self-exams and regular mammograms. And that’s why I think it’s emotional, because women know how common breast cancer is. How curable it is—caught soon enough—and how deadly it is if ignored.
Does government have a role in helping people to understand new medical research, in this case, findings that mammograms—while life-saving—may not be quite as effective for all women as initially thought?
I think government does not have a role in helping patients decide what their care should be. I think that role should rest with the doctor. If government has done research that is relevant, they should put that research out there to doctors and the public. But it’s not government’s role to then, as this task force did, recommend changes in care. They are overstepping their role. And that’s why so many women are concerned.
Many insurance companies deny coverage to breast-cancer survivors. One of the goals of the health-reform legislation in front of Congress right now—which you’ve said you oppose—is ending that practice. Should insurance companies be able to deny coverage due to preexisting conditions?
No. And that’s why I’m a supporter of health-care reform that solves the problem. You’re absolutely correct that the denial based on preexisting conditions impacts women harder than everyone else. There are very targeted ways to solve that problem, but it is not solved by having government run health insurance.
What are some of the policy changes you’d recommend?
One would be providing choice and competition among health-insurance plans. Another would be to specifically incent or subsidize companies so they would continue carrying people with preexisting conditions. I absolutely agree that all Americans should have access to quality, affordable health care, and women in particular. But the health-care bill wending its way through Congress doesn’t solve this problem.
Dana Goldstein is an associate editor and writer at The Daily Beast. Her work on politics, women’s issues, and education has appeared in The American Prospect, Slate, BusinessWeek, The New Republic, and The Nation.