Rose Kushner
Encyclopedia
Rose Rehert Kushner was an American
journalist
and pioneering advocate for breast cancer
patients. She wrote the 1975 book Why Me? What Every Woman Should Know About Breast Cancer to Save Her Life.
an immigrants Israel and Fannie Gravitz Rehert, both of whom died by the time she was 10 years old. As a child, she aspired to a career as a physician
, but her family was unable or unwilling to send her to college. After high school
she worked at the Johns Hopkins School of Medicine
from 1947 to 1951 and took pre-med courses at Baltimore Junior College in 1949.
In 1951 she married Harvey Kushner and had three children, born between 1952 and 1958. She returned to college in the 1960s, changing her concentration to journalism, and in 1972 receiving an A.B. degree summa cum laude from the University of Maryland
. In the late 1960s and early 1970s she did medical writing
and freelance journalism work, including work in Bolivia
and Vietnam
, as well as coverage of the 1973 Yom Kippur war
.
, breast cancer became the focus of her life. On the basis of her library research into breast cancer treatment, she objected to the treatment which was then standard, in which a tumor biopsy
and radical mastectomy
were performed in a single surgical operation while the patient was under anesthesia
. However, she had difficulty finding a doctor who would perform a diagnostic biopsy and allow her to decide what action to take next. After a biopsy determined that her tumor was cancerous, she resisted the then-standard radical mastectomy procedure, in which muscle tissue and lymph nodes were removed along with the breast. In order to have a less invasive procedure, she traveled from her Kensington, Maryland
home to Buffalo, New York
, where she had found a doctor (Dr. Thomas Dao
) who was willing to do a modified radical mastectomy.
As Kushner recovered from her surgery, she started writing about her experiences with breast cancer. She was outspoken in her criticism of Betty Ford
's September 1974 treatment for breast cancer, using personal connections in Washington, DC, in an unsuccessful effort to convince the First Lady
not to undergo a one-step biopsy and radical mastectomy. After being told that "the President has made his decision" (regarding his wife's medical treatment) she railed against the "male-chauvinist-piggery" represented by that statement, writing in a letter: "That statement has got to be engraved somewhere as the all-time sexist declaration of no-woman rights."
Her first major article on the topic of breast cancer was published in The Washington Post
on October 6, 1974. She traveled to Europe
to learn about breast cancer treatment there, finding that the radical mastectomy was not used as widely as in the United States. Upon her return home, she started a book about the causes, diagnosis, and treatment of breast cancer, completing the manuscript in just seven weeks. The book, was published in 1975 under the title Breast Cancer: A Personal History and Investigative Report. The book contained extensive medical information and advice for patients, including strong criticism of radical mastectomies and the practice of performing a biopsy and a mastectomy as a one-step surgical procedure. In her critique of prevalent medical practices she used rhetoric familiar to the 1970s feminist movement
, with statements such as "No man is going to make another impotent while he's asleep without his permission, but there's no hesitation if it's a woman's breast." The book was strongly endorsed by Dr. Dao, who had conducted research on breast cancer treatment and had performed Rose Kushner's surgery, but it was widely criticized by other doctors and the American Cancer Society
.
With a friend, in 1975 Kushner established a telephone hotline
called the Breast Cancer Advisory Center, based in Kensington, Maryland
, that operating until 1982, responding to calls and letters from thousands of women wanting information about breast cancer and its treatment. The center's establishment was motivated in part by Kushner's desire to promote patient self-help and mutual support, thus displacing the medical profession and the American Cancer Society from their roles as information "gatekeepers".
Kusher became a relentless critic of the treatment of breast cancer by the medical profession. She attended numerous meetings of medical professionals, interrupting presentations, questioning conclusions, and speaking against the prevalent practices of one-step breast cancer surgery and radical mastectomy. In 1975 she was "booed off the stage" at a meeting of the Society of Surgical Oncology, whose members objected to her challenges to traditional treatments.
In spite of her unpopularity with the mainstream medical profession, Kushner's work was well-received in the public and won increasing respect in official circles. In June 1977, she was the only lay member
appointed to a ten-member National Institutes of Health
(NIH) panel that evaluated treatment options for primary breast cancer. In 1979, the panel issued its findings, concluding that the Halsted radical mastectomy should no longer be the standard treatment for suspected cases of breast cancer, instead recommending total simple mastectomy as the primary surgical treatment. Additionally, Kushner convinced her fellow panel members to include a statement calling for an end to the one-step surgical procedure. At the time of her death, Dr. Bruce A. Chabner of the National Cancer Institute
said she was "probably the single most important person" in ending the practice of one-step surgery for breast cancer, because of her persistence and because she brought medical information to a wide public audience that otherwise might have remained unaware of the options.
Following her service on the NIH panel, President Jimmy Carter
appointed Kushner to the National Cancer Advisory Board as the board's first lay member, and she was engaged by the NIH to review grant applications. She took pleasure in the fact that she was working within the system, joking “I'm a full-fledged member of the Establishment
.”
After Kushner's cancer recurred in 1981, she refused chemotherapy
, which she considered to be unacceptably toxic, and was treated with tamoxifen
. In the 1980s she campaigned against aggressive use of chemotherapy. In a 1984 article "Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the '80s?" she suggested that chemotherapy was being used as indiscriminately as radical mastectomy surgery had been in earlier decades, saying that doctors gave insufficient attention to the serious side effects of chemotherapy, and calling chemotherapy "therapeutic overkill." Barron Lerner has suggested that the vehemence of her attack on chemotherapy may have reflected a conflict of interest
, related both to her personal interest in the implications of her own decision to refuse chemotherapy and a "close working and financial relationship with the manufacturers of tamoxifen."
She continued to advocate for the interests of breast cancer patients for the rest of her life. In 1986 she was a cofounder of the National Alliance of Breast Cancer Organizations, an umbrella organization
on whose board she served from 1986 to 1989. In 1989 she was appointed to the Breast Cancer Task Force of the American Cancer Society
. Up until a few days before her death in 1990, at the age of 60, she was actively lobbying for the U.S. federal government to require health insurance
to cover mammograms.
in 1980 and 1985 for her books and articles about breast cancer. The American Cancer Society
honored her with its Medal of Honor in 1987 and its Courage Award in 1988.
In 1990 she was the posthumous recipient of the James Ewing Award of the Society of Surgical Oncology, recognizing outstanding contributions by a lay person to the fight against cancer.
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
journalist
Journalist
A journalist collects and distributes news and other information. A journalist's work is referred to as journalism.A reporter is a type of journalist who researchs, writes, and reports on information to be presented in mass media, including print media , electronic media , and digital media A...
and pioneering advocate for breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
patients. She wrote the 1975 book Why Me? What Every Woman Should Know About Breast Cancer to Save Her Life.
Early life and career
Rose Rehert was born on June 22, 1929, in Baltimore, Maryland. Her parents were Eastern EuropeEastern Europe
Eastern Europe is the eastern part of Europe. The term has widely disparate geopolitical, geographical, cultural and socioeconomic readings, which makes it highly context-dependent and even volatile, and there are "almost as many definitions of Eastern Europe as there are scholars of the region"...
an immigrants Israel and Fannie Gravitz Rehert, both of whom died by the time she was 10 years old. As a child, she aspired to a career as a physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
, but her family was unable or unwilling to send her to college. After high school
High school
High school is a term used in parts of the English speaking world to describe institutions which provide all or part of secondary education. The term is often incorporated into the name of such institutions....
she worked at the Johns Hopkins School of Medicine
Johns Hopkins School of Medicine
The Johns Hopkins School of Medicine , located in Baltimore, Maryland, U.S., is the academic medical teaching and research arm of Johns Hopkins University. Hopkins has consistently been the nation's number one medical school in the amount of competitive research grants awarded by the National...
from 1947 to 1951 and took pre-med courses at Baltimore Junior College in 1949.
In 1951 she married Harvey Kushner and had three children, born between 1952 and 1958. She returned to college in the 1960s, changing her concentration to journalism, and in 1972 receiving an A.B. degree summa cum laude from the University of Maryland
University of Maryland
When the term "University of Maryland" is used without any qualification, it generally refers to the University of Maryland, College Park.University of Maryland may refer to the following:...
. In the late 1960s and early 1970s she did medical writing
Medical writing
Medical writing is the activity of producing scientific documentation by a specialized writer. The medical writer typically is not one of the scientists or doctors who performed the research....
and freelance journalism work, including work in Bolivia
Bolivia
Bolivia officially known as Plurinational State of Bolivia , is a landlocked country in central South America. It is the poorest country in South America...
and Vietnam
Vietnam
Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...
, as well as coverage of the 1973 Yom Kippur war
Yom Kippur War
The Yom Kippur War, Ramadan War or October War , also known as the 1973 Arab-Israeli War and the Fourth Arab-Israeli War, was fought from October 6 to 25, 1973, between Israel and a coalition of Arab states led by Egypt and Syria...
.
Breast cancer advocacy
After Rose Kushner's June 1974 discovery of a cancerous lump in her breastBreast
The breast is the upper ventral region of the torso of a primate, in left and right sides, which in a female contains the mammary gland that secretes milk used to feed infants.Both men and women develop breasts from the same embryological tissues...
, breast cancer became the focus of her life. On the basis of her library research into breast cancer treatment, she objected to the treatment which was then standard, in which a tumor biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
and radical mastectomy
Radical mastectomy
Radical mastectomy is a surgical procedure in which the breast, underlying chest muscle , and lymph nodes of the axilla are removed as a treatment for breast cancer....
were performed in a single surgical operation while the patient was under anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...
. However, she had difficulty finding a doctor who would perform a diagnostic biopsy and allow her to decide what action to take next. After a biopsy determined that her tumor was cancerous, she resisted the then-standard radical mastectomy procedure, in which muscle tissue and lymph nodes were removed along with the breast. In order to have a less invasive procedure, she traveled from her Kensington, Maryland
Kensington, Maryland
Kensington is a town in Montgomery County, Maryland, United States. The population was 1,873 at the 2000 census. Greater Kensington encompasses the entire 20895 zip code and its population is an order of magnitude larger than that of the town at its center....
home to Buffalo, New York
Buffalo, New York
Buffalo is the second most populous city in the state of New York, after New York City. Located in Western New York on the eastern shores of Lake Erie and at the head of the Niagara River across from Fort Erie, Ontario, Buffalo is the seat of Erie County and the principal city of the...
, where she had found a doctor (Dr. Thomas Dao
Thomas Dao
Ling Yuan "Thomas" Dao was a Chinese American physician and specialist in breast cancer, its causes and treatment, who was one of the earliest proponents of minimalist alternatives to radical mastectomy as a treatment option for breast cancer, in addition to advocacy of breast self-examination and...
) who was willing to do a modified radical mastectomy.
As Kushner recovered from her surgery, she started writing about her experiences with breast cancer. She was outspoken in her criticism of Betty Ford
Betty Ford
Elizabeth Ann Bloomer Warren Ford , better known as Betty Ford, was First Lady of the United States from 1974 to 1977 during the presidency of her husband Gerald Ford...
's September 1974 treatment for breast cancer, using personal connections in Washington, DC, in an unsuccessful effort to convince the First Lady
First Lady
First Lady or First Gentlemanis the unofficial title used in some countries for the spouse of an elected head of state.It is not normally used to refer to the spouse or partner of a prime minister; the husband or wife of the British Prime Minister is usually informally referred to as prime...
not to undergo a one-step biopsy and radical mastectomy. After being told that "the President has made his decision" (regarding his wife's medical treatment) she railed against the "male-chauvinist-piggery" represented by that statement, writing in a letter: "That statement has got to be engraved somewhere as the all-time sexist declaration of no-woman rights."
Her first major article on the topic of breast cancer was published in The Washington Post
The Washington Post
The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...
on October 6, 1974. She traveled to Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
to learn about breast cancer treatment there, finding that the radical mastectomy was not used as widely as in the United States. Upon her return home, she started a book about the causes, diagnosis, and treatment of breast cancer, completing the manuscript in just seven weeks. The book, was published in 1975 under the title Breast Cancer: A Personal History and Investigative Report. The book contained extensive medical information and advice for patients, including strong criticism of radical mastectomies and the practice of performing a biopsy and a mastectomy as a one-step surgical procedure. In her critique of prevalent medical practices she used rhetoric familiar to the 1970s feminist movement
Feminist movement
The feminist movement refers to a series of campaigns for reforms on issues such as reproductive rights, domestic violence, maternity leave, equal pay, women's suffrage, sexual harassment and sexual violence...
, with statements such as "No man is going to make another impotent while he's asleep without his permission, but there's no hesitation if it's a woman's breast." The book was strongly endorsed by Dr. Dao, who had conducted research on breast cancer treatment and had performed Rose Kushner's surgery, but it was widely criticized by other doctors and the American Cancer Society
American Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...
.
With a friend, in 1975 Kushner established a telephone hotline
Helpline
A helpline was originally a telephone service which offers help to those who call. Many helpline services now offer more than telephone support - offering access to information, advice or customer service via telephone, email, web or SMS....
called the Breast Cancer Advisory Center, based in Kensington, Maryland
Kensington, Maryland
Kensington is a town in Montgomery County, Maryland, United States. The population was 1,873 at the 2000 census. Greater Kensington encompasses the entire 20895 zip code and its population is an order of magnitude larger than that of the town at its center....
, that operating until 1982, responding to calls and letters from thousands of women wanting information about breast cancer and its treatment. The center's establishment was motivated in part by Kushner's desire to promote patient self-help and mutual support, thus displacing the medical profession and the American Cancer Society from their roles as information "gatekeepers".
Kusher became a relentless critic of the treatment of breast cancer by the medical profession. She attended numerous meetings of medical professionals, interrupting presentations, questioning conclusions, and speaking against the prevalent practices of one-step breast cancer surgery and radical mastectomy. In 1975 she was "booed off the stage" at a meeting of the Society of Surgical Oncology, whose members objected to her challenges to traditional treatments.
In spite of her unpopularity with the mainstream medical profession, Kushner's work was well-received in the public and won increasing respect in official circles. In June 1977, she was the only lay member
Layman
A layperson or layman is a person who is not an expert in a given field of knowledge. The term originally meant a member of the laity, i.e. a non-clergymen, but over the centuries shifted in definition....
appointed to a ten-member National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
(NIH) panel that evaluated treatment options for primary breast cancer. In 1979, the panel issued its findings, concluding that the Halsted radical mastectomy should no longer be the standard treatment for suspected cases of breast cancer, instead recommending total simple mastectomy as the primary surgical treatment. Additionally, Kushner convinced her fellow panel members to include a statement calling for an end to the one-step surgical procedure. At the time of her death, Dr. Bruce A. Chabner of the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
said she was "probably the single most important person" in ending the practice of one-step surgery for breast cancer, because of her persistence and because she brought medical information to a wide public audience that otherwise might have remained unaware of the options.
Following her service on the NIH panel, President Jimmy Carter
Jimmy Carter
James Earl "Jimmy" Carter, Jr. is an American politician who served as the 39th President of the United States and was the recipient of the 2002 Nobel Peace Prize, the only U.S. President to have received the Prize after leaving office...
appointed Kushner to the National Cancer Advisory Board as the board's first lay member, and she was engaged by the NIH to review grant applications. She took pleasure in the fact that she was working within the system, joking “I'm a full-fledged member of the Establishment
The Establishment
The Establishment is a term used to refer to a visible dominant group or elite that holds power or authority in a nation. The term suggests a closed social group which selects its own members...
.”
After Kushner's cancer recurred in 1981, she refused chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
, which she considered to be unacceptably toxic, and was treated with tamoxifen
Tamoxifen
Tamoxifen is an antagonist of the estrogen receptor in breast tissue via its active metabolite, hydroxytamoxifen. In other tissues such as the endometrium, it behaves as an agonist, hence tamoxifen may be characterized as a mixed agonist/antagonist...
. In the 1980s she campaigned against aggressive use of chemotherapy. In a 1984 article "Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the '80s?" she suggested that chemotherapy was being used as indiscriminately as radical mastectomy surgery had been in earlier decades, saying that doctors gave insufficient attention to the serious side effects of chemotherapy, and calling chemotherapy "therapeutic overkill." Barron Lerner has suggested that the vehemence of her attack on chemotherapy may have reflected a conflict of interest
Conflict of interest
A conflict of interest occurs when an individual or organization is involved in multiple interests, one of which could possibly corrupt the motivation for an act in the other....
, related both to her personal interest in the implications of her own decision to refuse chemotherapy and a "close working and financial relationship with the manufacturers of tamoxifen."
She continued to advocate for the interests of breast cancer patients for the rest of her life. In 1986 she was a cofounder of the National Alliance of Breast Cancer Organizations, an umbrella organization
Umbrella organization
An umbrella organization is an association of institutions, who work together formally to coordinate activities or pool resources. In business, political, or other environments, one group, the umbrella organization, provides resources and often an identity to the smaller organizations...
on whose board she served from 1986 to 1989. In 1989 she was appointed to the Breast Cancer Task Force of the American Cancer Society
American Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...
. Up until a few days before her death in 1990, at the age of 60, she was actively lobbying for the U.S. federal government to require health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
to cover mammograms.
Works
The following are among Rose Kushner's published writings:- Kushner, Rose (1977), Why Me? What Every Woman Should Know About Breast Cancer To Save Her Life (originally published in 1975 as Breast Cancer: A Personal History and Investigative Report). ISBN 0451076923, ISBN 0-451-07692-3
- Kushner, Rose (1979), "If You've Thought About Breast Cancer..." (brochure), American Cancer Society, District of Columbia Division. Rose created and wrote the first six editions of this series, which was continued by the National Cancer InstituteNational Cancer InstituteThe National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
. - Kushner, Rose (1984), Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the '80s?, CA Cancer J Clin 1984; 34:345-351. DOI: 10.3322/canjclin.34.6.345
- Kushner, Rose (1985), Alternatives: New Developments in the War Against Breast Cancer, Warner Books. ISBN 0446345873, ISBN 9780446345873, ISBN 0-446-34587-3
Awards and recognitions
Kushner received awards from the American Medical Writers AssociationAmerican Medical Writers Association
The American Medical Writers Association is the world's leading professional association for medical communicators. AMWA has more than 5,600 members in the United States, Canada, and 26 other countries. AMWA is governed by a board of directors composed of a 14-member executive committee and...
in 1980 and 1985 for her books and articles about breast cancer. The American Cancer Society
American Cancer Society
The American Cancer Society is the "nationwide community-based voluntary health organization" dedicated, in their own words, "to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and...
honored her with its Medal of Honor in 1987 and its Courage Award in 1988.
In 1990 she was the posthumous recipient of the James Ewing Award of the Society of Surgical Oncology, recognizing outstanding contributions by a lay person to the fight against cancer.