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Oncologist María Bourlon: ‘Cancer is still closely linked to patriarchy’

The Mexican researcher co-authored a study showing that 1.5 million women’s deaths could be avoided through primary prevention or early detection

Doctora Maite Bourlon, especialista en Oncología
Dr. María Bourlon at her home in Mexico City; October 25, 2023.Aggi Garduño

There is widespread agreement regarding the male orientation of scientific research. Even research on women is usually done by and for men, while female scientists have been marginalized. The same holds true for patients. Numerous diagnoses and treatments have been developed based on male physiology and symptoms. About 30 researchers from four continents wanted to go further and find out about the effects of other variables on gender inequality — things like ethnicity and socioeconomic class. Their study — Women, Power and Cancer — published in the September issue of The Lancet, refers often to something called intersectionality: a framework for examining how systems of oppression influence experiences and opportunities. Dr. María Teresa Bourlon, an oncologist from Mexico and a co-author of the study, bluntly said, “Cancer is still closely linked to patriarchy. Patriarchy has various nuances that are now being identified in scientific studies. It doesn’t make sense to keep ignoring them.”

The study presents some very tough facts. At least 1.5 million women’s deaths could be avoided through primary prevention or early detection, and another 800,000 lives could be saved if all women had access to optimal cancer care. That’s 2.3 million unnecessary deaths every year. These numbers account for nearly half of the yearly cancer-related deaths in women (4.43 million). Bourlon attributes this in part to the absence of a gender perspective in public policies for prevention, diagnosis, and treatment. The issue often stems from the lack of reliable data concerning healthcare accessibility and treatment availability. “When data is lacking, we often neglect to address important questions like why women aren’t going to health centers, following treatment plans and receiving adequate support. It’s crucial to understand these contexts and have reliable, rigorous data to inform our actions.”

The economic barrier

Bourlon and her team asked all these questions and reached a profound conclusion: gender inequalities — economic, care, and violence — are major obstacles in the fight against cancer, and the economic barrier looms large. “Women bear the primary responsibility for housework, and those who have jobs are usually employed informally. As a result, many lack access to essential health services,” said Bourlon. This translates into delayed diagnoses. “Women, particularly those from more disadvantaged backgrounds, often are unable to seek treatment due to economic constraints. Unfortunately, this aspect is often overlooked in cancer studies.” Nearly 20% of women only seek medical consultations when the disease is already advanced and difficult to stop. Despite the misconception that it primarily affects men, lung cancer ranks as the second most common cancer in women after breast cancer. “The only cancers that require a distinct approach are those associated with male and female biology. However, they are not studied in equal measure.”

Another issue highlighted by Bourlon is concern about sexual abuse during medical consultations. Many women have experienced unwanted touching or even sexual assault during appointments. “There’s a significant number of male healthcare workers, and many women shy away from going to them after hearing stories from family and friends.” A clear example is seen in the significant disparity in colonoscopies between women and men. Colonoscopy is a procedure used to directly examine the intestines and detect conditions like colon cancer. “It’s not anecdotal, it happens a lot.” The study also delves into cultural barriers and the lack of health education in mainly rural areas. “Latin America is very diverse and there are many myths around chemotherapy or radiology that have to be debunked. This is the only way we can effectively provide health care to these areas.” In countries with a low Human Development Index, 72% of cancer deaths are premature. This percentage is nearly halved in countries with medium and high incomes.

Dr. María Bourlon at her home in Mexico City; October 25, 2023.
Dr. María Bourlon at her home in Mexico City; October 25, 2023.Aggi Garduño

Female caregivers are neglected

Caregiving poses another significant health challenge for women. While they often take on the responsibility of caring for sick partners, parents and children, they suffer from a lack of support when they become ill. “They often have to quit scarce jobs to provide care, but they rarely receive any care in return. This leads them to forgo treatment and neglect their symptoms,” said Bourlon. The authors of the study offer a key recommendation that resonates with many feminist demands: pay the caregivers. In Mexico, this could account for up to 2% of the country’s health-related spending.

Failure to change this perspective could exacerbate the situation, as the incidence of these types of illnesses tends to escalate over time. In 2020, approximately 9.23 million women around the world received a cancer diagnosis, and 4.43 million died from the disease. By 2040, these numbers are projected to rise to 13.3 million new cases (a 44% increase) and 7.1 million deaths (a 60% increase). Bourlon says, “We have to start talking about the gender perspective now — it’s urgent.”

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