Rose Kushner: War correspondent and breast cancer advocate

Rose Kushner, 60, author, journalist and an outspoken advocate for women with breast cancer, died Jan. 7 at Georgetown Univ. Hospital in Washington of the disease that was her crusade for the past 17 years. She lived in Kensington, MD.

Kushner was one of the few female war correspondents in Vietnam as a reporter for the Baltimore Sunpapers. She gained national attention in 1975 when she turned her journalistic talents to chronicling her struggle with breast cancer. Her first book on the subject was “Breast Cancer: A Personal History & An Investigative Report,” published by Harcourt Brace Jovanovich. Her second book, “Why Me? What Every Woman Should Know About Breast Cancer to Save Her Life,” published by W.B. Saunders Co. in 1977 is regarded as a standard reference.

Tenacious and opinionated, Kushner became a leading critic of standard medical procedures. At the same time, she supported increased funding for cancer research and legislation requiring insurance reimbursement for mammography screening.

“She did more for women with breast cancer than any other human being in the world,” said Helene Brown, director for community applications of research at the Jonsson Comprehensive Cancer Center at UCLA and a member of the National Cancer Advisory Board. “Prior to Rose, you were a good patient if you sat still and took the treatment and you were a bad patient if you asked questions. She gave women–and men–the right to question their doctors.”

Kushner frequently was at odds with physicians, and especially surgeons, over what they considered standard therapy for breast cancer. Her first target was the then routine “one step” procedure, in which women with suspicious lumps in the breast would be anesthetized, the lump removed for biopsy, and if it was found to be malignant, the breast would be removed. A woman often did not know whether she would wake up from surgery with one breast or two.

She also strongly opposed routine use of the Halstead radical mastectomy, particularly after the National Surgical Adjuvant Breast & Bowel Project studies demonstrated that modified radicals, and in many cases, lumpectomies, were just as effective and less disfiguring.

When Kushner found a lump in her breast in 1974, she refused to submit to the one step procedure. In “Why Me?” Kushner wrote about her search for information about breast cancer. She found a general surgeon who performed the biopsy and then found a breast cancer specialist to perform a modified radical mastectomy.

The American Cancer Society was one of the establishment groups that Kushner fought vigorously on the issue. “In the early 1970’s, we didn’t see eye to eye,” said Alan Davis, vice president for government affairs at ACS. “She kept at it and finally convinced the doubters.”

In “Why Me?” Kushner called ACS “a conservative organization that moves with the speed of a senile snail.” Later, she became an advisor to the society and served on its Breast Cancer Task Force. In 1987, ACS gave Kushner its highest award, the Medal of Honor. Last year she also received the American Cancer Society D.C. Division’s Courage Award.

The other NCAB appointees are Rose Kushner, author, former cancer patient and Washington D.C. area activist in cancer patient counseling, the other lay appointee ; Robert Hickey, director of M.D. Anderson Hospital & Tumor Institute; Gale Katterhagen, Tacoma medical oncologist, past president of the Assn. of Community Cancer Centers, and currently a member of the Cancer Control & Rehabilitation Advisory Committee; LaSalle Lefall, chairman of the department of surgery at Howard Univ. and immediate past president of the American Cancer Society; and William Powers, Wayne State Univ. radiotherapist, chairman of the Committee for Radiation Oncology Studies, and the only Board member with an expiring term this year to be reappointed. 

Kushner and Landers fill the seats held by Mary Lasker, whose lobbying efforts played the key role in establishing the National Cancer Program and in the continuing battle to fund it adequately; and William Baker, president of Bell Telephone Laboratories. 

Lasker has been a member of the Board since it was created by the Act. She was reappointed once, but her involvement with the Presidential campaign of Ted Kennedy probably assured she would not be again.

The National Cancer Advisory Board displayed some coolness toward the new Community Clinical Oncology Program along with a reluctance to interfere with its implementation when the Assn. of Community Cancer Centers and Assn. of American Cancer Institutes made presentations at the Board’s annual program review last week. 

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Board member Rose Kushner expressed concern about “combination chemotherapy being used too indiscriminately,” although acknowledging that “most breast cancer patients want to be treated at home.”

Kushner picked up on the argument by some of those. interested in the Cancer Control Program that funds earmarked by Congress for cancer control will be used to help finance COOP. “I would like to have a ruling from the HHS general counsel on whether cancer control money can legally be used for experimental therapy,” Kushner said.

“We’ve been doing research with cancer control funds for six years,” Director Vincent DeVita said, referring to the cooperative group cancer control program which costs about $5 million a year and will be phased out as the CCOPs are funded. “If it’s illegal, we’re already in trouble. The stipulation that no control money be used to support research is an NCI policy, and it came from the feeling that cancer control money should not be used to fund grants.” Because it is an NCI policy, it can be changed by NCI without consulting HHS, DeVita indicated .

Kushner insisted that the involvement of the Div. of Cancer Treatment required to implement and manage CCOP should involve some DCT support for the program. “If there is cross division responsibility, there should be cross division funding.”

“It all comes from the same pot,” DeVita said.

“No, cancer control money going to CCOPs is not going to cancer control activities,” Kushner said.

Rowley wondered “if it is appropriate to support this at all in light of the budget problem. Some feel there are enough centers.” Rowley objected to what she said was the “fait accompli that there are going to be CCOPs and the only question is the mechanism (contract, grant, or cooperative agreement) . There is a central premise here that has not received review.”

“Our Board (of Scientific Counselors of DRCCA) did a good part of the development of the program,” DRCCA Director Peter Greenwald said.

“They have a vested interest in it,” Rowley said.

“No, there are mixed interests on that Board,” DeVita said.

“It is essentially done, and I don’t think anything short of action we’re not prepared to take will stop it,” Amos said.

“CCOP has been rammed through without enough thought,” Kushner said. “Others feel as I do, we’re uncomfortable with it. It is not too late.”

Rose Kushner says she has had to pay for long distance phone calls, postage and other nonreimbursible expenses, since becoming a member of the National Cancer Advisory Board, on Board related business. “There is no way someone not independently wealthy, or married to someone with a good job, can serve on this board,” she told the board’s Subcommittee on Activities & Agenda. 

Some members are affiliated with institutions which pick up those tabs. William Powers and Maureen Henderson put the pay they receive as board members (about $150 a day) into funds administered by their institutions and used to reimburse individuals for out of pocket expenses incurred. 

Sheldon Samuels pointed out that personal services contracts could be used for expenses other than those connected with legislative matters, such as letters to the president and members of Congress, which Chairman Henry Pitot has sent this year.” That has to do with the independence of the board,” Samuels said, and suggested that some small foundation might be interested in helping out. 

The subcommittee asked Barbara Bynum, director of the Div. of Extramural Activities, to study various options and report at the next meeting.

Rose Kushner, fresh from victory in the long fight to get Medicare to pay for mammography screening, has formed a political action committee to finance a continuing fight

“to find political solutions” in the search for new methods to reduce the toll from breast cancer.

Kushner, author and women’s health activist, established the Breast Cancer Advisory Center several years ago to provide information to women concerned about the disease. The new BreastPac will raise money to contribute to campaigns of politicians who support breast cancer programs. “I ask every woman in the U.S. who has ever found a lump in her breasts to contribute $1 to .BreastPac.” 

Advances in medicine are not driven entirely by science, physician and historian Barron Lerner, author of “The Breast Cancer Wars,” said March 13 in a seminar in Washington for health journalists, held by the National Press Foundation.

“Scientific knowledge has been constructed as an objective entity for so long, but scientific data is filtered through a social context,” Lerner said.

It is no coincidence that William Halstead’s disfiguring mastectomy operation—the standard breast cancer treatment for 60 years—began to be challenged at the beginning of women’s liberation in the 1960s and 1970s, Lerner said.

Some of the foremost challengers were women journalists-turned-activists, including Rose Kushner, a Kensington, MD, writer. After finding a lump in her breast, Kushner didn’t go to a doctor’s office. She went to the National Library of Medicine and read articles on breast cancer biology and treatment. She refused to have the anguishing “one-step” procedure, in which a patient went under anesthesia for a biopsy and did not know until she awoke whether her breast would still be there.

Kushner was turned down by nine surgeons until she found one at Roswell Park Cancer Institute who agreed to perform only a biopsy. Kushner later served on an NIH Consensus Conference panel that, among other things, recommended that physicians end the “one-step” procedure.

On Nov. 4, 2022, Duke Cancer Institute Executive Director Michael B. Kastan, MD, PhD, was honored by the Duke Medical Alumni Association with a Distinguished Faculty Award.

Established in 1968, the Medical Alumni Association Distinguished Awards were created to recognize those who make important contributions to the establishment and growth of the four-year medical school and to the world of medicine. The awards are designed to honor alumni and friends whose distinguished careers and unselfish contributions to society have added luster and prestige to Duke University and its School of Medicine. A committee appointed by the Dean of the School of Medicine selects the recipients from nominations solicited from alumni and medical school faculty.

The story and video here cover the highlights of Kastan’s decades-long research and clinical career.

On Thursday, April 14, 2022, Duke Cancer Institute clinical providers, researchers, staff, and leadership came together to celebrate the 50th anniversary of the Duke Comprehensive Cancer Center (now called Duke Cancer Institute).

As the DCI 50th kickoff celebration was gearing up on the grassy circle in front of Duke Cancer Center building in Durham, a few patients stopped by the adjacent Seese-Thornton Garden of Tranquility for some respite. A breast cancer patient of Susan Dent, MD, braced for a long day of chemotherapy infusions. A man with stage 3 melanoma, being treated by Brent Hanks, MD, chatted in the shade of a tree with his wife ahead of his next appointment. A woman on her way to the Duke South clinics, meanwhile, shared her worries over her brother’s recent esophageal cancer diagnosis, their strong family history of cancer, and the importance of keeping up with her mammograms.

Joe Moore—who hung up his DCI lab coat in 2019 after a 44-year Hematology/Oncology career —was admiring the newly-installed Sound of Hope bell (a gift of the J. Gordon Wright family in honor of Nancy Wright, a pancreatic cancer survivor) before Jana Wagenseller, RN, escorted him across the grass to a front-row seat, stage right. (Moore had begun his medical career at Duke in 1975 as a fellow and Wagenseller had begun her nursing career at Duke in 1976 and served in multiple leadership roles before retiring in 2004).

The Duke University Marching Band made a jubilant entrance onto the green and briefly performed in front of a big-screen slideshow showcasing moments in DCI history before the official program began.