This week: why lung cancer can get missed when you’ve never smoked, why getting treated at the same cancer center doesn’t mean women have the same odds of surviving ovarian cancer, and why brain fog shouldn’t automatically get filed under menopause.
Also: an estrogen study that’s a finding, not a prescription, and a $20 billion plan for women’s health that still needs the minor detail of congressional funding.
Lung cancer rates are now higher in women than men under 65.
About 1 in 5 people who die from lung cancer never smoked. But routine screening is still built around smoking history, which leaves a pretty obvious blind spot. Annual screening is recommended only for people 50 to 80 who smoked a pack a day for 20 years, or quit in the past 15. One 38-year-old woman figured her lingering cough was pneumonia. It turned out to be Stage 4 lung cancer.
What to ask: If a cough or other respiratory symptom isn't resolving, ask what else needs to be ruled out — even if you've never smoked. And test your house for radon. It's the second-leading cause of lung cancer, and nobody may think to mention it.
Same cancer center. Black women with ovarian cancer still died at higher rates.
A recent study at one Alabama cancer center found Black women with ovarian cancer had a 45% higher risk of death than white women — after accounting for age, cancer stage, tumor type, and when they were diagnosed.
Neighborhood conditions explained about 40% of that gap. Women in the most vulnerable neighborhoods — scored on poverty, housing, transportation, and education — had a 20% higher risk of death. Same cancer center doesn’t automatically mean same chance of surviving it.
What to ask: Ask your care team what support services they actually offer: patient navigation, transportation assistance, childcare, survivorship resources. These are what keep women in treatment.
Estrogen-only hormone therapy was linked to fewer Alzheimer's signs. Nobody knows why those women were taking it.
Researchers found women who'd used estrogen-only hormone therapy had 35% lower odds of showing Alzheimer's hallmarks in their brains than women who had never used it. A finding. Not a prescription.
The study shows an association, not that estrogen prevents dementia. Researchers didn't know why any of these women were prescribed estrogen or whether they'd had hysterectomies — which matters, since estrogen alone is mainly recommended for women who have. The authors themselves note the women who took it may simply have been healthier or better insured.
What to ask: If you’re on HRT, ask whether this changes anything about your prescription. The answer is probably no. If you’re not on HRT, this study isn't a reason to start.
Women's health organizations have a $20 billion plan. Congress has not funded it.
Women are more than half the U.S. population and live about 25% of their lives in worse health than men. Across 706 heart failure trials, they were 26% of participants. Congress required women to be included in federally funded clinical research in 1993, so apparently we've had some follow-through issues.
The National Strategy to Close the Women’s Health Gap, a new 10-year, $20 billion strategy, proposes spending on research, the women's health workforce, better data, regulatory coordination, and public awareness.
What to ask: Contact your representative and ask whether they support the National Strategy to Close the Women’s Health Gap, and what they're doing to fund it. You do not need to know the appropriations process. That's literally their job.
Brain fog is common in perimenopause. That doesn't mean perimenopause gets custody of every forgotten word.
Up to 60% of women get some version of it — losing words, names, numbers, the reason you walked into the kitchen. For most women, the cognitive changes are mild and don't appear to persist after perimenopause.
But it isn’t limited to perimenopause. An estimated 75% of women with sleep apnea are never diagnosed — partly because up to 40% of women who have it don’t snore, don’t choke at night, and have no episodes anyone could witness.
What to ask: If brain fog is affecting your daily life, ask what else should be ruled out before everybody blames menopause. Sleep apnea, B12 deficiency, celiac disease and long COVID can all cause cognitive symptoms.
That's your list for the next time someone says, ‘Any questions?’
Know someone in the “wait, what the hell is happening” years? Forward this to her.
See you next Friday. — Trista