Paralympics, amazonians and amputees – where does breast reconstruction fit in?

The UK and international audiences, both physically present and through the medium of television, radio and the internet will be turning up and tuning in for what is going to undoubtedly be the world’s largest ‘celebration’ and re positioning of attitudes around ‘disability’ tonight – Wednesday 29th August 2012.  We could well be witnessing the ‘tipping point’ on awareness around disability, and thoughtful re positioning on how people facing disability from birth or accrued along the way through life’s outrageous meting out of misfortune – be it terrorist attack, congenital illness, warfare, or work based or transport related accidents – are a full and complete part of human society.  The competition has been highlighted by Baroness Tanni Grey Thompson writes in today’s telegraph that

We are no doubt also going to see a change in the landscape of British sport. It always happens ….  It is going to be a tough new world out there once we no longer have ‘2012’ to talk about, especially for disability sport which has seriously benefited from a home Games.

We should expect (an) increase in people wanting to take part in disability sport, but the litmus test will be if local clubs can fulfil this demand. So far, I do not think mainstream sport has been put under too much pressure in the area of participation, but this could all change.

The danger would be governing bodies backing away from their integration plans now the incentive is not there. The test of the good governing bodies are the ones that will have taken personnel and athlete changes into account and create the most meaningful legacy of all – a change in sporting culture which includes disabled athletes.

Full integration of disability needs in the world of Elite and Local sporting opportunities is vital for the evolution of full integration and the change in a culture of full acceptance of the presence of a diverse world of human experience in which sport plays an important ‘showcasing’ and liberating role. The 2 million seats sold out at the Olympic Park shows that a major turning point has been reached at the London 2012 Paralympics in this dimension.

It got me thinking however. Do women who have endured mastectomies on their way through breast cancer interventions qualify in the category of amputee which is one of the five categories which are the gateways to Paralympic participation.  The formal Paralympic categories are  amputee, cerebral palsy, intellectual disability, wheelchair, visually impaired, and  athletes with disabilities which do not fall into the other five categories; these include achondroplasia, dwarfism, congenital disorders and multiple sclerosis.

If for instance a woman has had a full mastectomy and reconstruction work which has entailed either the harnessing of stomach muscle and tissue in a TRAM flap  or  through the exploitation of the latissimus dorsi one of the large muscles in the back, nestling under the shoulder blade, this is a significant medical intervention.  The work of the latissimus dorsi is to move the arm into one’s side and backwards. Other muscles around the shoulder also do the same job so it is not a hugely disabling intervention, but its potential impact in muscle morbidity in the back has been raised by various medical studies as not without significance.  The intervention is as my surgeon told me two years ago ‘not trivial but highly efficacious’. And indeed it has proved so.

Now this is all by way of wondering whether there is a place for post cancer major surgery survivors to participate in the Paralympics to enable those who would like to compete at elite level to do so with some hope of achieving success, after interventions which would in someway disturb their ability to participate with equality against others who had not endured this sort of intervention.  This is where the boundaries of health, ability, disability, and the obstacles people endure to participating with equality become really interesting and challenging.

With one in nine women facing a diagnosis of breast cancer somewhere along the pathway of their lives, some of whom will have to face radical mastectomy and reconstruction in the pathway back to health, and the nation wide ‘race for life’ having achieved tremendous profile for the need for regular exercise and awareness around the scourge of breast and indeed prostate cancer.  It is said that the ancient tribe of Ἀμαζόνες (Amazon women) which Herodotus reported in the vicinity of contemporary Ukraine, were warriors some of whom participated in the Trojan War – so a similar environment emerging to the origin of the Marathon in Sparta and the formation of the Olympic Games in Athens.  They were in popular etymology a-mazos without a left breast – supposedly so that they could be more effective in their archery and unencumbered in their deployment of the bow or in the hurling of spears.  The ‘A-mazonian’ element of the games  is a conversation which some of our large cancer charities might open up with the International Olympic Committee for the future, as the range, reach and influence of the Games continues.

Over 4 billion spectators tuned in at some point to the Olympics with an opening ceremony paying such a wonderful tribute to the work of the NHS, and many millions will be watching tonight as the Paralympics opens.  Everybody will be inspired by the feats achieved by participants in wheelchair rugby to Athletics to sitting volleyball – and wonder at the range of challenges which those competing have overcome.

Maybe there should be an explicit space for Cancer survivors who have worked through their surgery to compete again at elite level – and the opportunity to raise international awareness around the importance of self examination – as people’s personal stories of resilience and fortitude are rehearsed.  But in which Olympian dimension should this be?  Are we at the early day of flying a kite for another dimension of Olympian competition where survivors of heart surgery, cancer interventions, diabetes and indeed the morbidity of obesity can compete internationally and raise awareness of these major hazards for a flourishing and healthy life – and showcase hope for everybody the other side of major surgical intervention.

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About oneinninewomen

The founder and the managers of this site are all survivors of breast cancer, or have lost someone close to them through the disease. One in nine women is a growing network of women seeking to raise awareness on early detection thus enhancing survival rates on cancers in general, transform the regimes of treatment to something somewhat less barbaric and industrial and enhance full recovery and uptake of the gift of life which remains the other side of cancer attack! - we all play a part in enhanced understanding, empathetic support of those suffering and pro-activity for a world eventually cancer free.
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