Thursday, November 19, 2009

Mammogram Controversy

Not surprisingly, the recent statement by the US Preventive Services Task Force that women may not benefit form mammograms until age 50, and then recommending that they be done every other year, has been politicized. This is unfortunate; women are left confused and fearful.

I agree with the task force. Keep in mind that it still recommends that women under 50 be screened on an individual basis, if their special circumstances warrant it. So, why the fuss? Follow the money. Those opposed to any Health Care reform are screaming “rationing”, arguing that more of it would come along with reform. Yes, there would be more rationing; but that is exactly what we need, given the carefree spending health care corporations have instituted for themselves, not for the public.

What we need is clearheaded thinking to analyze the problems we have had on cancer screening for a long time. Many feel we have been doing more harm than good by early screening. Again, don’t have a cow: wait to read the whole article so that you may see that women at risk will continue to be screened as before.

Rather than give you my opinion on screening in general, read what I have copied form recent articles on the subject:

“Rethinking Screening for Breast Cancer and Prostate Cancer”,

“After 20 years of screening for breast and prostate cancer, several observations can be made. First, the incidence of these cancers increased after the introduction of screening but has never returned to prescreening levels. Second, the increase in the relative fraction of early stage cancers has increased. Third, the incidence of regional cancers has not decreased at a commensurate rate. One possible explanation is that screening may be increasing the burden of low-risk cancers without significantly reducing the burden of more aggressively growing cancers and therefore not resulting in the anticipated reduction in cancer mortality. To reduce morbidity and mortality from prostate cancer and breast cancer, new approaches for screening, early detection, and prevention for both diseases should be considered."

Translation: screening early may be a mistake. A significant number of cancers lie dormant and we die of something else. An aggressive cancer will kill us, anyhow; so, why worry for more years, having detected the cancer early?

“Contribution of Clinical Breast Examination to Breast Cancer Screening”, Breast cancer detection rates and sensitivity were higher, but so were false-positive rates, among mammography centers that offered clinical breast examination in addition to mammography,

"Overall, we found higher breast cancer detection rates and sensitivities for [clinical breast examination] referral than those previously found in other community-based studies, which suggests that the accuracy of [clinical breast examination] can be improved in screening programs that offer high-quality [clinical breast examinations] by specially trained nurses," the authors write. However, they note, the benefits of adding clinical breast examination must be weighed against potential risks and costs due to false-positive results and the anxiety associated with additional evaluations… For a theoretical population of 10,000 women between the ages of 50 and 69 years, the addition of clinical breast examination would lead to the detection of breast cancer in only four women whose cancer would be missed by mammography. However, adding clinical breast examination would also lead to false-positive results for an additional 219 women, the editorialists point out.”

“What is Wrong with Cancer Tests”,

Many experts feel that early detection of breast cancer, prostate cancer may not do any good. “Tests may be picking up small cancers that would never have caused any symptoms…Once they are diagnosed, almost everybody gets treated-and we know that treatment can cause harm.”

• “Screening’s power to cut risk of dying has been wildly overinflated…By the time cancer is big enough to be seen on a mammogram or other test, it’s already sent seeds to other parts of the body.”
• Detecting small cancers may not do any good. In Denmark a study showed that 39% of middle aged women who died of other causes had breast cancer at autopsy.
• 60% of men at age 60 have undetected prostate cancer; yet only 3% of deaths are due to this cancer
• Only the pap smear has shown a decreased in the risk of death
• Inflated numbers. For instance, colon cancer mortality drops by 60% with colonoscopies. But, mortality is really reduced from 2.3% down to 0.9%. “A benefit, yes, but not necessarily big enough to outweigh all other considerations.” If ½ of those people advised to have a colonoscopy got it done, it would cost more than $110 million dollars/year
• Better tests in the pipeline:
Oncotype DX test measures the activity of 21 genes in tumor cells to calculate the likelihood of the cancer reoccurring in 10 years.
ERG and PCA3 genes: if they are inactive in prostate cancer cells, aggressive therapy could be avoided.
• Screening may be right for you if:
You have a family history, you have a risky mutation, like BRCA 1&2 for breast cancer, you have already had cancer
• Think twice about screening if:
You have another serious illness (it may do you in before the cancer)
You are under 50 or over 70, you are significantly afraid of being harmed by treatment you don’t need
• Other ways you may be overtreated:
CTs involve a lot of radiation
MRIs for back pain are unnecessary
Back Surgery, Knee surgeries
Angioplasties or stents add no survival value over drugs and lifestyle changes, unless you’re in the middle, or aftermath of a heart attack.

Read the book “The Secret History of the War on Cancer” by Dr Davis if you want to understand why we are in disarray when it comes to cancer. We have known for decades that cancers are mutations of our DNA caused by toxins in the environment, poor nutrition and stress. But, we have not concentrated our efforts on these parameters; rather, we focus on chemotherapy, radiation, surgery and expensive screening for cancers that are already there. Why? Follow the money.

The book “Life’s Delicate Balance: The Causes and Prevention of Breast Cancer” was written in 2000 by Dr. Sherman, an Internal Medicine and Toxicology specialist, former EPA board member. She is currently teaching in the Department of Sociology at Western Michigan University on causes of illnesses in workers. She feels that the causes of breast cancer are endocrine active chemicals, pesticides, plastics, and radiation. She does not pull any punches:

“Why is our well funded National Cancer Institute not devoted its efforts to prevention of breast cancer? Has breast cancer, like so many aspects of our culture just another business opportunity? There is a massing, in a few hands, of control of production, distribution and use of pharmaceutical drugs and appliances; control of the sale and use of medical and laboratory tests; the consolidation and control of hospitals, nursing homes and home care providers. We are no longer people who become sick. We have become market. Is it any wonder that prevention receives so little attention? Cancer is a big and successful business! Reflecting on the purpose of the corporation to sell products and services and maximize profits, it becomes apparent that prevention cannot be in the interest of the bottom line. What a sad and bitter realization”.

The 2009 Nobel Prize in Medicine was awarded to researchers who discovered that the longer the tail of our chromosomes(telomere), the longer we live and the less cancers and chronic diseases we have. Well, guess what makes you telomere longer…. antioxidants, good nutrition. It turns out that good food like green tea, curcumin, cruciferous veggies, etc., decrease the risk of cancer by 2/3. Why was this fact not shouted on the 10 o’clock news?


At December 9, 2009 at 8:45:00 PM PST , Anonymous Anonymous said...

Thank you for your forthright commentary on this subject. Your "follow the money" theory is so true.

At December 10, 2009 at 5:47:00 PM PST , Anonymous Anonymous said...

I appreciate your condensation of this important information, and your pointers to authors who have documented the abuses described here. Thank you very much for your work!

At December 17, 2009 at 7:48:00 PM PST , Anonymous Anonymous said...

The PSA test is known to produce a high number of false positives (I have heard that false positives are about 85%). Each false positive usually causes all sort of others test including MRI and biopsies of the prostrate.
Also it seems to me that each biopsies may cause the release of cancer cells into the blood stream and cause the cancer to spread. Why does the government not seek better diagnostic tools. I do not expect private companies to have any interest in finding tools that would limit their income.


Post a Comment

Subscribe to Post Comments [Atom]

<< Home