Less Mammography in my future

[Zen]

Drug prices being raised, mammography schedules changing...more changes will come as society prepares for socialized medicine.

Socialized medicine?
Don't even start that one.

[uforgot]

Every year for me too. Until my mom was diagnosed with breast cancer, we had no history either. It was diagnosed early, wasn't in the lymph nodes, but reappeared in the other breast within a few years and she lost the battle. Two years is too long. I've seen what it does.

[Tuckervill]

If annually is good, why not every six months? Or every quarter?

This is an honest question.

Karen

[Pedal Wench]

If annually is good, why not every six months? Or every quarter?

This is an honest question.

Karen

It's thought that the growth of a tumor can be controlled if caught within a year.

[lunacycles]

I'm 44, and I've had two. Such fun! But I do feel a little mixed, and I am really not pro-screening for the reasons they just upped the recommended age to 50. Having said that, I have a friend who had one in her late 40's (with little or no family history), and it literally saved her life (or we hope, double mastectomy and 3 rounds of chemo later...)

I also find it interesting that, even with all the new drugs and ways of testing for cancer, that survival rates haven't changed much in the last few decades.

[Pedal Wench]

I also find it interesting that, even with all the new drugs and ways of testing for cancer, that survival rates haven't changed much in the last few decades.

Margo, at the 3-Days, they've been saying that survival rates, with early detection, have gone from about 75% up to something like 98%

These stats stress the extreme importance of early detection:

Stage I:100%

Stage IIA: 92%

Stage IIB:81%

Stage IIIA:67%

Stage IIIB:54%

Stage IV:20%

[KnottedYet]

Have we seen any studies saying men shouldn't bother having their prostates looked at during their annual check-ups?

Have we seen any that say men shouldn't bother doing their self exams for testicular cancer, because they are too fragile to touch themselves and it would stress them out?

ETA: Because of family history of breast cancer and personal history of cancer, I've been getting mammos every year since I was 35. They are about as comfy as lying face-down on a hardwood floor, but not nearly as painful as all the excisions I had for cancer here, there, and everywhere. (I like my cancer fresh and little and REMOVED.) I get more radiation from my monthly flights to San Francisco than I do from my annual mammo, and even more if I have a whiskey and coke during the flight. (did you know a fifth of whiskey emits 400 beta rays per minute?)

I may glow in the dark, and I may have some entertainingly cheloided excision scars; but dammit I'm not dead yet (Knottedyet, get it?) and I'm going for the gusto!

[ny biker]

Interesting column in the Washington Post today:

http://www.washingtonpost.com/wp-dyn...703140_pf.html

[OakLeaf]

Have we seen any studies saying men shouldn't bother having their prostates looked at during their annual check-ups?

As a matter of fact, yes. This was the medical consensus over a year ago, and all along, it's been much easier for physicians to dispute the corporate wisdom on prostate cancer screening than breast cancer. (I could point out the massive amount of profit in breast cancer screening vis-a-vis prostate...)

None of this is new, and the only part of it that's "news" is that the public health authorities have decided to bring their recommendations more in line with a real risk/benefit analysis. This has been building for at least 15 years, and there have been several well-publicized studies this past year alone. I don't know why this seems like it's a new issue to so many people here.

If you want to analyze the gender issues, my take is that (1) in general, women tend to be more easily led by their physicians or any supposed "authority;" and (2) physicians in general love to practice "bikini medicine" on women, whereas a physical exam of a man usually takes a much closer look at the whole body, even de-emphasizing the sex organs.

I'll just repeat two things, and then I'm outa here.

Screening is not harmless. Screening has known and well-recognized harms that go far, far, far beyond "worry." In coming up with these recommendations, public health authorities try to balance the known/potential harm against the known/potential benefit. If an individual is asymptomatic and not in a risk group, then they stand a much, much greater chance of being harmed by screening than of receiving a benefit.

In any individual case, there is no way to know whether treatment for an identified cancer has been beneficial, harmful, or had no net effect. All the public health authorities have to go on is retrospective statistics. This is true of most procedures. But making an individual decision is more complex, and involves looking honestly at quality of life issues. People who have already been through the procedures believe what they need to about the decisions they've made in the past; people contemplating a future decision need to be smart about it.

Is it worth turning over complete control of your life to the medical establishment, being treated like a piece of meat without emotions, intellect, pain, or, indeed any body parts other than the one(s) being treated for cancer, in exchange for a 10% to 30% chance of extending the duration of one's life? That's a decision each individual has to make for herself.

[lunacycles]

pedal wench said:

Margo, at the 3-Days, they've been saying that survival rates, with early detection, have gone from about 75% up to something like 98%

These stats stress the extreme importance of early detection:

Stage I:100%

Stage IIA: 92%

Stage IIB:81%

Stage IIIA:67%

Stage IIIB:54%

Stage IV:20%

Thanks for that. I haven't heard that. I wasn't speaking specifically about breast cancer. I read, NYTimes I think (that's the only news source I really read regularly these days), but who knows for sure, that over the last few decades overall cancer survival rates have barely changed/improved...despite all the new treatments out there. Please understand I am not stating an opinion that I think screening is a bad idea AT ALL. Like I said, I think it saved the life of a friend of mine, and I bet we all know someone for whom it did.

[Trek420]

These stats stress the extreme importance of early detection:

Stage I:100%

Stage IIA: 92%

Stage IIB:81%

Stage IIIA:67%

Stage IIIB:54%

Stage IV:20%

That can depend on who you are, if you have access to health care. From http://www.sistersnetworkinc.org/news.html

"An estimated 19,540 new cases of breast cancer are expected to occur among African American women in 2009

The overall incidence rate of breast cancer is 10% lower in African American women than white women.

African American women have a five year survival rate of 77% after diagnosis as compared to 90% for white women."

I don't know the statistics for other communities.

Access to health care, making it available & affordable, promoting a culture of wellness saves lives (not to politicize the board).

If I was uninsured and a clinic offers free exams if I fear that if something is found I could not get care or worse would never be insurable in the future would I go?

[shootingstar]

Access to health care, making it available & affordable, promoting a culture of wellness saves lives (not to politicize the board).

If I was uninsured and a clinic offers free exams if I fear that if something is found I could not get care or worse would never be insurable in the future would I go?

Have wondered about this for a long time, Trek with respect to U.S. present health care system.

But that's another long, long separate discussion.

[Trek420]

Have wondered about this for a long time, Trek with respect to U.S. present health care system.

But that's another long, long separate discussion.

I'm not in the medical field, no training in it whatsoever etc. I do work in a busy call center where most of the folks I talk to are both poor and disabled and have done so over 13 years, so I've heard a lot.

Difficulties like being unable to get to preventative and after care appointments are common challenges. Some live in areas with no public transportation, one illness where suddenly you can't drive and preventative and after care is out of the question if you do not have an awesome support network. Others can't afford the time off required to do all that.

You'd be surprised the number of tales I hear of one disease or diagnosis, a lost job or being on disability and a spiral into poverty or maybe you wouldn't.

If I had $5.00 for every time I've heard "I used to be like you with a good job, never thought this could happen to me ...." I'd be retired .... and probably being an activist for this cause full time.

I'd really like to see figures on cancer survivorship by income level but you are right .... that's a whole 'nother discussion.

[nc tam]

http://www.acr.org/HomePageCategorie...TFDetails.aspx

The fact that this is from the American College of Radiology will automatically make it suspect for some of you. Just thought you might be interested in what radiologists think of the recommendations since radiologists are reading the mammograms.

And from the American Cancer Society:
http://www.cancer.org/docroot/MED/co...Guidelines.asp

As far as other possibilities for screening... ultrasound is very operator dependent and is too insensitive for microcalcifications, a common presentation of both in situ and invasive ductal cancers. MRI is too time consuming, requires IV contrast and has too many false positives (more than mammography in some series) to be a screening study. Researchers are working on all sorts of things. Only time will tell.

[SLash]

I'm not sure if this is allowed, if not I'll remove the link/post, but I think it tells a side of the story on the new mammography/self-exam guidelines better than anything else I have read (or written). The link is to a FB page (I know, FB ), it is the Young Survival Coalition fan page. It appears to be open to everyone because I logged out and tried the link and it worked. It starts about mid-page.

I think their stories and comments help us to understand why there is the outrage toward the new guidelines and also maybe help those younger than 50 understand the risk of following them. http://bit.ly/3S1Wy6

I hope this isn't viewed as political or something, but I think it is just too important a subject not to post this.