If you ask the average American for the best advice you can give your friends and family when it comes to cancer, you will almost certainly hear that screening and early detection are the best tools we have. And for the longest time, that’s what we’ve heard from our doctors and the media. But the times, they are a-changin’, and The American Cancer Society is reversing its long-supported position that frequent screenings will lead to fewer cancer deaths, especially in breast and prostate cancer.
Tumor growth is actually relatively common; however, most tumors are benign, and do not invasively grow further outward or take up residence in other locations. That process, known as metastasis, is the true killer in cancer, as the body becomes unable to fight off the multiple new tumors that begin to disrupt normal body function.
The ACS is now telling patients that we may be over-treating the less-threatening tumors, and in the process missing more-threatening cases.‚ Since advocating screening, the ACS acknowledges that cancer diagnoses have increased. However, for frequent screenings to actually prove beneficial to the public health, there should have been a corresponding decrease in cancer deaths. Instead, widespread screening has only led to an increase in the discovery and treatment of tumors that would have remained harmless and wouldn’t have required any intervention.
While screening has resulted in fewer late-stage cancer cases for colon and cervical cancers, unfortunately there’s no data to show that we’ve seen fewer deaths in breast and prostate cancers, and doctors are now worried that the public has been over-promised on the benefits of some cancer screens.
However, Colin Begg, a biostatistician at Memorial Sloan-Kettering Cancer Center in New York told The Times that he’s worried that the message will confuse the public who will assume that all cancer screenings are unnecessary. “I am concerned that the complex view of a changing landscape will be distilled by the public into yet another “Ëœscreening does not work’ headline. The fact that population screening is no panacea does not mean that it is useless” he said.
For now, it will just take time for doctors and researchers to determine which tumors should be treated, and which, counter intuitively should be left alone. In the mean time, follow the advice of your doctor, whatever that might be.
This shows why people cannot trust the ACS. For years they have been selling early detection with mammograms (which can also CAUSE cancer since they are dangerous x-rays.) This article does not mention how many cancers could have been caused by this. How many lives were destroyed by the fear and unnecessary treatment?
And when will the ACS come to their senses about the link between bras and breast cancer? Wearing tight bras for long periods of time each day is the leading cause of breast cancer, but the ACS refuses to do any research into the bra/cancer link. They refuse to even consider the issue scientifically, and just scoff at the theory. Maybe they will change their minds someday on this one, too.
Unfortunately James, there has only been one study performed regarding the link between wearing bras and breast cancer, but the study lacked any scientific rigor, meaning no usable conclusions could be drawn from it. Secondly, the pathology suggested by the review (“compression of the lymphatic system leading to a build up of toxins”) has been widely discredited by the medical community.
And while yes, x-rays are an ionizing radiation that can lead to DNA damage and eventually develop into cancer, the amount of radiation from a standard mammogram (about 0.7 mSv) is a small fraction of the 20 mSv that US DoE states that you can safely be exposed to on an average year, and approximately the same amount of radiation you receive over a typical three month span–clearly not a dangerous amount of radiation. X-rays are still one of doctors’ most widely used tools for internal visualization and likely will be for a long time. Put another way, there really isn’t a way to quantify the risk of getting an x-ray because it’s so small; missing a malignant tumor because you skipped your mammogram, however, will almost certainly lead to death.
While screening may not be having the desired effect on an epidemiological level for breast and prostate cancer, it’s still catching the dangerous tumors in as many patients as well. There’s give and take on every situation, and only your doctor and her many years of medical training can determine what’s necessary for you.
So what does this translate into in practical terms? What are the recommendations for mammograms, prostate tests, etc. I’ve yet to have a mammogram , preferring manual testing, because it seems to me to be submitting my body to danger, in the guise of preventative care. Are there new guidelines?
Speaking from the standpoint of scientific rigour logic, if there is only one poorly conducted research on the â€œcompressed breast leading to cancerâ€ theory (that does not sound silly at all), while it can not be said the theory has been proven, it can not be said it has been disproved either since it would require a scientifically rigorous study to do that (and that is lacking too); thus, we are still waiting for a conclusive answer – lack of positive evidence does not mean that no evidence exists, just that none has been found. If there were a lot of studies on the bra – breast cancer argument, and all were negative, we could assume statistically that the probability for not finding positive evidence are high, but since there are no ones present that assumption can not be made so the phrase â€œwidely discredited by the medical communityâ€ carries very little weight here.
As for the dangers of mammography I concur: only in those rare cases of hereditary cancer where patients where checked-up by yearly mammograms for years the cumulative X-ray dose may be taken in consideration as contributing to cancer, and that only in radiation hypersensitive tissue individuals. It still remains the best diagnostic method for breast cancer detection (do not forget advanced ultrasound exams – to be done in specialised centres by highly trained experts on top machines – that reduce the long term radiation exposure too) since palpation (falling under the â€œbetter than nothing, but not the bestâ€œ category even when done by an experienced examiner) will miss a portion of cancers in smaller sizes, compared to instrument diagnostic methods, where some of them might still be curable.