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Better Read Than Dead! Keeping abreast of the new guidelines November 19, 2009

Posted by Admin in Cancer, Diary, Health Quote of the Week, Healthonymous, huh?.
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How many mammograms have I had in my life? At least 26, and most likely between 30-40. I want my mammograms read and to have them be part of our new health insurance plan. The United States Preventative Services Task Force has issued new guidelines for women to follow for breast cancer screening. Their position is that too much screening generates excess anxiety, testing, false positives, and doesn’t save enough lives to warrant screening for women between the ages of 40-49.

If I had followed that advice, given my two cancer diagnoses, I might not be here to write this blog.

At 40, I had survived a cancer with a 2cm tumor (found by self-examination at age 26) and a smaller more aggressive cancer at 39, found by routine screening for a cancer survivor. I did not have any false positives, unnecessary biopsies or guilt. Anxiety, of course.

As Lynne K. Varner wrote in The Seattle Times on November 18-

“Women are not responsible for false-positive readings. The solution is not to take away a woman’s choice to have  a mammogram, but rather to work to reduce the rate of false readings.”

In the New York Times on October 20 of this year,  Dr, Otis Brawley, of the American Cancer Society, was quoted:

“The issue here is, as we look at cancer medicine over the last 35 or 40 years, we have always worked to treat cancer or to find cancer early,” Dr. Brawley said. “And we never sat back and actually thought, ‘Are we treating the cancers that need to be treated? ”

Whoa Nelly: If we have to now have conversations with our doctors about how we have cancer, but it is no big deal…….that is a huge difference in patient education that has to change immediately. This would be an excellent time to model reimbursing health care providers for discussion with patients, in addition fee for service. And to lessen the occurrence of false positive or negative readings for patients.

While I understand the recommendations for the population in the aggregate, the message still needed for women is one of individualized care, decided by a woman and her MD, ARNP or PA. Not by a board somewhere, or a faceless bureaucrat, but by a couple of well-informed people in an exam room or an office. Don’t pat us on the head!

A woman under 50, with or without a family history of cancer should be able to discern, in consultation with her health care provider, what her preventative care is going to look like. To mammo or not to mammo? To pat in concentric circles-or to wash without a washcloth? Leave that tumor where it is-just like “do not disturb the asbestos in the popcorn ceiling and it will be fine”!

Don’t leave women in the lurch, when trying to rule things out. Women, expect better, hold yourself and your health care provider to a higher standard of education.

We can handle the uncertainty, the anxiety and the information.


This just in-Secretary Sibelius issues statement on 11-18-09: Don’t change what you are already doing, she says.


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Comments»

1. Kelly Powers - November 22, 2009

That was my reaction completely. Why wasn’t there a call to apply good ol’ American ingenuity to come up with a better way to lower the false positive rate and to figure out the best treatments for the various types of cancer — including which tumors can go without treatment?

I always understood that cancers under 40 were especially scary because they tend to be grow faster.

We all know women in their 40 that survived breast cancer and some that died. Both women I know had young kids. Motherhood is a powerful motivation for keeping up with the screening.

Also wondered if it might not been more politically savvy to recommend less mammograms, but not give them up altogether — say every 1.5 years for women under 50?


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