Thursday was a busy day. I had meant to write a new post. I am also a hospice volunteer. Today I saw a new patient, a lung cancer victim, and they needed me longer than expected. We have the girls today. This is not the best picture of Isabel but it suits our Friday news theme. I have had messages from Sandi Wisenberg, author of this month’s Book Club selection “The Adventures of Cancer Bitch”. She is planning to join us in our Monday discussions so please be ready to submit your comments. Readership has been high on Mondays and Tuesdays so I figure there are plenty of you out there reading. Thanks for your continued support!
~ One in three breast cancer patients identified in public screening programs may be treated unnecessarily, a new study says.
Karsten Jorgensen and Peter Gotzsche of the Nordic Cochrane Centre in Copenhagen analyzed breast cancer trends at least seven years before and after government-run screening programs for breast cancer started in parts of Australia, Britain, Canada, Norway and Sweden.
Once screening programs began, more cases of breast cancer were inevitably picked up, the study showed. If a screening program is working, there should also be a drop in the number of advanced cancer cases detected in older women, since their cancers should theoretically have been caught earlier when they were screened.
Overall, Jorgensen and Gotzsche found that one third of the women identified as having breast cancer didn’t actually need to be treated.
Some cancers never cause symptoms or death, and can grow too slowly to ever affect patients. As it is impossible to distinguish between those and deadly cancers, any identified cancer is treated. But the treatments can have harmful side effects and be psychologically scarring.
“This information needs to get to women so they can make an informed choice,” Jorgensen said. “There is a significant harm in making women cancer patients without good reason.”
Jorgensen said that for years, women were urged to undergo breast cancer screening without them being informed of the risks involved, such as having to endure unnecessary treatment if a cancer was identified, even if it might never threaten their health.
Doctors and patients have long debated the merits of prostate cancer screening out of similar concerns that it overdiagnoses patients. A study in the Netherlands found that as many as two out of every five men whose prostate cancer was caught through a screening test had tumors too slow-growing to ever be a threat.
“Mammography is one of medicine’s ‘close calls,’ … where different people in the same situation might reasonably make different choices,” wrote H. Gilbert Welch of VA Outcomes Group and the Dartmouth Institute for Health Policy and Research, in an accompanying editorial in the BMJ. “Mammography undoubtedly helps some women but hurts others.”
Experts said overtreatment occurs wherever there is widespread cancer screening, including the U.S.
Britain’s national health system recently ditched its pamphlet inviting women to get screened for breast cancer, after critics complained it did not explain the overtreatment problem.
Laura Bell of Cancer Research UK said Britain’s breast cancer screening program was partly responsible for the country’s reduced breast cancer cases.
“We still urge women to go for screening when invited,” she said, though she acknowledged it was crucial for women to be informed of the potential benefits and harms of screening.
~ A consumer advocacy group says it will sue Bayer Healthcare if it continues to claim its One A Day vitamins for men reduce the risk of prostate cancer.
The Center for Science in the Public Interest says the company’s ubiquitous TV and radio ads misleadingly claim that a key ingredient of One A Day Men’s Health Formula helps prevent cancer.
The group says the National Institutes of Health found no evidence the ingredient selenium prevents prostate cancer in men.
“The largest prostate cancer prevention trial has found that selenium is no more effective than a placebo,” said David Schardt, the group’s senior nutritionist. “Bayer is ripping people off when it suggests otherwise in these dishonest ads.”
~ Radiofrequency Ablation (RFA) is a promising local therapy that has evolved rapidly in recent years for the treatment of primary and secondary cancers in the lung. The feasibility and safety profile in humans are well established. Complications following RFA are similar to those of CT-guided lung biopsies. However, sufficient long term results beyond 5 years are not yet available due to the relatively short time that this technology has been in use. Patients with smaller tumors (less than or equal to 3 cm) and fewer tumor nodules (less than or equal to 5 lesions) who are considered poor surgical candidates or who develop residual or recurrent disease despite maximal conventional therapy, and have tumors that are away from vital structures are the best candidates for RFA. Hence, RFA can be safely offered to patients who cannot undergo surgical resection. However the role of RFA in patients who are candidates for surgical resection is unproven, and there is no evidence on whether RFA is more or less effective that focused radiation (sterotactic body radiation therapy). Overall, RFA is a highly promising modality that may be used to our patients’ advantage either as a solitary treatment or in combination with conventional therapy.