Mammograms, Breast Cancer and the Cost of Early Screening

 

Breast cancer is the leading cause of death among women aged between 44 and 55. It is therefore no surprise that talk of breast cancer can trigger such emotive responses, or that logical and balanced discussion remains difficult. Cancer patients that voice doubt over the mantra of early screening or are reticent about the use of surgery/radiation/chemotherapy are often dismissed as reckless, despite the growing burden of evidence that supports this stance.

In any case, while the improvements in survival compared the billions spent is obviously dismal, it is not the purpose of this article to criticize the ‘cut/burn/poison’ approach but to provide the reader with data so that they can ask their own questions of the current status quo. While some individuals already realise that chemotherapy is largely ineffective for most types of cancer – with only 2 to 4% of cancers responding (Moss, 1995) – fewer even think of questioning the concept of regular mammograms and early screening.

Mammograms provide an image of the breasts, formed from two X-rays of each breast. Radiologists then review the results to ascertain whether there are any abnormal growths. If such growths are found, the woman will be called back for further testing. According to Cancer Research UK – perhaps the most vocal advocates for regular mammograms in the country – only 4 in 100 women who has a mammogram will be asked to return and, of these, only 1 in 5 will have cancer. Mammograms are currently recommended for women between the ages of 50 and 70.

Even Cancer Research UK accept that, of the 15,500 women diagnosed each year with breast cancer as a result of screening, 4,000 (26%) are overdiagnosed. This term is used to describe situations where women undergo treatment for either early stage cancer or ductal cancer in situ (DCIS) that would otherwise never have developed into a late stage cancer. Obviously, as anyone who has experienced or witnessed the brutal effects of chemotherapy, radiation and surgery can tell you, the implications of this are serious. Nonetheless, Britain’s leading cancer charity states: “Doctors can’t tell which early breast cancers or cases of DCIS would never cause a problem. So the safest option at the moment is to treat them all.” (Cancer Research, 2012).

Natural practitioners have long criticized the used of mammograms as a screening tool for breast cancer, pointing out that their accuracy is suspect and note how radiation exposure increases the chances of cancer developing at the exposed tissues (Pijpe et al, 2012). Although drug companies enjoy a near-monopoly on scientific studies that make their way into the science journals, more and more research has begun to emerge in recent years to justify this standpoint.

Last month, research was made public in the New England Journal of Medicine after scientists analysed data from the last 30 years. This latest study represents the most damning indictment yet of a practise that has long been labelled as ‘quackery’ and a ‘sales tool for the cancer industry’. The most important conclusions made were: – by 1976, mammograms had become the standard of care in the US. Since then, the number of ‘early stage breast cancers’ detected has doubled. So too has the number of women being treated for breast cancer. However, the number diagnosed with late-stage breast cancer has only dropped just 8 per cent – this means that 92% went through horrendous treatments (chemotherapy, masectomy, radiation) even though the would never have developed late-stage cancer – In 2008, 31% of all diagnoses of breast cancer was “overdiagnosed”

One Norwegian study (Kalager et al, 2010) found that regular mammograms reduce the risk of breast cancer by less than 10 percent overall. They also concluded that, for every one death from breast cancer prevented, the use of mammograms came at a cost of 1000 false alarms and 5-15 unnecessary treatments. Another study (Autier et al, 2011), which compared the rate of breast cancer in European countries that adopted mammograms in the 1990s versus those that did so in the 2000s, made a slightly different conclusion; the screening tool made no difference whatsoever to the number of deaths from breast cancer. Sadly, the only impact appears to be on the number of women undergoing harrowing courses of chemotherapy or mastectomies.

More and more individuals are waking up to the fact that the recommendations made are very rarely with the interests of the patient in mind. Due to the emotionally-charged and out-dated information provided by cancer charities, the public fear off cancer has never been higher. Sadly, the increased money that the public has donated to these charities has only coincided with increased misinformation and increased rates of cancer. The message given to the layman is: – cancer simply strikes at random – early screening is, by definition, a good thing – by helping early screening, mammograms are a necessity – once a cancerous tumour is diagnosed, it will only get worse – that the patient is always best served by beginning a course of chemotherapy / radiation / surgery

All of these statements are misguided. Some are just wrong. This explains why screening for breast and prostate cancers finds huge numbers of early cancers but has little to no impact on the development of late stage cancers. The existence of cancerous cells does not necessarily mean ‘cancer’ as we know it, and the discovery of early stage cancer does not necessarily mean late stage cancer. Acknowledging this fact can be of great assistance when making decisions in your own care.

People forget that, every single day in every single individual, around 300 million cancer cells are produced. cancers can appear and disappear on their own, often without the individual even noticing. Dr Thea Tlsty, a professor of pathology at the University of California and considered one of the world’s most distinguished cancer researchers, remains suspicious of the default approach to start chemotherapy treatment so quickly. She looked into precancerous cervical cells found using a Pap smear, noting that, without treatment, 60% of these cells returned to normal within one year. 90% of these cells returned to normal within three years. The question raised here is: how many cancers actually threaten an individual’s quality of life and how many millions are living with all kinds of cancer without even knowing about it? Obviously, we will never be able to get an answer to this without invasive and multiple biopsies on a the population at large, and that is not going to happen.

Regardless of what the actual numbers are, ‘early detection’ (and the horrendous side-effects of treatment that follows) would do no good for these people. The only people to benefit would be the companies that provide the chemotherapy drugs (at up to 2,000% mark-up) and the radiation equipment, together with the doctors who can claim ‘increased survival’ from their treatment (early detection identifies cancer in more individuals that would never have developed life-threatening problems, thus were destined to live long and happy lives come what may).

While the latest research provides a further blow to the current approach within the cancer industry, many questions still remain unanswered for the individual. The scope of this article was not to provide these answers (cancer is a complex area), but to help the readers understand what sort of questions to ask.

However, for those worried about cancer, maintaining a healthy body with well-nourished and well-supported organ systems remains a sensible strategy. To this end, it may be helpful to ask a professional about a diet that includes an array of helpful phytonutrients; the provision of various vitamins and minerals, especially Vitamin D3 and Iodine; the avoidance of excessive stress that would otherwise suppress the immune system; and the maintenance suitable detoxification through liver support and fermented foods/probiotics. Although many studies link these factors to reduced cancer incidence, none of the above is an anti-cancer intervention per se. All can help maintain the integrity of key organ systems so that the body never reaches a state of disharmony whereby cancer can begin to develop. Above all else, it pays to remember that cancer cannot develop in a healthy body. Unfortunately, this message is unlikely to be adopted in the mainstream, as the powers that be make no profit from the maintenance of a healthy body using food, exercise and naturally-formed nutrients.

Conversely, the ever-present public fear of cancer makes newer and more sensitive diagnostic devices more profitable than ever before. These machines can detect cancer earlier and make over-diagnosis even more likely, warns Dr Barry Kramer, a director at the National Cancer Institute: “With increasingly sensitive screening tests for a variety of cancers, the problem is likely to increase.”

References:

Autier P et al, 2011. Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database. British Medical Journal, 343:d4411.

Bleyer A and Welch HG, 2012. Effect of Three Decades of Screening Mammography on Breast-Cancer Incidence. New England Journal of Medicine, 367:1998-2005

Cancer Research, 2012. Mammograms and Breast Screening. Available online at http://www.cancerresearchuk.org/cancer-help/type/breast-cancer/about/screening/mammograms-in-breast-screening Accessed 03 Dec 2012

Kalager M, Zelen M, Langmark F, Adami H-O (2010). Effect of screening mammography on breast-cancer mortality in Norway. New England Journal of Medicine, 363:1203-1210.

Moss R, 1995. Questioning Chemotherapy. Equinox Press.

Pijpe A, Andrieu N, Easton DF, et al. Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: retrospective cohort study (GENE-RAD-RISK). British Medical Journal. Published online September 6 2012

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