Thanks for this great article.
Sadly women get a happy screening story and are rarely advised of risks and actual benefits. In fact, in some cases we get a blanket recommendation, almost an order and some women are actually coerced into cancer screening. (In the States women are often "required" to have pap smears, pelvic and breast exams before a Dr will prescribe the Pill (sometimes also rectal exams!) None of those exams are required for the safe use of the Pill, cancer screening has nothing to do with contraception. In fact, all cancer screening requires our informed consent and everything (except the pap smear) is not even recommended in the UK or Australia in an asymptomatic women, pelvic and breast exams are of low to poor clinical value and expose the woman to risk. (more testing, biopsies and even surgery)
It is really important for every woman to clear her mind and start again, do your reading.
I don't participate in cancer screening, informed decisions (although I did have a FOT last year, but I'm still doing my reading!) I don't trust doctors or the screening authorities - womens health care is highly emotional, highly political and very lucrative with lots of vested interests.
I always thought I'd have mammograms, my close friend is in remission after receiving treatment for breast cancer. (she picked up the lump at age 45)
But after spending a year reading, I've decided to pass...
One thing that helped me were articles by Prof Baum, Gilbert Welch and the Nordic Cochrane Institute.
I'm sorry that most women never see these articles, usually all safely locked away in medical journals. Doctors have been hotly debating the risks and benefits of screening for many years, but not including us in the discussion - that's paternalistic, unethical and unacceptable. No one has the right to accept risk on our behalf and they don't even have the decency to give us an honest overview of the pros and cons of testing. Some women don't feel they have a choice about cancer screening and that's wrong - cancer screening is always voluntary!
Articles by Professor Michael Baum, UK breast cancer surgeon, helped me, "Why I'm still a screening skeptic" (online) and many others - more recently he's even called for the UK screening program to be shut down, too many women are being harmed.
The major problems are false positives and over-diagnosis, the latter refers primarily to ductal carcinoma in situ (DCIS) and lobular carcinoma. DCIS is a slow moving cancer that is usually non life-threatening, women die with it, not from it, but once biopsied, it may become invasive and the breast is usually removed and treatment commenced...
If it's picked up, it's usually treated, unless the woman decides to watch and wait, which can be very stressful and affect her quality of life.
Lobular carcinoma is not even cancer, it's a marker a woman "might" develop cancer later in life. Sometimes (especially in the States) these women are aggressively managed and made very sick.
There is also concern about the risks associated with radiation exposure and the compression of delicate breast tissue.
The Nordic Cochrane Institute (NCI) were so concerned at the lack of information being given to women that they produced, "The risks and benefits of mammograms" - it's at their website. They criticized the BreastScreen brochures from several countries including the UK, Australia and the States.
What to do? I know US women have clinical breast exams right through life, starting in some cases, from teens. I looked at starting CBE's - our doctors don't recommend them at any stage of life. I also couldn't find any evidence of benefit (The NCI couldn't find any evidence to recommend them either) but I found evidence of harm, they cause biopsies, so does breast self-exams, which haven't been recommended for many years now.
Today we all feel like we should be doing something, but sometimes it's best to do nothing at all...apart from live a healthy and happy lifestyle. I do wonder about this preoccupation with cancer these days, is it a healthy outlook?
Anyway, I've decided to be "breast aware" - a method devised by Dr Joan Austoker from Oxford University - you just take note of the look and shape of your breast every morning in the mirror after showering...
It concerns me that most Australian women are completely unaware of the risks of breast and cervical screening and the actual benefits...
We're all entitled to the truth and the final decision to screen OR NOT, should be ours to make and be respectfully accepted by doctors and others.
Comment Reply
Thanks for this great article.
Sadly women get a happy screening story and are rarely advised of risks and actual benefits. In fact, in some cases we get a blanket recommendation, almost an order and some women are actually coerced into cancer screening. (In the States women are often "required" to have pap smears, pelvic and breast exams before a Dr will prescribe the Pill (sometimes also rectal exams!) None of those exams are required for the safe use of the Pill, cancer screening has nothing to do with contraception. In fact, all cancer screening requires our informed consent and everything (except the pap smear) is not even recommended in the UK or Australia in an asymptomatic women, pelvic and breast exams are of low to poor clinical value and expose the woman to risk. (more testing, biopsies and even surgery)
It is really important for every woman to clear her mind and start again, do your reading.
I don't participate in cancer screening, informed decisions (although I did have a FOT last year, but I'm still doing my reading!) I don't trust doctors or the screening authorities - womens health care is highly emotional, highly political and very lucrative with lots of vested interests.
I always thought I'd have mammograms, my close friend is in remission after receiving treatment for breast cancer. (she picked up the lump at age 45)
But after spending a year reading, I've decided to pass...
One thing that helped me were articles by Prof Baum, Gilbert Welch and the Nordic Cochrane Institute.
I'm sorry that most women never see these articles, usually all safely locked away in medical journals. Doctors have been hotly debating the risks and benefits of screening for many years, but not including us in the discussion - that's paternalistic, unethical and unacceptable. No one has the right to accept risk on our behalf and they don't even have the decency to give us an honest overview of the pros and cons of testing. Some women don't feel they have a choice about cancer screening and that's wrong - cancer screening is always voluntary!
Articles by Professor Michael Baum, UK breast cancer surgeon, helped me, "Why I'm still a screening skeptic" (online) and many others - more recently he's even called for the UK screening program to be shut down, too many women are being harmed.
The major problems are false positives and over-diagnosis, the latter refers primarily to ductal carcinoma in situ (DCIS) and lobular carcinoma. DCIS is a slow moving cancer that is usually non life-threatening, women die with it, not from it, but once biopsied, it may become invasive and the breast is usually removed and treatment commenced...
December 9, 2010 - 9:25pmIf it's picked up, it's usually treated, unless the woman decides to watch and wait, which can be very stressful and affect her quality of life.
Lobular carcinoma is not even cancer, it's a marker a woman "might" develop cancer later in life. Sometimes (especially in the States) these women are aggressively managed and made very sick.
There is also concern about the risks associated with radiation exposure and the compression of delicate breast tissue.
The Nordic Cochrane Institute (NCI) were so concerned at the lack of information being given to women that they produced, "The risks and benefits of mammograms" - it's at their website. They criticized the BreastScreen brochures from several countries including the UK, Australia and the States.
What to do? I know US women have clinical breast exams right through life, starting in some cases, from teens. I looked at starting CBE's - our doctors don't recommend them at any stage of life. I also couldn't find any evidence of benefit (The NCI couldn't find any evidence to recommend them either) but I found evidence of harm, they cause biopsies, so does breast self-exams, which haven't been recommended for many years now.
Today we all feel like we should be doing something, but sometimes it's best to do nothing at all...apart from live a healthy and happy lifestyle. I do wonder about this preoccupation with cancer these days, is it a healthy outlook?
Anyway, I've decided to be "breast aware" - a method devised by Dr Joan Austoker from Oxford University - you just take note of the look and shape of your breast every morning in the mirror after showering...
It concerns me that most Australian women are completely unaware of the risks of breast and cervical screening and the actual benefits...
We're all entitled to the truth and the final decision to screen OR NOT, should be ours to make and be respectfully accepted by doctors and others.
This Comment
Reply