I'm not a physician but the idea of ignoring cancer, in any form, whether linked to breast cancer or prostate cancer seems absurd.

It may seem absurd until you understand the consequences of treatment for something that may not be life-threatening. Chemo, lumpectomy, or worse and all the side-effects for women. Possible impotence or incontinence for men not to mention a not-very-much-fun biopsy procedure for us guys with high PSA (I know, I have had one (negative and now they want me to do another)). It's not a trivial thing to understand what choice to make when the treatment can have a significant impact on your life and even the experts are divided on the best course of action.

But it isn't. Yes, it seems that way if you don't understand how cancers grow and how many times they grow very slowly over many, many years. A man with prostate cancer may live many years, but if he is treated aggressively immediately he may live the same number of years or less with some pretty nasty side effects from treatment. A woman who is diagnosed and treated immediately with aggressive treatment may live another 30 years, but with debilitating effects from treatment, disability, or end up with another cancer (and the first one) that may not have grown if she hadn't had the toxic treatments from the first one.

I'm not advocating ignoring cancer per se, but jumping on immediate aggressive toxic treatment just isn't always the best option. Radiation just isn't something you want to have unless it is a real necessity and neither is chemo, so the goal is to diagnose those cancers that truly would grow and kill or disable and treat them, but leave the ones that aren't going to make a person sick alone and not bombard them with radiation, surgeries, and chemicals that could be a catalyst for further growth. We just don't have all the answers, and it's hard to know the absolute best course of action sometimes. Ignore? Perhaps not. Become more judicious in diagnosis and treatment? Absolutely.

ram i can agree with what you said, however the other side of the coin is waiting till the cancer is a problem, which happened to a friend of ours, who really did not want to go thru the treatments if it was not necessary.

She waited too long and died. So your damed if you do and your damed if you dont. kMaybe on day they will find a treatment that is not so nasty.

and that is exactly why rising health care costs are difficult to curb...people want more care even if the diagnostic tool doesn't have much clinical utility. We need more funding for better, cheaper diagnostics that tell us information about the biology/biochemistry, rather than relying on all this fancy (and very, very expensive) medical technology. The -omics tests are the future!

Ok, here is where I have to disagree. They do not specify which cancers they should ignore...they just state in this article that the study says mammograms overdiagnose cancers of the breast.

They are saying to stop doing mammograms. Screening saves lives and is infinitely less expensive than treating a woman at age 55 with stage 3B or 4 cancer that could have been dealt with earlier, but because of mandates that state women need to wait until they are 50 it didn't get caught in time.

I am willing to go through the risk of the biopsies, the risk of treatments in an early ductal in situ cancer removal, than to leave 3 children and a husband because some panel thought it was more cost effective to wait.

Ductal in situ can be nothing or they can progress. Maybe look at the options of lumpectomy with more frequent mammograms after that instead of the oral chemos and radiation?

I realize that other cancers kill women more than this..ie. lung cancers and certainly heart disease is the biggest threat to a woman's health overall, but the medical community at large is at fault for ramming this whole preventative medicine with mammograms early and often in the first place. You have entire generations of women who would revolt, regardless of research, at the thoughts of leaving any malignancy in their body.

It should be a conversation that the healthcare provider and the patient have together. Not decided by a government or panel of people who have nothing to gain or lose by their suggestions.

For what it is worth, a mammogram saved the life of 2 women I work with. They were both 32 at the time of diagnosis and had very aggressive tumors that no one expected them to have.

If the so-called over-diagnosis saves the life of only one woman, it's worth it. Believe me, I was thrilled to know that the small lump in my breast was benign. How would I have known had they not checked it? And had it been malignant, at least they would have caught it early.

I guess you don't understand what some of the treatments involve. The treatments can be as invasive as if the actual cancer were there. It is better to be sure that it is a real thing before you start treating it just for the sake of treating. I had a cousin tht had a colon caner screening. Some polyps were found and cut out. Two years later he was diagnosed with colon cancer and the site was everywhere thy cut the polyps. If they hadn't messed with them he would still be alive and cancer free today.

f they hadn't messed with them he would still be alive and cancer free today.

Utterly and completely false statement. I understand the need to find a reason for everything, and surely a temporal relationship seems like enough...until you stop and think about it...

I agree with Eric. The polypectomy did not cause the cancer. If there was cancer present, it may have been missed but removing the polyp or "letting the air get to it" does not cause a cancer to spread nor does it cause cancer. There are non-polypoid colon cancers and they can be hard to diagnose early.

The same goes for doing a biopsy of suspicious areas found on mammogram. In fact, biopsies of small lesions or suspected carcinoma in situ can now be accomplished with a needle and/or ultrasound or CT localization that does not leave a scar any bigger than a pinprick.

There is a misconception in some of the statements concerning treatment also. No reputable radiation oncologist or medical oncologist is going to treat a person for a cancer that is not biopsy proven. A negative breast biopsy means no chemotherapy or radiation. As far as treating prostate cancer, that is more complicated. Everyone with early prostate cancer does not need treatment, but don't bet your life on it without discussing it with your oncologist or with more than one oncologist.

It's because your understanding of the word cancer is a little off. There can be things that are "cancer" that do not spread and do not threaten your life.

As a women who has had 4 lumpectomys, I can tell you that I am glad I had them removed. Maybe another women would opt to just watch them. I am not one of them. I think its a shame that the decision to choose what is right for ones own healthcare is dictated by these mandates and studies. Ultimately, it's the individuals RIGHT to choose what is best for THEM. And I would rather be safe than sorry. I have too much to live for.

Based on the evidence presented, the issue isn't Mammograms, which are intended to detect anomalies that could lead to breast cancer. Mammograms save lives, because without them, there would be no way to detect cancer until after the person gets sick, which is often too late.

No, the REAL issue that the article seems to point out, is the overzealous treatment of benign cysts without first making sure they really are cancerous.

IMHO, this is yet another attempt to strip the public of vital health prevention programs, and in some circles, another attempt by ultra-conservatives to deprive women control over their own bodies.

JerzeeGurl-3964159 wrote "Ultimately, it's the individuals RIGHT to choose what is best for THEM. "

If people want excessive treatment, there should be an easy way to pay for it, either out of pocket or within EPOplusplusxxtra plan with a higher annual cost.

thats a lot of comments and they all make some sense. its clearly a tough problem. and to anyone with the disease or a concern about having the disease, i wish you the very best.

Stephen-3215347 wrote "another attempt by ultra-conservatives to deprive women control over their own bodies. "

In the interest of fairness to both sexes, why isn't an equivalent amount of money spent on male health care under the age of 50? Or, if you don't give a crap about a lower male life-span, lower health insurance costs would allow more people to afford health insurance.

There is more cancer and mortality data available and more experience with various preventative measures. What's wrong with channeling money spent on useless preventative health care into useful prevention?

I am in t6he middle of the same situation (only a hair worse) with prostate screening.

My "helpful" family physician decided, all on his own, that I needed to have PSA screens and did them for four years without consulting me. When one came up higher, he did the full PSA thing (free PSA, PSA velocity, etc) and ir came back much, much higher. He then referred me to a urologist "for a biopsy."

There was a federal blue ribbon task force set up to determine the risks/benefits of PSA screening. They determined that there was no benefit in survival to be had from PSA screening. Period. NO BENEFIT. They recommended that men under 40 not be screened unless they have already had treatment for prostate cancer. They recommended against screening for the remainder citing the lack of evidence that mortality or quality of life is improved by screening, biopsies, and aggreessive treatment. Their recommendation is that if a physician wants a patient to be screened, the physician should "fully inform him", a process that takes a minimum of 20-30 minutes.

It is a bad thing to do a procedure on someone without their consent and against current best practices. But it is even worse when you realize that a PSA test is invalidated if the patient had ejaculated within 72 hours (or 5-7 days if he has had a vascetomy.) Without knowing to do so, the physician has no way of knowing if he did. Moast PSA tests are inmvalid for this reason alone.

But I went to the urologist, who, in his best conversational manner, described the horrors of dieing from prostate cancer, used the phrase "just to be safe" exactly 11 times, and badmouthed the federal blue ribbon task force on mamograms (as a backhanded reference to the prostate panel) and described the biopsy as no-risk, easy, painless, and only minor inconveniences for side effects. He failed to mention that prostate biopsies are the second highest rate of re-hospitalization within 30 days, very high rates of infection, occasional permanent loss of sexual or uninary control forever, or that biopsies are being blamed for the conversion of many slow-growing to fast-growing cancers in a process called "needle trace tracking."

And even if you have the biopsy, you only have bad options --- you are going to eliminate a cancer with a one-in-twenty chance of killing me and senselessly run the risk of loss of quality of life. But at the cost of saddling 19-in-twenty with many of the same losses for no good reason.

There have been three major studies so far comparing various amounts of intervention between those with and those without aggressive testing, biopsies, and treatments. There was a slight difference between the groups in mortality from prostate cancer. But there was absolutely no diifference in overall mortality between the groups. So your choice ended up being whether you would have your heart attack playing beach volleyball or have it shopping for Depends.

This whole thing is a madness of unnecessary chaos and trauma in people's lives. And sometimes you just have to settle back and be the adult in the room and do the right thing. A lot of people make a lot of money from overdiagnosis and overtreatment and unnecessary screening associated with it. Those people have to be weeded out of medicine. But who's gonna do it?

The point of diagnostic tests is to identify areas of concern and then keep tabs on them so they don't become major problems in the future. You can't head off a problem if you don't know it's there. It seems we are being advised to close our eyes and stick our heads in the sand until our medical problems become so obvious they can no longer be ignored, at which point the medical community will tell us there is no point in treating the condition because it is too far advanced. A lot of people will suffer needlessly but it sure will save the insurance companies a lot of money.

you are right on the mark.

they keep talking about 15 to 25% who may be overdiagnosed.

Hey.....what about the 75 to 85% who benefit from the diagnosis.

cutting down on screenings makes absolutely 0% sense to me.

my wife is in her first year of recovery from triple negative breast

cancer treatment. People are commenting on this subject who's only

connection with cancer is reading these blogs.

When the cancer problem slaps you squarely in the face you become

a quick study of the disease and it's treatments.

75 to 85% of patients ARE NOT OVER DIAGNOSED.

I'll go with those odds everytime!

I don't know that I would go quite so far in the assignment of motives by the medical community as you did, taho, but you are very right on some of your other points.

"Strippers and whores are the only way a woman can have power..." Not really. That's a fallacy younger women believe. An older, respected mother figure will always have more power than the stripper on a pole. You're just talking to the wrong women. I agree pretty much with the rest of what you say, though.

Not only that, it is a rerun of an article done a year or more ago. It is also dangerous and irresponsible to write an article like this.

The Norwegian population is less genetically diverse than that of the U.S. Some subsets of women in the U.S. are far more likely to have aggressive forms of breast cancer than others. Young women in general and young Black women in particular are likely to have more deadly forms of breast cancer.

There are also published articles from U.S. studies that show that breast self-examination and exams by physicians are not enough. Mammograms have to be included as well to diagnose early breast cancers. It is very hard for a woman or a physician to feel a 1 cm. lump at the back of the central part of a breast, especially in a young woman with dense breast tissue or in any woman with fibrocystic changes.

This article is so irresponsible in its implications that I would consider it malpractice to use it as a reason not to do mammograms in the U.S.

Sorry about your father. I'm sure he would have preferred riding off a cliff in a glorious fiery chariot, but instead he was tortured in a hospital away from everything he enjoyed.

An excessive portion of health care costs are for costly near-end of life procedures. These need a re-evaluation in favor of spending money for superior care during other periods of life or an overall reduction in health insurance costs to allow more people access to medical care.

Couldn't agree more! The incidence of one particular type of breast cancer has increased by 328% since mammograms went into widespread use. Radiation and compression are NOT good for breast tissue.

Because the science is very imperfect. We don't currently have a compete understanding of which cancers need to be treated and which will not be harmful if left alone. So lots of women are left believing that they "would have died if they didn't have a mammogram" when, in fact, for a significant percentage of these women, that is totally untrue. But doctors don't always know which cancers to treat and which to leave alone, and no doctor is going to tell somebody not to worry because they don't want to be sued. And what woman, having been through a painful and exhausting cancer treatment, wants to believe that it was all unnecessary? She will consider her treatment successful, not knowing it could have been successful because that particular cancer would not have progressed or caused harm.