January 3rd, 2010
For women, breast cancer is the second most common cause of cancer and according to the Centers for Disease Control 41,000 women die each year from the disease.
Breast cancer has affected many women in every community in America. Some women have themselves been diagnosed; but even when a relative or friend gets the news, it still can be a very personal experience for everyone involved: spouses, partners, children, parents, and friends.
Even for the health care community, breast cancer can be a very sensitive topic. A recent article in the Journal of the American Medical Association encourages doctors and health care authorities to rethink cancer screening guidelines and the U.S. Preventive Services Task Force has actually changed mammography screening recommendations. You may have heard about these changes on television news or in the New York Times. The outcry from the media, legislators, and doctors has been substantial.
It certainly is a good time to take a careful and reasonable look at breast cancer issues. This week, I will outline the screening recommendation changes and their reasons. In following weeks, I will discuss approaches to breast cancer screening, prevention and treatment that make sense from a mainstream medical and naturopathic perspective.
With the changes in recommendations, no one is disputing whether mammography works for detecting early stage breast cancer; it does. The concern is that all of the suspicious lumps found by mammogram result in many unnecessary biopsies and unnecessary worry - at some point the cost outweighs the benefit. According the best statistical evidence, for women 40-49 years old it takes screening almost 2,000 women to identify one cancer that would be helped by treatment. For women 50-59 years old the number falls dramatically to about 1,300 women screened to identify one cancer helped by treatment. For women 60-74 years old, the numbers get even lower.
The bottom line is that there are potential benefits and costs to any health care choice. With the guidance of your physician, you get to choose the approach that makes sense to you; - every woman has different risk factors and concerns.
Next week, I will discuss prevention and other screening options.
Be well,
Richard Malik, ND
Tags: Breast Cancer, Mammograms, Recommendations, Screening
Posted in Cancer, Menopause, Over 50, Wellness, Women | No Comments »
January 11th, 2009
According to American Academy of Family Physicians (AAFP), U.S. Centers for Disease Control (CDC) and theU.S. Preventive Services Task Force (USPSTF), colonoscopies should be done every 10 years to help identify lesions that may become cancerous.
According to these same organizations, annual fecal occult blood tests (FOBT) are as effective at detecting colon cancer as colonoscopies done every 10 years. A FOBT would be followed by a sigmoidoscopy or colonoscopy only if positive (most are negative).
FOBT costs $10-$25. Over ten years the cost would be between $100-$250
One colonoscopy done every ten years costs $800 to $1,600 dollars - three to six times more costly than annual FOBTs.
Annual FOBT is less invasive, has fewer side effects (actually there are no side effects), is much less expensive, and gets you in to your physician for your annual physical so other possible health conditions may be identified early.
With all the buzz about colonoscopies you might think that you would be getting second rate care with FOBT. However, annual FOBT is the colorectal cancer screening method with the best scientific data to support its efficacy and safety.
As a matter of fact, about colonoscopy the USPSTF states; “It is unclear whether the increased accuracy of colonoscopy compared with alternative screening methods (for example, the identification of lesions that FOBT and flexible sigmoidoscopy would not detect) offsets the procedure’s additional complications, inconvenience, and costs.”
Which method is better? Which method has minimal adverse effects? Which method has a positive impact on skyrocketing healthcare costs?
You can choose the method that makes the most sense to you.
A recent article in the New York Times that explains that two new, non-invasive tests can be used to screen for colon cancer: virtual colonoscopy (basically a CT scan) and a whole stool DNA test. I’ll keep my eyes and ears open for information on these emerging methods.
The Bottom Line:
You have choices in how to get the best, most proactive healthcare. Now that is alternative medicine!
Tags: Colonoscopy, Colorectal Cancer, Fecal Occult Blood Test, Screening
Posted in Men, Over 50, Prevention, Women | No Comments »
January 11th, 2009
The U.S. Preventive Services Task Force has recently changed its recommendations on colorectal cancer screening. The change applies to people over 75 years of age.
The new recommendation reads: “The USPSTF recommends screening for colorectal cancer (CRC) using fecal occult blood testing, sigmoidoscopy, or colonoscopy, in adults, beginning at age 50 years and continuing until age 75 years. The risks and benefits of these screening methods vary.”
About people from 75 to 85 years old, it reads: “The USPSTF recommends against routine screening for colorectal cancer in adults age 76 to 85 years. There may be considerations that support colorectal cancer screening in an individual patient.”
About people over 85 years old, it reads: “The USPSTF recommends against screening for colorectal cancer in adults older than age 85 years.”
The Bottom Line:
If you are between the ages of 50 and 75, you should be screened for colorectal cancer with a fecal occult blood test or colonoscopy (I don’t say sigmoidoscopy because it is the only recommended method that does not check the entire colon and rectum).
If you are between the ages of 75 and 85, in most cases colorectal cancer screening is not recommended, but there may be exceptions.
If you are over the age of 85, colorectal cancer screening is not recommended.
Please see my blog posting comparing fecal occult blood testing to colonoscopy.
Tags: Colonoscopy, Colorectal Cancer, Fecal Occult Blood Test, Prevention, Screening
Posted in Men, Over 50, Prevention, Women | No Comments »