Prostate and Breast Cancer Screenings Cause Harm

Having a husband with (thank goodness) no prostate cancer but prostate problems leads me to read everything that comes my way. A year ago he had a procedure that shrunk his prostrate yet as of today it is the same size as it was. The chances of all this turning into cancer is one we don't talk about.

It was just reported that the American Cancer Society's philosophy has changed. Although they are the ones who have preached about cancer screenings, they now feel that these screenings when it comes to breast and prostate have been overstated.

The fear, which though it has made the news, is not being widely spread right now. Early in 2010 expect to see some new information on the ACS website regarding screening. It may say something like breast and prostate cancer screenings can be risky because doctors may treat small cancers but miss the big ones.

The bottom line: the advantages to screening have been overstated so the reports say.

For a long time prostate cancer screenings have gotten a bad rap. In fact the cancer society doesn't suggest that all men be tested for prostate cancer. There has been research that showed PSA tests do not prevent prostate cancer deaths.

As a women who not only gets mammograms but breast MRIs I am paying close attention to this. We know that for 20 years mammograms reduced the death rate from breast cancer by 20%. But that was up until the 80s.

This all came about because of a recent article published in The Journal of the American Medical Association. The article showed that researchers found a "40 percent increase in breast cancer diagnoses and a near doubling of early stage cancers, but just a 10 percent decline in cancers that have spread beyond the breast to the lymph nodes or elsewhere in the body. With prostate cancer, the situation is similar."

The researchers don't think we should stop getting screened. We should; however, know that there are pros and cons to our decisions. The fact we are told that mammograms will protect our health may not be true.

Doctors and many researches are having their say about this. Colin Begg, a biostatistician at Memorial Sloan-Kettering Cancer Center in New York, is concerned that we'll get confused and stop getting mammograms because I am telling you (from a variety of sources) that they are not a panacea.

Some doctors are truly finding cancers that do not need to be found because they would never spread and kill or even be noticed if left alone. So we have more women with "breast cancer" that in fact if not detected would not be a problem.

A major issue in breast and prostate screening is that it is not usually clear which tumors need aggressive treatment and which can be left alone. But as a women with a grandmother who had breast cancer it is hard for me to just say that I'll ignore some types of breast cancers because they might just go away.

Over diagnosis may be pure, unadulterated harm but I'll risk the harm. I'd rather see over diagnosis than under diagnosis. I'd rather be treated for a cancer that might go away on its own and trust that the radiologist also finds the cancer that won't go away on its own. That's all I can hope for at this moment.

Sources

JAMA
MedPage Today
NY Times