I will say to them what I said to my sister's lazy gyno, "If our aunts had waited til they were 40 for their first mammograms, they would have died of breast cancer. Oh yeah, they did and they died. So shut up and give her the damn test."
Don't make me have to go back for every appointment until she's 50. I only have the one sister, and I am lucky to have such a sweet one. She, on the other hand, is happy that I am a loud bitch when it comes to our health.
@BetteD: Gladly. Thanks to breast cancer, I am down to a sister and a mom for close female relatives, and it is chipping away at my cousins. I am adamant that I NEED my sister to get old with me.
I worked for a natl. cancer org, and I knew plenty of women who got cancer before 40, found lumps themselves, and others who found cancers through mammograms. What ever happened to the old adage "Better safe than sorry?" There are no "harms" to having a biopsy done or having regular mammograms.
@badmutha: All medical procedures, including biopsies and mammograms, have risks. This group's findings indicate that for a certain group, 40-49 with no increased risk of breast cancer due to genetic mutation or chest radiation, the risks outweigh the benefits.
It's not as simple as "better safe than sorry;" more medicine isn't always better. I don't have the expertise to dig into their methodology completely, but they seem to have been pretty specific in their findings about who this applies to and who it doesn't.
I had a conversation with my nurse practitioner, who works with cancer patients, about these guidelines today. She doesn't know how she feels about them yet. But she said some interesting things, amongst them, that it is believed that there are certain cancerous cells that may begin to grow in women's breasts in their 40's that actually would go away on their own without treatment. In those cases, treatment is unnecessary. And the treatment we are talking about, a mastectomy, chemotherapy and radiation, is life changing. In fact, chemotherapy and radiation may actually shorten your life. In those cases, it would actually be better for a woman to never know she has the cancerous cells.
She also said that when you look at survival rates after detection and treatment, there is some evidence suggesting that the reason the number of years of survival is higher for women in their 40's is because they are in their 40's and therefore there are all those years of recovery between when it was discovered and when it would have been discovered if they didn't have a mammogram until their 50's. This is because many cancers detected when women are in their 40's grow so slow that they are still treatable 5 or more years later.
Of course, she also said there are women whose lives have been saved or extended by early detection of aggressive cancers.
To me, this is what you have to balance. It is not just money and there are health risks either way.
@Lymed: I'm in the same boat as your NP which is why I haven't said too much on the issue. I will say that I have decided not to get screened until I'm 50 because I have read the studies and I don't believe that in my case mammograms are warranted. Mammograms are also an imperfect tool (although the technology is improved) - especially on younger, denser breasts. That said, they are fairly inexpensive and the radiation exposure is minimal, so it's all about the risk and benefit for each patient.
Medicine is a science, but also an art - the art is taking the science and applying it to the community you serve and the individual in front of you.
@boobookitt: Your last sentence is perfect. Guidelines can be phenomenal tools. But every patient is different and there are even different types of breast cancers. The problem is not in the guidelines themselves, they are in insurance companies misusing guidelines to deny treatments and tests.
The bottom line to me is we need more research. If there are some breast cancers that actually reverse and go away on their own, perhaps we can learn from them less harmful ways to eradicate the cancer.
@Lymed: I work at the National Cancer Institute, and you're absolutely correct. I had a discussion with a colleague who's a foremost expert on breast cancer, and she said the same thing.
What about improving the affordability and access to MRI's that are (1) less prone to false positives; and (2) more nuanced in the size of tumor it detects?
Also, this is going to be the nail in the coffin for health care insurance reform, from what it seems. It's only a matter of time before this gets truncated into a right wing talking point. I mean, don't we recall what they did about the "old people" killing meme?
@Trulymadlyme: The MRI thing confuses the hell out of me. They sent my mom for one of those after a red flag on the mammogram, but I always wondered why they didn't just do that in the first place if they were going to need to do one anyway on the off chance something showed up.
@CynicalPink: Insurance rarely covers breast MRI's which make it insanely expensive (hello the whole purpose for insurance reform).
The breast cancer fuck up will be the end of the health care mess. It'll fizzle or die because the president and Congress are taking way too long and continue to make stupid, unnecessary findings like this commission. The timing of this whole mess just seems...opportune?
Okay you're going to get mad but, you know what? Why is the Obama administration CONSISTENTLY letting health care discussions veer off in this direction, issuing only the occasional milquetoast denial? I realize this is probably faith that people can see through the crazy; but if Lou Dobb's interview with Jon Stewart was any evidence last night, far too many of them can't, AND THAT'S A PROBLEM.
@PilgrimSoul: I'm not mad, I'm agreeing. They had an effective infrastructure in place to deal with this crap during the election. I'm boggled as to why they would not continue to use it now, when they apparently need it most. Letting the other side control the conversation is not the way to get your bill passed, or indeed, anything else done. You have to be out there every day pushing your own message and shooting theirs down. The GOP, which ostensibly understands nothing else, understands that. And that is why they win. Obama needs to understand it if he wants to get anything done.
@Hooplehead: Thank you for saying this so well. I supported teh administration, and continue to support it, but letting the GOP hijack media taglines and define what gets placed in front of people's eyes is a sure fire way to fail on every initiative. Way to let them define the scope of the problem - scare tactics work and unless there is a strong statement of confident opposition, they are going to continue working. I felt the same way with the lack of correction or strong stance to counter the whole "offing Granny" fiasco. I helped fund the stimulus package, can't I step in and hire better PR for the White House? It's the effing WHITE HOUSE, someone out there should be up to the task, no?
@fancypantsftw: You'd like to think that people aren't stupid enough to fall for obvious garbage like the "death panels" meme. But the GOP has shown us clearly that we can't take for granted that the American public has any sort of critical thinking skills or healthy skepticism towards the pronouncements of politicians anymore.
Unless they're Democrats, in which case, hard proof isn't remotely enough.
@Snowbunny: Glad to hear the state of your house is more important to you than the pain your cat experienced as a part of its body was being ripped from it forever. Declawing is a brutal practice. Pretty sure you wouldn't want anyone removing your fingernails, hm? Why should it be any different for an animal?
Is there a UK Jezie around who can explain this law to me? Being eligible for your partner's estate seems like a good thing, so why is Baroness Deech saying it sets women back? Am I misunderstanding the Law Commission's statement or is she commenting on an old law?
@jemandtheholograms: Ruth Deech is a very well respected expert on family law. Her views on divorce are interesting in that she does not believe that women who are otherwise able to work should be awarded any maintenance in a divorce [business.timesonline.co.uk] (this does not affect child support) and her views on cohabitation are similarly esoteric. [headoflegal.blogspot.com]
Basically, my understanding of her position is that she thinks that people ought to be encouraged to ideally (a) make wills, so that their estates are awarded according to their express wishes, or, failing that (b) get married or form a civil partnership, which has benefits for society. Just cohabiting with someone ought not be enough to have the estate awarded to that person, as opposed to their children, siblings or parents, absent their express wishes as set out in a will.
The lesson here is for everyone to please, please please make a will. Your assets will need to be divided no matter how small your estate is, and the legal bills will be more if you do not have a will.
Congratulations to Shane Ryan! You've just earned yourself a special spot in the brand new 1,000th circle of hell where you'll find accommodations like:
-Reliving your horrible life on earth!
-Being reminded of how pathetic you are!
-Seeing the consequences of your actions firsthand!
-Thinking about what you did!
-Ultimately realizing that your existence was a sad and pitiful one!
And that's not all! If you continue to behave in such a way, you'll get all of these wonderful accommodations for... ETERNITY!
11/19/09
Don't make me have to go back for every appointment until she's 50. I only have the one sister, and I am lucky to have such a sweet one. She, on the other hand, is happy that I am a loud bitch when it comes to our health.
11/19/09
11/19/09
11/19/09
11/19/09
11/19/09
11/19/09
It's not as simple as "better safe than sorry;" more medicine isn't always better. I don't have the expertise to dig into their methodology completely, but they seem to have been pretty specific in their findings about who this applies to and who it doesn't.
11/19/09
She also said that when you look at survival rates after detection and treatment, there is some evidence suggesting that the reason the number of years of survival is higher for women in their 40's is because they are in their 40's and therefore there are all those years of recovery between when it was discovered and when it would have been discovered if they didn't have a mammogram until their 50's. This is because many cancers detected when women are in their 40's grow so slow that they are still treatable 5 or more years later.
Of course, she also said there are women whose lives have been saved or extended by early detection of aggressive cancers.
To me, this is what you have to balance. It is not just money and there are health risks either way.
11/19/09
Medicine is a science, but also an art - the art is taking the science and applying it to the community you serve and the individual in front of you.
11/19/09
The bottom line to me is we need more research. If there are some breast cancers that actually reverse and go away on their own, perhaps we can learn from them less harmful ways to eradicate the cancer.
11/19/09
#tips
11/20/09
11/19/09
Also, this is going to be the nail in the coffin for health care insurance reform, from what it seems. It's only a matter of time before this gets truncated into a right wing talking point. I mean, don't we recall what they did about the "old people" killing meme?
[www.rightactionforwomen.org]
11/19/09
On NPR yesterday there was a story about how in Japan, MRIs cost about $160.00. Here? 10 times that, if not more. It's ridiculous.
11/19/09
11/19/09
The breast cancer fuck up will be the end of the health care mess. It'll fizzle or die because the president and Congress are taking way too long and continue to make stupid, unnecessary findings like this commission. The timing of this whole mess just seems...opportune?
11/19/09
11/19/09
11/19/09
11/19/09
Unless they're Democrats, in which case, hard proof isn't remotely enough.
11/19/09
11/19/09
11/18/09
11/18/09
11/19/09
11/18/09
11/18/09
I love how it involves everyone from custodial staff to doctors.
11/18/09
11/18/09
11/18/09
11/18/09
11/18/09
Basically, my understanding of her position is that she thinks that people ought to be encouraged to ideally (a) make wills, so that their estates are awarded according to their express wishes, or, failing that (b) get married or form a civil partnership, which has benefits for society. Just cohabiting with someone ought not be enough to have the estate awarded to that person, as opposed to their children, siblings or parents, absent their express wishes as set out in a will.
The lesson here is for everyone to please, please please make a will. Your assets will need to be divided no matter how small your estate is, and the legal bills will be more if you do not have a will.
11/18/09
11/18/09
-Reliving your horrible life on earth!
-Being reminded of how pathetic you are!
-Seeing the consequences of your actions firsthand!
-Thinking about what you did!
-Ultimately realizing that your existence was a sad and pitiful one!
And that's not all! If you continue to behave in such a way, you'll get all of these wonderful accommodations for... ETERNITY!