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Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
Some Doctors Claim Breast Cancer Is Overtreated

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jonesy
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
Even though a cancer can be "harmless" it is still a malignancy. Personally, as someone who works in breast pathology, there is no decision to make. A mammogram is vital, it saves lives. I'd rather go through the mammogram and subsequent treatment than take the risk and let it turn into some of the things I've seen.
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NellMood
08/17/09

@jonesy: Thanks. There seems to be some confusion here- we're not talking about benign tumors, right? This is actually cancer being discussed?
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shorty63136
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
"Harmless cancer" sounds like an oxymoron to me. I mean, I'm not an oncologist or biology major by any means but if it is actually cancer (and not some benign tissue just chillin out), how is it harmless? I'm not so sure about "taking a guess" or "waiting to see" if it gets bad pretty quick and kills me (or causes me to need a really aggressive treatment).
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Rare Affinity
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
I had a mammogram a few weeks back. Free and automatic for women of my vintage (Madonna’s) on the NHS. (Take that US rightwing politicos!) The procedure was uncomfortable and somewhat painful as I had a heat rash on my breasts making them especially tender. In addition, because of their size, the technician said she would have to check the first set of x-rays to see if she needed to do more to ensure a comprehensive record. Whilst I waited for the second batch of x-rays, another woman said if men had to go through the same kind of screening for testicular cancer, they would have invented a less invasive and painful method years ago.
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ihateyourescalade
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
What, and miss the yearly opportunity to wait in a freezing room for an hour to get seen, smash my breasts against cold metal while holding my breath until I want to pass out, have the crap scared out of me as the technician keeps asking for more and more pictures, and wait a week for the sonogram they've now scheduled to check out the suspicious area only to be told, finally, that everything is fine--this time? What fun would that be?
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NellMood
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
I'm not sure I could walk around with any kind of cancer in my body, even if was harmless and never progressed.
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NefariousNewt
08/17/09

@NellMood: Why take the chance, especially when it seems they can't tell you exactly which ones will and won't spread?
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NellMood
08/17/09

@NefariousNewt: I definitely wouldn't. I come from a family in which every single person of the past two generations has had cancer, so it's not something I could be casual about.
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LaComtesse
08/17/09

@NefariousNewt: @NellMood: If you're in poor health, or elderly, and there's a pretty good chance the "cancer" (tumor) is benign, it may be advisable to skip treatment. The treatment of cancer/the results of treatment can be very dangerous indeed. One day, it is my hope that we will look back at chemo/radiation and think "Oh my god, that's barbaric."
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NefariousNewt
08/17/09

@LaComtesse: Avoiding Man Men Spoilers Today: I just heard the voice of Dr. McCoy from Star Trek IV: The Voyage Home: "Barbaric. We're dealing with Medievalism here..."
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NellMood
08/17/09

@LaComtesse: Avoiding Man Men Spoilers Today: I'm very biased because my dad is a radiation oncologist. But you're right- I can't speak to how I would feel if a cancer was discovered in my breast at age 80. Right now, at 26, I'd want it out.
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LaComtesse
08/17/09

@NefariousNewt: I do try to channel nerd culture whenever possible.

@NellMood: My aunt, 42, was recently in this dilemma herself. They found cells that COULD be cancerous in her uterus. After dealing most of her life with fibroids, she underwent a complete hysterectomy and chemo and (as I'm sure you're aware) that shit is like a tour in 'Nam.

She made the right decision for her but even at that young age, I don't know that it would have been the right decision for me. I think "When in doubt, treat it" is probably the best stance to take, but I think we should reassess how we define "doubt."
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ihateyourescalade
08/17/09

@LaComtesse: Avoiding Man Men Spoilers Today: Not to be pedantic, but this is probably worth noting: In the article, the cancers the mammos find are not benign (which is a contradiction in terms anyway). Some of the cancers are very aggressive, but some are very slow-growing and may never get big enough to cause a problem. Otherwise I totally agree with you.
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NellMood
08/17/09

@LaComtesse: Avoiding Man Men Spoilers Today: I hope your aunt is recovering quickly and is doing well.

It's just so hard to know what you would do until you're in that situation. I assume that I would want to aggressively treat everything, because of my family history and growing up in family where cancer treatment was my father's livelihood. That said, I don't know what I would do in a situation where my uterus would be removed in treatment based on a diagnosis of "could be cancerous." I hope I never have to face a choice like that, but I think many of us probably will.
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NefariousNewt
08/17/09

@LaComtesse: Avoiding Man Men Spoilers Today: The problem is, we are at the very beginning of our knowledge into how cells work and how they become cancerous. Without greater of more detailed knowledge, we're in the "if it looks like a duck and quacks like a duck" phase of diagnosis. Women are going to have to make due with the current style of mammogram until cellular biology and cancer research have reached a point where they can differentiate between truly benign and possibly/definitely malignant cancer cells.
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LaComtesse
08/17/09

@ihateyourescalade: Yes, thank you. I was speaking in more general terms.

@NellMood: Absolutely. It's like when women go on about EXACTLY how a birth experience is going to go before they're even preggers. And thank you: my aunt is doing beautifully (and her super-short hair is adorable).

@NefariousNewt: Yeah. Technology and knowledge being what it is, we're acting accordingly but, unfortunately, it's inevitable that in some cases we may be doing more harm than good even though we're making the best decisions available to us.
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NefariousNewt
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
The studies don't mean that women should abandon mammography, most experts say. But some think it's time to reconsider the way that mammogram screening is done.

Well, that's fine, but I don't think it's necessary to put this information out there as definitive, before some adjustment to the screening process has been attempted. If there is an over-diagnosis, then work needs to be done on tweaking the mammogram, or creating a new, less obtrusive test that can find that types of breast cancer that are troublesome. This may just lead to some women reducing their screenings unnecessarily and causing breast cancer rates to increase.
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galaxina
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
Oh jeez. I'm seeing this just as I'm about to pick up the phone to schedule a follow up screening to my annual mammogram because the first showed "an area that requires further evaluation." My heart is pounding. I realize most of these things turn out to be normal, but it's scary to keep being told, "We need to zap your boobs again."
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Zombie Ms. Skittles
08/17/09

@galaxina: Good luck! It probably is nothing, but I know it's horrible and nerve wracking to have something "abnormal." When it turns out to be nothing, make someone go buy you a few drinks.
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ihateyourescalade
08/17/09

@galaxina: Breathe, breathe. I am a veteran of this. It will be nothing. Promise.
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galaxina
08/17/09

@Zombie Ms. Skittles: Thank you! I got called back last year for extra imaging and it was nothing, but I've also had a scare this year with an ovarian cyst (which has since disappeared) and discovered I have fibroids. It's been a stressful year all around, so everything is making me just a little crazier than it normally would.
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galaxina
08/17/09

@ihateyourescalade: Thank you. I really appreciate it. As I mentioned to ZMS above, it's been a stressful year. Losing someone you love (my mom) makes you all too aware of your mortality.
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dianersb was bit by a zombie
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
I'm pretty sure that harmless cancer is an oxymoron.
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LaComtesse
08/17/09

@dianersb was bit by a zombie: It is. I think they mean 'benign tumors.'
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Flackette Goes Retro
08/17/09

In reply to Study: Mammograms May Lead To Overtreatment Of Harmless Cancers
The phrase "harmless cancer" does not compute. How do they know whether a cancer will just magically go away on its own? I would prefer to have all the info and choose treatment from there.
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Betsy
08/17/09

@Flackette Goes Retro: The correct term here would be "benign tumour", and you get them more often than you think (eg moles).
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NellMood
08/17/09

@Flackette Goes Retro: The article said that they can't "distinguish cancers that will turn life-threatening from the harmless ones."
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cocobanal
08/17/09

@Flackette Goes Retro: I know! I came here specifically to ask what is a "harmless" cancer. What?
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cocobanal
08/17/09

@Betsy: So "benign tumor" is the same as "harmless cancer"? Because I think of "cancer" as malignant, and something benign as, well, just benign.
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formergr
08/17/09

@Flackette Goes Retro: There are actually some forms of prostate cancer that are "harmless". They are so slow-growing, that it would take 30 years for them to be problematic, and since they often don't appear until the patient is in his late 60's or early 70s, they are "harmless".

The trick, though, is trying to figure out which are that kind, so they can be left alone, or which are the kind that are aggressive and can kill in less than a year.
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Flackette Goes Retro
08/17/09

@Betsy: Then that isn't a cancer, it's a different type of thing entirely. Perhaps the original article is misleading in its wording.
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NellMood
08/17/09

@Flackette Goes Retro: @Betsy: The article, as I understand, isn't about benign tumors. It's about slow-growing cancers. The word benign was never used.
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schweppes
07/10/09

In reply to Some Doctors Claim Breast Cancer Is Overtreated
I think this is more about "giving patients all the information" - - - I think a lot of times, the second people hear the C-word, it's sirens blaring, wanting the most aggressive treatment possible when, for some individuals, it might be better for long-term health to be a little less vigorous. If you have a slow-growing cancer and you're older, it might make sense for you not go through the whole shebang.
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Atomic Bowling
07/10/09

@schweppes: Well that's one thing I wonder about - how much do they have to do to determine which type of cancer it is? Because if it's just a matter of a biopsy (which I think is unpleasant but non-invasive for most people), then the doctors should definitely be trying to highlight for patients those instances when aggressive treatment might not be wise. If they have to start major treatment to make that determination, then it might be kind of a moot point.
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formergr
07/10/09

@Atomic Bowling: There's a growing push in healthcare for what's called "informed decision making", and there are tools developed to accompany it.

Basically they are neutral videos or pamphlets that present to the patients all the costs and benefits from a certain procedure. It's intended to be separate from the physician's counsel, since he or she can't know everything about the patient's outlook on life, family, philosophies, or religious influences-- all things that can influence their treatment decisions. Also, it's kept separate because surgeons tend to recommend surgery, ya know?

It tends to be used most for things like prostate cancer treatment in older men, lower back surgery, lumpectomy vs. mastectomy for breast cancer, etc. All procedures that don't often have clear-cut science backing one exclusively over the other. Instead, they are situationally dependent.
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morninggloria
07/10/09

In reply to Some Doctors Claim Breast Cancer Is Overtreated
Men will look for any excuse to handle breasts. The other day, it was "whoops, the train stopped abruptly and my hand brushed them." What's it going to be tomorrow? "You have cancer and now I have to touch them a lot."?
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hippichx sez PEACE PLEASE
07/10/09

In reply to Some Doctors Claim Breast Cancer Is Overtreated
Doctors can distinguish between the two if they take a biopsy, then view the cells under a microscope. Many doctors will send a sample out to a lab to be stained for Her2/Neu. The amplification of this gene is correlated with fast progressing breast cancers. My personal belief (having been through other cancers) is, "if in doubt, cut it out." The sooner, the better.
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PinkSoxHat
07/10/09

@hippichx sez PEACE PLEASE: Seriously. If I have something in my breast that may be, possibly, we're not sure it's cancer, cut it out. I'd rather lose a breast for the possibility of cancer than lose my life because they were wrong.
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Red-headed bookworm
07/10/09

@hippichx sez PEACE PLEASE: My mom has had multiple instances of breast cancer. One of these cases has metastasized to her lung. While it's slow growing and she isn't on chemo now, I would hate to have that happen to someone else because of breast cancer not being treated aggressively enough.
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andBegorrah
07/10/09

In reply to Some Doctors Claim Breast Cancer Is Overtreated
"Doctors say metastasizing cells just being emotional."
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wtfox?!
07/10/09

@andBegorrah:"But prostate cancer cells, on the other hand, are just having a bad day."
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lucystrawberry: Tier 2 is the new black
07/10/09

In reply to Some Doctors Claim Breast Cancer Is Overtreated
This is clearly evidence that government run breast cancer screenings are dangerous and causing untold unnecessary suffering. Thus, government should stop funding it and all other health initiatives. UNIVERSAL HEALTH CARE MAKES PEOPLE DIE.
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hippichx sez PEACE PLEASE
07/10/09

@lucystrawberry: Tier 2 is the new black: by michael moore... coming soon to a theater near you.
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thePrototype
07/10/09

@lucystrawberry: Tier 2 is the new black: I know right, I was listening to Glen Beck this morning and he was going on about how you are 12% more likely to die of cancer in the UK than in the US, so therefore we shouldn't try to improve on the model we currently have.

If my commute to work wasn't so short I would have called in to tell him that as usual, he was completely missing the point.

the sad thing is I hear people parroting him and Rush all day long... and believe it :(
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Triphena
07/10/09

In reply to Some Doctors Claim Breast Cancer Is Overtreated
I know chemo, radiation, etc. is awful, but all the same, if I've got any sort of cancer, TREAT THAT SHIT, YO.
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margareita metermaid
07/10/09

@Triphena: I agree-- I'm of the 'better safe than damn sorry' school of thought here.
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