Cancer screening: More sensitive than ever, but is it doing any good?
Years ago, a doctor friend of mine told me about a flight he’d taken from Colombia to Madrid. As the plane was suspended over the vast Atlantic, the pilot came over the PA system and told the passengers: “Don’t worry; we’re lost, but we’re making very good time.”
I think of that incredible story every time I read propaganda from racketeers like the American Cancer Society, badgering you to have annual cancer screenings. Many of us on the fringes of medical correctness have been grumbling for 30 years about the paradox of cancer testing, accurate or not, when the “cures” -radical mastectomies and prostatectomies, for example-are often worse than the disease.
“Well yes,” the “experts” respond, “the diagnosis is getting more sensitive, but the treatment, as far as effective cure is concerned, remains elusive.” There we have the beast by the ankles. But nothing happens; things go on as before; same surgery, same ineffectual, highly toxic drugs, same destructive radiation of tissues-same smoke and mirrors for the patients.
But now maybe, just maybe, they’re starting to catch on. Here it is in one clear and indisputable sentence from the PNYT-the Prestigious New York Times: “Medical researchers are increasingly questioning one of the most widely held beliefs in preventive medicine: that screening healthy people for cancer and catching it early saves lives.”
Before the momentous admission above, the PNYT carried the “early diagnosis equals cure” mantra for the AMA and the American Cancer Society faithfully, sincerely believing that it was contributing to the medical knowledge of those intellectuals who rely on the PNYT for their “attitude of the day.” Unfortunately, this profoundly and insidiously subversive rag has been misinforming the world’s college-educated intellectualoids on everything from cancer to communism for 70 years.
One thing’s certain: Benefits of screening are uncertain to say the least
More and more doctors are admitting that for the average person, who shows no symptoms and who has no family history of disease, it’s a “little premature” (translation: useless, and even downright dangerous) to undergo routine screening.
It’s been known for some time that the PSA test used to screen for prostate cancer may not translate into increased survival.
Autopsies done on men in their 80s show that many of them -up to 70 percent-actually had some form of prostate cancer that they were unaware of and never required treatment, since all the men died of other causes. Early prediction of prostate cancer leads to unnecessary treatment, anxiety, and decrease in quality of life for many men.
All of this hassle for a “problem” that may never have impacted their lives.
The same holds true for mammography. I’ve written extensively about the dangers of mammography (most recently in the January 2002 issue of Real Health), and the controversy continues. There are so many false positives that people get bogged down with anxiety and end up undergoing unnecessary medical procedures. Scientists in Denmark recently confirmed this sad state of affairs. They reported their analysis of mammography studies and found that the tests did not lower the overall death rate from breast cancer and that, as a group, women who had the tests ended up with more surgery, including mastectomies, more radiation and more chemotherapy than women who were not screened.
Lung cancer screening: One doctor learns the hard way
Dr. Stephen Swensen, the chairman of the radiology department at the Mayo Clinic, began a study of lung cancer screening three years ago, “hoping to find it could prevent deaths from lung cancer,” the leading cancer killer in the U.S. Swensen was in for a surprise and a good, practical education on cancer screening.
He screened 1,520 smokers and former smokers and found, as expected, some cases of lung cancer (37 in all). But he also found more than 2,800 suspicious lung nodules, hard lumps of cells ranging in size from a grain of rice to a pea, that “required further testing.” Sometimes the “testing” included chest surgery, which itself carries a 4 percent risk of death.
There’s all kinds of junk in our bodies-from overlooked surgical sponges and buckshot to lumps and scar tissue-and the majority of it is of little or no significance. But all this stuff looks “suspicious” to the alert young radiologist and his eager surgical colleague. It must be investigated; it might be cancer. In the end, Swensen said, more than 90 percent of the group had something suspicious on one or more of their scans.
This fits the new definition of the American medical mind, which operates under the assumption “Everyone is sick; we just haven’t found the sickness yet.”
It is not even clear whether the early diagnosis of lung cancers helped, Swensen said.
Some of the tumors might have been too slow-growing to be dangerous and others might have already spread by the time he found them. People who undergo spiral CT lung scans probably “assume that this could save their lives,” Swensen said. “That is absolutely, unequivocally unproven,” he reported.
Can a leap of faith keep you healthy?
The significance of this report will be lost on most people, including most doctors. When testing as a preventive is a multi- billion dollar business, it’s no real surprise that they aren’t too keen on listening to the evidence.
“I believe in screening,” said Dr. Andrew Wolf, associate professor of general internal medicine at the University of Virginia. “But I think physicians as well as the public tend to overblow the risks of cancer. And, more important, we overblow the risk reduction conferred by screening.” Then why does he “believe” in screening? Sounds like “faith-based science” to me.
I’m not denying that some people may have had their lives saved or improved by the discovery of something or other, but I still firmly maintain that the odds are more in favor of inviting a medical disaster. Too many people suffer needless operations and other procedures for something that may be innocuous. RH
“Cochrane review on screening for breast cancer with mammography,” Lancet 2001; 358(9,290): 1,340-1,342
“Questions Grow Over Usefulness of Some Routine Cancer Tests,” New York Times, Late Edition, Section 1A, Page 1, Column 1, 12/30/01