Monday, November 16, 2009

Save the Ta Tas? Evidently, not so much.

Interesting headline today. Regular exams and self-exams have been drilled into our heads for years. Remember those cards they used to hand out for you to hang in the shower? Well, now they're saying none of that actually works, AND they're saying we shouldn't get regular mammograms until we're 50.

"The value of breast exams by doctors is unknown. And breast self-exams are of no value."

I have friends who have found suspicious lumps by doing self-exams. I would think THEY would say they are effective! Some have been cancerous and early detection was very helpful in minimizing the severity of treatment. Others found (some after a biopsy) a benign mass, and a few went through much agonizing worry over what was actually nothing. The new report says that the older you get, the slower the cancer grows, making self-exams pointless. Basically, wait to be diagnosed 'til your regular office check-up. 

And they're saying that, statistically, it's not worth it for women in their 40's to have mammograms. Also, it's not recommended for women after age 75 because the benefits are unknown.

"Starting at age 40 would prevent one additional death but also lead to 470 false alarms for every 1,000 women screened. Continuing mammograms through age 79 prevents three additional deaths but raises the number of women treated for breast cancers that would not threaten their lives."

I don't know. I understand wanting to reduce the number of false alarms. But, if you're catching more cases earlier, increasing the odds of effective treatment, isn't it worth it? The new advice says no, that we're only saving one life for nearly 500 false alarms. But, what about catching the cancer earlier? Doesn't it follow that the earlier it's caught, the less aggressive and intense the treatment needs to be? What does it mean, "not threaten their lives?" Because they would statistically die soon anyway? I don't know. It's a lot to suddenly digest when we've been told something so different for so many years.

I do understand wanting to reduce unnecessary medical costs, but to me it feels a bit like we're balancing the issue of human life and suffering with cutting budgets. The timing of these findings just seems interesting. Yes, statistics are important to give us an accurate picture. But, we need to be careful that medicine does not become just a statistical quandary. If women over the age of 75 are not given mammograms at all because, well, they're going to die of something anyway, aren't we putting an age limit on the value of human life?

"You save more lives because breast cancer is more common, but you diagnose tumors in women who were destined to die of something else. The overdiagnosis increases in older women," said one researcher.

The findings and recommendations hint ever-so-slightly at an underlying moral issue medical professionals deal with on a daily basis. And government-funded insurance, no matter how much they try to steer us away from it, is going to face the same dilemma. Where will our limited financial resources go? It may not be termed a "death panel," but it maybe could be termed a "who's more expendable panel."

If it's a choice between a 35 year old with over half their life left before them and a 75 year old who could die in a few years or twenty, who gets the dollars for treatment? Because, limited finances DO force choices. And no matter how we try to work and re-work it, finances ARE going to be limited. Medical establishments and professionals ARE going to be trying hard to cut costs, and could be rewarded by the government for doing exactly that. 

It's a scary, scary future, no matter how you slice it, looking at people solely based on statistics and age. I'm not saying this article focuses on that, I'm saying there is a hint. Suddenly the government (government paid medical professionals) becomes responsible for who gets treatment and who doesn't. Who lives and who dies. It about who can contribute the most to society. Which, is very logical... and devaluing.

It will be interesting to watch what comes of this new advice.
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Amy said...

today my very dear friend Marsi told me she had stage 3 inoperable breast cancer. Last week they found the lump during her regular mammogram. I don't care about numbers and statistics right now, I only care that Maddi and Harrison still have their momma this time next year.

Cortney said...

Though it wasn't breast cancer, but melanoma, that took my mom, I still plan on starting mammograms at 35. Even if I have to pay out of my own pocket. Cancer seems so common these days and for govt. to decide who is more expendable for society is asinine. I am sure that if Michelle Obama was diagnosed with cancer, we would be hearing a different tune. Maybe.

MomOfDudes said...

Had my first mammogram at 47 because we have no history in our family, had a false alarm and could not believe how many of my friends shared that they too have had false alarms. HOWEVER...Every one is grateful for the awareness... I say, better to get the test when you are not worried than be worried about something you found then getting tested.

Kelleigh Ratzlaff Designs said...

"Starting at age 40 would prevent one additional death but also lead to 470 false alarms for every 1,000 women screened."

It seems to me that the one person whose life was spared because they had their mammogram earlier than now recommended would say that it was worth 470 false positives in other women. Good grief!