Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I'll add my name to the other cancer survivors who have already posted and are very thankful that they: a) underwent cancer screening, and b) did not decline treatment.
I'm 54 and have a cancer-disposing genetic condition. My first breast cancer was found when I was 39, the second, unrelated to the first, at 45. Both of them were found early, stage 1, The treatments (surgery/chemo/radiation) were admittedly annoying, but I have zero lasting side effects and have enjoyed perfect health for the past 9 years.
My cousin had the same genetic condition and also developed breast cancer at a relatively young age. Unfortunately, she was not going in for mammograms and so her tumor was not found until it had already spread to the lymph nodes (stage 4). She suffered for six or seven years and died at 55 with metastatic cancer in her bones and liver.
Her brother also had this genetic condition and died in his mid-50s of prostate cancer.
So, my feeling is that a person certainly has the right to decline routine screenings and also decline to treat anything that may show up, but then cannot complain about a poor outcome, Honestly this attitude seems very foolish to me. Treatments for early-stage cancers are not fun but they are also not as horrible as people imagine, and certainly not as bad as suffering and dying from what could have been a curable condition.
By the way, I don't believe that mammograms cause benign growths to become cancerous. In my case, when my first tumor was found, I had never actually had a mammogram because I was only 39. My second tumor was found by MRI. So thinking that avoiding mammograms will prevent a person from getting breast cancer is absolutely incorrect thinking.
I'll add my name to the other cancer survivors who have already posted and are very thankful that they: a) underwent cancer screening, and b) did not decline treatment.
I'm 54 and have a cancer-disposing genetic condition. My first breast cancer was found when I was 39, the second, unrelated to the first, at 45. Both of them were found early, stage 1, The treatments (surgery/chemo/radiation) were admittedly annoying, but I have zero lasting side effects and have enjoyed perfect health for the past 9 years.
My cousin had the same genetic condition and also developed breast cancer at a relatively young age. Unfortunately, she was not going in for mammograms and so her tumor was not found until it had already spread to the lymph nodes (stage 4). She suffered for six or seven years and died at 55 with metastatic cancer in her bones and liver.
Her brother also had this genetic condition and died in his mid-50s of prostate cancer.
So, my feeling is that a person certainly has the right to decline routine screenings and also decline to treat anything that may show up, but then cannot complain about a poor outcome, Honestly this attitude seems very foolish to me. Treatments for early-stage cancers are not fun but they are also not as horrible as people imagine, and certainly not as bad as suffering and dying from what could have been a curable condition.
By the way, I don't believe that mammograms cause benign growths to become cancerous. In my case, when my first tumor was found, I had never actually had a mammogram because I was only 39. My second tumor was found by MRI. So thinking that avoiding mammograms will prevent a person from getting breast cancer is absolutely incorrect thinking.
Obviously, those of us responding to this topic about screening/treatment/alternative treatment are providing somewhat biased data points...we survived to offer our POV. Those who didn't and subsequently died because of it are rather silent on the subject .
Obviously, those of us responding to this topic about screening/treatment/alternative treatment are providing somewhat biased data points...we survived to offer our POV. Those who didn't and subsequently died because of it are rather silent on the subject .
True, but I want to add some balance to this discussion.
For the vast majority of people who get screening, they will experience no measurable benefit as no cancer would be found. In fact, we could try and ask if they were made worse off from all those extra doc appointments, co-pays, and perhaps stress (balanced against peace of mind when nothing is found). It will be a minor negative, but this will be accrued over a large sum of people.
Then there are the people, like perhaps you and Saibot, who benefited tremendously. Decades likely added to your life.
Then there is another category of people, those who were wrongfully diagnosed, and had a benign tumor aggressively treated. A tumor that would never kill them. These people may have even had years taken off their life (certainly QOL). So the negative to them is considerable.
So how we conceptualize this is by doing RCT to see if diagnostic cancer screening improves the life of the average person. To date, no RCT has shown that it improves outcomes over the populations diagnostic tests are recommended for.
What that means for me is we give these tests too broadly, only thinking of the upsides and never the downsides. Medicine should focus on targeting specific populations for these tests instead of anyone over a certain age.
Speak to your doctor if diagnostics are right for you and your risk factors, and ask them to cite you an RCT showing that people like you are likely to benefit. If no RCT can be found, ask them to qualify the percentages of a cancer being caught in your group vs the risk of a false positive. All tests have a false positive %.
Then there is another category of people, those who were wrongfully diagnosed, and had a benign tumor aggressively treated. A tumor that would never kill them. These people may have even had years taken off their life (certainly QOL). So the negative to them is considerable.
Diagnostics are much better than they used to be, and are improving all the time. A mammogram or MRI may be inconclusive or be misread, but these days an actual biopsy is quite unlikely to give the false result that a benign tumor is malignant.
And, speaking specifically of breast tumors because that was my own experiences, if it is malignant, there are other tests that quantify just how aggressive or nonaggressive it is. One of them is specifically to identify whether chemotherapy would be beneficial or not.
My personal result was that chemo would greatly reduce the risk of recurrence, so I had chemo. A friend of mine, however, had such a low score that she was informed that chemo was not necessary. She had a lumpectomy and a couple of weeks of radiation and that was the end of it. No doctor was pushing her to get unnecessary treatment.
Diagnostics are much better than they used to be, and are improving all the time. A mammogram or MRI may be inconclusive or be misread, but these days an actual biopsy is quite unlikely to give the false result that a benign tumor is malignant.
And, speaking specifically of breast tumors because that was my own experiences, if it is malignant, there are other tests that quantify just how aggressive or nonaggressive it is. One of them is specifically to identify whether chemotherapy would be beneficial or not.
My personal result was that chemo would greatly reduce the risk of recurrence, so I had chemo. A friend of mine, however, had such a low score that she was informed that chemo was not necessary. She had a lumpectomy and a couple of weeks of radiation and that was the end of it. No doctor was pushing her to get unnecessary treatment.
Yes, that's fine, but no matter how good the test is, there are always false positives, and there are always people who are incorrectly treated. The question is how large are the false positives vs how effective the test is in catching a growth of cells early and identifying it as a malignant cancer that will kill you down the road. The test has to see into the future to treat you right now.
The gold standard way of studying this is an RCT. Pick a group of people you think will benefit from the screening, randomize some to get the screening, some to continue their life as normal, doing everything they would normally. Observe absolute mortality between groups. If the study cannot find the difference, the benefit from screening is small to nonexistent for that group of people.
That doesn't mean that some didn't benefit, but it does mean the harms vs positives eventually washed out or were too small to statistically measure.
That doesn't mean that some didn't benefit, but it does mean the harms vs positives eventually washed out or were too small to statistically measure.
I'm struggling to understand how the "harm" of being screened for a condition you never end up getting, or even the harm of getting a false positive, outweighs the harm of failing to discover that you have a malignant tumor until it is too late to treat.
If 100 women get routine screening mammograms and one of them discovers that she has a small, still treatable tumor, my opinion is that the other 99 should be glad that routine mammograms exist even if they did not personally benefit. And in fact, when I talk to other women, that is the general attitude they have, because virtually every woman my age knows/knows of at least one woman whose breast cancer was detected by routine mammogram.
I'm struggling to understand how the "harm" of being screened for a condition you never end up getting, or even the harm of getting a false positive, outweighs the harm of failing to discover that you have a malignant tumor until it is too late to treat.
If 100 women get routine screening mammograms and one of them discovers that she has a small, still treatable tumor, my opinion is that the other 99 should be glad that routine mammograms exist even if they did not personally benefit. And in fact, when I talk to other women, that is the general attitude they have, because virtually every woman my age knows/knows of at least one woman whose breast cancer was detected by routine mammogram.
Harm, because they waisted time and possibly some money getting screening that didn't benefit them. Opportunity cost, they could have done something better with that time. Not to mention perhaps stress. And as I mentioned it's a minor inconvenience, but it represents the majority of people. Also, people can do only so many screening tests, if they take the wrong ones they may miss the one's they're supposed to do.
Overall, the RCT quantifies the benefits and harms over the group of people given the screening test.
Last edited by WaikikiWaves; 12-14-2023 at 10:19 AM..
Harm, because they wasted time and possibly some money getting screening that didn't benefit them. Opportunity cost, they could have done something better with that time. Not to mention perhaps stress. And as I mentioned it's a minor inconvenience, but it represents the majority of people.
Overall, the RCT quantifies the benefits and harms over the group of people given the screening test.
Seems to me this falls under the same umbrella as paying taxes for services that you don't personally use, like funding schools even if you don't have children. Most reasonable people agree that it's in the best interest of society to educate children and provide good health care. Part of good health care is preventative screenings, which are less expensive (and tragic) in the long run than treating serious disease. Even if it's a minority of people who experience the serious disease. (13% of American women will get breast cancer at some time in their lives, so while that's a definite minority, it's also not rare.)
In any case, people can opt out of screenings. Anyone who considers a mammogram or colonoscopy a waste of time and money is welcome not to get one.
Seems to me this falls under the same umbrella as paying taxes for services that you don't personally use, like funding schools even if you don't have children. Most reasonable people agree that it's in the best interest of society to educate children and provide good health care. Part of good health care is preventative screenings, which are less expensive (and tragic) in the long run than treating serious disease. Even if it's a minority of people who experience the serious disease. (13% of American women will get breast cancer at some time in their lives, so while that's a definite minority, it's also not rare.)
In any case, people can opt out of screenings. Anyone who considers a mammogram or colonoscopy a waste of time and money is welcome not to get one.
Of course, everyone can do what they want. The question every patient needs to ask themselves is if the screening test is worth their time. I'm providing a framework for how to think about it. It's definitely not true that screening tests benefit everyone, in fact some people are hurt. So doctors and patients need to pick and choose carefully.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
.
