I watched my father die from cancer. Three months of slow decline and one ghastly day of counting his breaths, thinking each was his last, but there was always another one. Until there wasn’t. I was 15. I think I have a pretty good grasp on what a fatal illness does to a family.
Surreal quoted:
Ummm… that means that **FOUR OUT OF FIVE ** (that’s 80%, right?) were a threat and did need treatment. Why is this hard for YOU to comprehend?
To repeat: the mammogram is not the issue… the issue is making wise, sensible, thoughtful decisions about what the mammogram FINDS. <slaps self in head> This is pretty simple.
And the point is that relatively non-threatening cancers have heretofore been treated aggressively and possibly they didn’t need to be. But (to quote your own numbers back to you), that was only 20% of woman screened. The other 80% had cancer that needed to be treated (although, as pointed out above, it’s still the patient’s choice, and she can opt out of treatment).
The mammogram isn’t the culprit. It’s still good to find out if you fall into the 80%. I did. I had treatment. It was no big deal.
Not everyone reading your words does. And some people who have had that horrible experience, have very recent pain and raw wounds. Your words were painful to me.
I’m sorry about your father.
Stay classy, people. :rolleyes:
I’m very sorry about your loss, LavenderBlue.
The bottom line is that there’s no difference in overall mortality either way.
I think it is scary to realize that medicine is still developing and nowhere near an exact science. Obviously the OP and others mean well, but the reality is that some deadly cancers will be found in a mammogram. But some cancers grow so fast that it won’t matter and a scheduled mammogram won’t catch it. Plus a lot of cancers that would never cause problems will be found and operated on, which has its own risk which is higher than doing nothing. In the end, if you pick 1000 people the health benefits are not clear cut. The article you posted found that in the mammogram vs non mammogram groups, the death rate from breast cancer only varied between the groups by 0.01%.
People deserve to have an informed opinion about their health care though. This mentality that health care is all benefit, no drawback is not true. It is nuanced and full of gray areas.
Even if some question the OP, at least this thread will get people to think about their health and what preventative measures they want to use to stay healthy.
I am a bit surprised by the level of argument that was spawned here from a simple reminder. I am now dropping my planned thread on encouraging people to go get their skin examined by a dermatologist (from a melanoma survivor).
Because the simple reminder isn’t proven to work the way people want to believe it works. People deserve to have as much knowledge as possible when making a decision rather than looking at the issue with rose colored glasses.
That certainly makes sense to me. I’ve followed nutrition research for many years now but only more recently have I come to realize that, other than eating an appropriate amount of calories, there’s very little you can do with your diet to have any significant impact on your health or longevity.
Yet even people who ought to know better will make outlandish claims like “people who consume food X have been shown to have Relative Risk of disease Y of 0.284.”
STATISTICALLY, yes. But statistics only predict group results. Statistics say nothing about what may or will happen to any particular individual.
This is where I apply my principle for decisionmaking: *“What are the consequences of a miscaculation?” *In this case, if you apply the statistical evidence to yourself and you miscaculate, the consequences could be dire.
IF a mammogram increases one’s chances of being alive in the nearish future, then why wouldn’t this be reflected in the mortality rate?
The point that is being made here is not, “health, who cares?,” but that we should not put weight on anecdotal evidence over scientific trials that do not support the wishful thinking that we have a magical machine that could eliminate breast cancer deaths if only people would just make routine yearly use of it.
Yes, statistics do not say what will happen to an individual in a study group, but neither does anything else, so they are a useful tool for making an informed decision.
Surreal, while I believe from your subsequent posts that you’re apparently trying to have a real conversation about a serious issue, referring to someone’s story about losing a friend as a “silly N=1 anecdote” runs pretty hard against the principles of civility in discussion encouraged on this board. Don’t be a jerk.
And Bridget Burke, that kind of commentary is way out of line for IMHO. Don’t do it again.
To everyone, please don’t let this thread devolve into personal attacks. Thanks.
Surreal, I disagree with some of your analysis. Or links, anyway. Your first link starts with the researchers declaring “If we assume that screening reduces breast cancer mortality by 15%…” Now, I don’t know why they decide to make that assumption. I haven’t read the paper or the abstract. But just making the assumption pretty clearly contradicts you main point. If screenings reduce breast cancer mortality by 15% then it is absolutely an effective tool. Does it - on the whole - waste time and money overall for the population? Maybe. Maybe not.But that’s not the question. The question is whether a mammogram is effective and the researchers quite clearly concede that point in their assumptions.
Let me do my own assumptions. Numbers completely made up.
Assumptions:
1% of the population gets cancer annually.
100% of the population gets screened annually.
There’s a false positive rate of 10%.
Screenings reduce breast cancer mortality by 15%
So given those assumptions, here’s what we know:
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For basically 98.9% of the population each year, this test could be considered a massive waste of money. Could be. What price do you put on peace of mind? How often will the doctor discover something else of concern that wouldn’t have happened if you hadn’t showed up at the office?
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For .1% of the population, you just scared the bejesus out of them. They didn’t have cancer but the tests came back either positive or inconclusive. Sucks, huh? Certainly the test needs to be improved to cut down on false positives. But we’re a long way from chemo and cutting off parts of the body. More tests are needed. And if a patient comes out of it saying “I’d rather not have known than to have been subjected to all this for no reason,” I’d argue that’s not a problem with the test itself, but with the followup relationship with the doctor, and the choices the patient makes.
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For .85% of the population, the test did nothing. It showed them they had cancer and they still died anyway. But that’s not a problem with the test! Don’t shoot the messenger here. And we know it’s not a problem with the test because…
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For .15% of the population, this test was literally a life saver.
Now we as a society as a whole can make an argument on the cost of a human life and the prevalence of cancer versus costs of screening/treatment. But on an individual level, I think it’s really hard to argue that someone shouldn’t get a screening done because I think the potential positives outweigh the potential negatives, even in my absurd example.
There’s nothing absurd about your example. The numbers are made up, but the reality remains as you described it.
A tremendous number of studies are focused on the societal cost impact, your 98.9%. Not the 0.15%. As well, Bayesian statistics fool an awful lot of people, including medical researchers and policy analysts. You did a real nice job of laying it out.
If there is a shortcoming to mammograms specifically, versus just medical testing in general, it’s that most (not all) BCs are slow growing and would be found early enough by regular self-exams (or partner-exams :)).
So mammograms tend to detect cancers that would be usually be detected anyway a bit later, and often (not always) that later detection would still be early enough to get the same longer-term outcome.
I’m glad my cancer was detected at less than one centimeter (too small to feel) and BEFORE it had spread to any lymph nodes. I’m glad I didn’t wait until it was the size of a grape, ping pong ball, or tennis ball. :rolleyes:
I was completely ignorant of the world of cancer treatment until I found myself suddenly immersed in it. Reading studies and imagining how you would/could/should make decisions is different when it’s your own personal, sweet, diseased boob that you’re emotionally, not to mention physically, attached to. Carry on.
I agree completely. I’m now 20 years into living with (but not actually personally owning) such a diseased boob and all the subsequent anxiety, long term treatments, and metastases connected therewith. I’m the guy that gave a cautionary warning about vigilance in your otherwise (deservedly) euphoric graduation-from-treatment announcement. Believe me when I say I’m not speaking here from a position of comfort, but rather from a position of increasingly bitter experience.
I have outlined why there is an apparent disconnect between the reality that early detection of cancer is generally better than later detection, versus the statistical reality that mammograms don’t do as much statistical good as one would naively assume. You can choose to believe it or not. But it is a fact.
Late add: You apparently missed that I was agreeing with Enderw24’s point that there is value from mammograms which are not captured in the simple survival statistics.
In a country with universal health care, there is naturally a cost savings in prevention, early detection, etc, for any desese. My province has a Breast Screening program, that sends you a letter, when it’s time, every year! Your Dr enrols you whenever they think it’s time, depending on risks factors etc.
It really does save millions of dollars when you detect it early, and intervene! And saves lives too!
Sorry if I sounded argumentative. In my mind I wasn’t addressing anyone in particular, just stating my pov prior to exiting the discussion.
Thanks, LavenderBlue. I’m sorry for your loss. This thread has convinced me to take another hiatus from posting here. Since I’m dealing with screening-detected breast cancer right now, I don’t have the energy to contend with unnecessary jerkish behavior. See you all in a year or so.