Monthly Archives: September 2010

It’s Deja Vu Again: New Study Supports Screening Mammography For Women Ages 40-49

Sometimes it seems like deja vu all over again…


In the cancer screening world, there isn’t a more controversial topic in my opinion than the early detection of breast cancer, especially among women between the ages of 40 and 49. 


We have been through repeated and intense discussions over the past 11 months as to whether women in this age group should be screened or have discussions with their health professionals on the benefits and risks of screening.  And last week the fires heated up again with a study in the New England Journal of Medicine looking at women over age 50, and coming to the conclusion that the benefits of screening mammograms were “modest.”


Today, we have another report in the journal Cancer (which in the interest of disclosure is published by the American Cancer Society, and whose editors are independent of the Society) that–especially given the media interest that has occurred already–suggests that screening women in their 40’s significantly reduces the risk of death from breast cancer.  And the question that most women and those that love them are asking is, “What the heck does all this mean for me?”





The … Continue reading →

What Norway Tells Us About Screening Mammograms And Access To Care

An article and editorial in today’s edition of the New England Journal of Medicine once again calls into question the true value of screening mammography.  And, despite the quality of the study there are still some serious questions that are likely not going to be quickly put to rest.


Mammography remains at the forefront of much discussion and contention among experts and much confusion among the public.  Now comes a new study on the subject which aims to determine how much of a role screening mammograms actually play in reducing deaths from breast cancer in women between the ages of 50 and 74.


To look at that question, the researchers examined the very thorough medical records of women in Norway who underwent screening mammography as part of a nationwide roll-out of mammography services between 1996 and 2005, and compared their death rates with women who were not screened. Their conclusion?  Patient self-awareness and improved treatment likely accounts for more of the success in reducing deaths from breast cancer than does screening mammography.  But it’s not clear that we can draw that conclusion from this study just yet.



The way the study was done reflects the interesting circumstances … Continue reading →

We Can Run But We Can’t Hide: Less (Or No) Insurance Means More Advanced Prostate Cancer At Diagnosis

An article published this week in the medical journal Cancer Epidemiology, Biomarkers and Prevention and written by my colleagues at the American Cancer Society sends me a message that we can run but we can’t hide. 


The topic of the research is the relationship between whether or not a man has adequate (or any) health insurance and how far advanced and aggressive his prostate cancer is at the time of diagnosis. 


The message we seem to be running from is that we continue to bury our heads in the sand at the sad truth that people without adequate health insurance are somehow less worthy of having some decent level of medical care that might save their lives, especially when viewed through the cancer lense.




Perhaps it was no surprise that the researchers found that there was a direct relationship between insurance coverage and measures of the aggressiveness of prostate cancer: the less insurance coverage (or no insurance coverage), the more likely it was that the man had more advanced and more aggressive disease.


This is a message there that is consistent with what we have seen before in similar studies about cancer diagnoses and … Continue reading →

A Message From Curt

“There’s more to it of course, but I wanted to give the flavor of the choices you can be faced with way before you think you’ll need to.”


That, my friends, is a message from Curt.  Read it carefully, because it is a message from a young man who is facing a circumstance that none of us ever want to contemplate.  His need to make decisions about his life and death came upon him without warning at a time when no one would have ever expected this to happen.




I don’t know Curt personally.  I have “met” him through a good friend and colleague, who in turn was concerned about his good friend who suddenly found himself facing his mortality.  Otis Brawley-who is the American Cancer Society’s chief medical officer-and I were consulted several times to provide advice to Curt and his wife during his time of need.


Curt is a young man with a loving, concerned wife and family who had just started a new job which I suspect he was looking forward to with enthusiasm.  He had been engaged in this new position for about a month when suddenly one day he had a … Continue reading →