Rita J. Stec, M.D.
Womens Health Information Links
HEALTH NEWS
November 22, 2009 SCREENING MAMMOGRAMS When should we get them? Different recommendations have just come out from the US Preventive Services Task Force, which differ from what the American Cancer Society, the American College of Radiology, the American College of Obstetricians and Gynecologists, and other expert groups recommend. The USPSTF is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services". Personally, I value their recommendations because they take a very comprehensive look at all the available information on a given disease or health topic. Their reviews include looking at how effective a particular treatment or procedure is, and whether the potential benefits outweigh the potential risks.
The bottom line, however, is that their recommendations are just guidelines for physicians to use in discussing the procedure, in this case mammograms, with their patients.
Keep in mind that mammograms are not 100% accurate. Some women experience "false positives", meaning the mammogram looks like a cancer is there, but after additional procedures, which could include more xrays, ultrasound, MRI and/or biopsy, no cancer is found. Women are relieved, of course, but then wonder why they had to go through not just the additional procedures, but also the anxiety, to find out no cancer was there to begin with.
On the other hand, some normal appearing mammograms turn out to be "false negatives", meaning no cancer was seen on the mammogram, but later the patient herself found a lump, or the subsequent mammogram showed a cancer. This results in a delayed diagnosis, allowing the cancer to grow and possibly spread before treatment is started.
If mammograms were absolutely 100% accurate, all this confusion would be eliminated.
One report which questioned the current screening mammogram recommendations was titled "What is the point: will screening mammography save my life?", was published in April 2009 in BMC Medical Informatics and Decision Making 2009, 9:18. Their conclusion was that the benefits of screening mammograms depend on the age of the woman being screened.
Breast cancer is the most common cancer in women, and should be screened to detect it at the earliest possible time. I still encourage my patients to do self breast exams. After all, you know your breasts better than anyone else. I include the breast exam on all annual physicals. I recommend a screening mammogram after discussing with the patient risk factors for breast cancer. After being informed of the potential risks and benefits, getting a screening mammogram is your choice.
REMEMBER To minimize your risk of breast cancer, it's back to the basics. Eat well, exercise daily, get restful sleep, and manage your stress.
July 12, 2009 HEALTHCARE is in the headlines yet again. And again, the focus is on who and how will we pay for everyone to have health insurance.
This is a very important matter. BUT, of more fundamental importance, who will help Americans get healthier,
and decrease the need for healthcare and health insurance? The disease burden in this country is increasing more rapidly than
our resources to take care of everyone, even if everyone did have insurance! Our increasing obesity and decreasing physical activity
dramaticaly increase our risk for diabetes, heart attacks, strokes and cancer. These diseases, as well as the chronic health problems of
our aging population, are already over-burdening our healthcare resources. If we do not start reducing the disease burden in this country, we will never
be able to provide healthcare for everyone, no matter how much money we spend on it. I am reminded of the children's story
"The Emperor Has No Clothes". AMERICA HAS NO HEALTH. America's most urgent problem is how to improve our health and wellness
first. Only then will we have adequate resources to take care of all the diseases we cannot prevent.
Food for Thought
The data are clear - reducing your consumption of red and processed meat improves your health by reducing your risk for heart attacks, strokes and cancers. But do you know that you also have a positive impact on our global water, energy and climate crises? Yes, the less red meat you eat not only makes you healthier, but also improves the world's health. Read more in The Archives of Internal Medicine volume 169 page 543.
Fresh fruits and vegetables are the foundation of optimal human nutrition and wellness. Wouldn't it be wonderful if every man, woman and child on this planet could eat a fresh piece of fruit everyday? Of course, this would require tremendous effort and CHANGE by farmers, governments, and the entire food industry. I have a dream for the wellness of every person on our planet. Won't you join me?
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