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Posts tagged ‘prevention’

we either start thinking outside the box or we’ll end up with more and more people inside the box (as in 6 feet under)

November 24, 2011

fransiweinstein

Andre Picard, who writes the ‘Second Opinion’ column in the Globe and Mail made the front page this morning.  His story, “When it comes to breast cancer, science trumps wishful thinking” gives us yet another opinion of yesterday’s news:   After years and years and years of having the importance of yearly mammograms and early detection drummed into our heads, the Canadian recommendations on screening are changing.

What they’re now saying, in a nutshell, is that only post menopausal women should have mammograms — and less often than we’ve been told in the past.  Specifically, unless you are at high risk (family history of breast cancer or positive for breast cancer genes BRCA1 or BRCA2):

  •  Canadian women 50 to 74 should now have mammograms every two to three years — instead of yearly from 50 – 69 as per their earlier recommendation.
  • Women 70 to 74 should now have mammograms every two to three years — a group who were previously excluded.
  • Women under 50 should now not have mammograms at all.
  • Clinical breast exams and breast self-examination are no longer perceived to have value — so there is no longer any medical reason to fondle your breasts.

The article goes into all kinds of details and reasons, but seeing as how I am giving you the link (see above) and you can read it yourself, I’ll just give you the topline:  “Many women who undergo screening mammography have false positives (meaning they are told they have cancer when they do not) and some are treated unnecessarily.  (therefore, let’s throw the baby out with the bathwater).

I have many questions, but the most burning issue of all for me is this:

  • It would appear to me that our screening methods may be flawed (and don’t get me started on how many lives may have been lost because of this).
  • Not even one article I’ve read (and I’ve read several) has reported that the folks on the Canadian Task Force on Preventative Health Care Guidelines are concerned about this.
  • Not one article has reported that these same folks are thinking or suggesting that we should be improving our diagnostic techniques.
  • The recommendation is not to address or try to solve the root problem.  To think differently.  To look for innovative solutions.  No … instead of finding ways to IMPROVE screening, and screen EARLIER and, therefore, prevent more disease and save more lives (and money because prevention is less costly than treating patients over and over and over again) let’s just screen fewer people.  Yeah … that’ll fix the problem — sweep it under the rug for another ten years and it will be somebody else’s problem by then!

‘Innovation‘ is one of the hottest topics around these days.  It’s almost getting as much attention as the economy.  As well it should.

And if this debacle doesn’t prove that we are in dire shape in this country I don’t know what does.  Every health care practitioner … every hospital administrator … every researcher … every silly servant at every level of government … every philanthropist … every insurer … every strategist … every creative thinker … every journalist who covers health care should all be hanging their heads in shame.

We have to stop deluding ourselves.  We need change.  Radical change.  We need it now.  We need to put our heads together and figure it out.  Not just for breast cancer — for our health care system in general.  It is not working.  Period.

I was so pissed off, frustrated, horrified and disappointed when I read Andre Picard’s article this morning I emailed him.  We bantered back and forth a couple of times — and in the end he did agree that “we need better prevention and treatment and more realistic presentation of what we’re able to do now.”  So I do have one, last question for Andre Picard:

Instead of justifying the new recommendations why didn’t you ask the tough questions that need to be asked?

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