-
Too Many Breast Cancers Diagnosed by Mammograms?
Tweet Share on Facebook July 10, 2009 Comment (19)When it comes to breast cancer, there are certain dogmas that we accept as fact: First, a malignant tumor—allowed to grow unchecked—will eventually spread throughout the body and kill. Second, regular mammograms are a must for women over 40 to find every mass before it turns deadly. The trouble is, these "truths" aren't substantiated by scientific evidence. A new and somewhat shocking study out today shows that about 1 in 3 breast cancers detected on screening mammograms is overtreated. In other words, these malignancies wouldn't have caused symptoms or death in a woman's lifetime, according to research published in the British Medical Journal.
The study, reviewing data from women who began screening at age 50, specifically found that mammograms save 1 life for every 10 cancers that are diagnosed and treated unnecessarily. (Another study published three years ago measured 1 saved life for every 2 cancers unnecessarily treated.) What this means is that mammograms lead to far more unnecessary surgeries and chemotherapy treatments than saved lives. "The real question is, how hard should we be looking for breast cancer?" asks Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Research who wrote an editorial that accompanied the study. That's a toughie because most women wouldn't feel comfortable knowing that they might have a potentially deadly breast tumor lurking in their body undetected. And, as breast surgeon Susan Love previously told me, doctors aren't able to discern the deadly cancers from the benign ones.
-
Breast Cancer: One Woman's Tough Treatment Decisions
Tweet Share on Facebook July 10, 2009 Comment (2)This past spring, I spent several days at the University of Maryland Medical Center reporting on a piece about the art of medicine. It detailed how tough it is for doctors and patients to make medical decisions when the science is lacking to guide them. One patient I met was Miriam Smyth, a 51-year-old breast cancer patient from Gambrills, Md. She'd been diagnosed with a small breast tumor back in December and immediately decided to have a lumpectomy and radiation since her cancer had been caught early. But like so many other cancer patients, Smyth soon discovered that other treatment decisions aren't so easy to make.
Her first major dilemma—whether or not to have chemotherapy—was particularly difficult. "I assumed I wouldn't need it, had even decided not to tell my young son or coworkers that I had cancer," Smyth tells me. Smyth, an oncology researcher at the University of Maryland Medical School, thought she'd have her surgery over Christmas break and head back to work without missing a beat. But then she had a test called Oncotype Dx, which revealed that her tumor had certain markers that put her at somewhat higher risk of having a recurrence. Suddenly, chemotherapy was back on the table.
-
Think You Have Swine Flu? What to Do
Tweet Share on Facebook July 8, 2009 Comment (30)In recent conversations with friends, all I've been hearing about is swine flu. "I had it. I was sick for three days," one friend told me. Her middle child came down with a mild case as well. Another friend said she had to cancel her business trip to Germany after her daughter tested positive for the virus. She was warned that she could be quarantined in her hotel room if she came down with it while traveling; she spent the week indoors with her kindergartner who had a 48-hour sore throat and fever—but didn't wind up getting ill herself.
After hearing about my friends' experiences, I'm wondering why H1N1 is still big news. (Today, Reuters reports that 11 cases of H1N1 have appeared on a U.S. military base in Afghanistan! The country's only known pig was finally released from quarantine, "two months after he was locked away because of swine flu fears.") As of June 25, the Centers for Disease Control and Prevention estimated that more than 1 million cases of H1N1 have occurred in the United States. "Yet the vast majority of these are mild cases," says infectious disease expert William Schaffner, chair of preventive medicine at Vanderbilt Medical Center in Nashville. "Most people haven't been diagnosed because only the most severely ill are likely to be tested for the virus." In fact, he tells me, this flu virus has so far been only "slightly more severe" than seasonal influenza.
-
Can Mark Sanford Save His Marriage? Probably Not
Tweet Share on Facebook July 2, 2009 Comment (17)I couldn't help cringing yesterday when I heard a marriage therapist comment on Good Morning America about the state of South Carolina Gov. Mark Sanford's marriage. "I see this all the time," marriage therapist Terry Real said on the broadcast. "The big secret . . . 'I'm not in love with my wife.' Not being in love with your spouse is part of marriage. It doesn't mean you're in a bad marriage . . . It's perfectly normal not to be in love."
-
Smart Snacking to Combat Obesity
Tweet Share on Facebook July 2, 2009 Comment (5)Big news today: We're getting fatter. Obesity rates in adults increased in 23 states and didn't decrease in a single state over the past year, according to this report released today by the Trust for America's Health and the Robert Wood Johnson Foundation. I suppose this news isn't so shocking, considering that the trend has been going on for some time. Two thirds of us are now overweight or obese.
You might think we'd lose weight during a recession, but actually the opposite happens. Healthful foods like fresh fruits and vegetables tend to be more expensive than pasta, chips, and other processed foods. So people counting every penny tend to turn to cheap, calorie-dense fare. The report states, "The current economic downturn is likely to push these numbers even higher as rising prices and constrained incomes make it more difficult for families to buy healthy foods." And of course, many of us choose sweet, rich comfort foods like ice cream and brownies when we're feeling stressed or down in the dumps.
[Photo Gallery: See the Top 10 Fat States Where Obesity Rates Are Highest]
-
Fear of Crowds? When You Need Help for Anxiety
Tweet Share on Facebook July 1, 2009 Comment (3)While taking a little holiday in Manhattan over the weekend, I breathed in all the sights, sounds, and smells of Fifth Avenue and Central Park. Though I lived in the city 15 years ago, I'd forgotten about the crowds: swarms of people strolling along the sidewalks or clustering around street dancers who were doing flips and moonwalks in tribute to Michael Jackson. While I certainly enjoyed watching all the buff performers—especially those roller-dancing in the park—I found myself yearning for a bit of solitude. Even while wandering through 38 acres of Central Park "wilderness" known as the Ramble, I found I wasn't alone for more than 30 seconds.
