Cancer, Cancer Everywhere

Cancer, cancer everywhere and not a drop of info that makes sense.

Ok, mammograms are out—or they’re not. Pap tests are out—or they’re not. Prostate cancer. Whew- if you had surgery and are now impotent or incontinent maybe you and your doctor moved too fast. How does that make you feel? Ditto for mastectomy based on a mammogram interpreted as risk but now, maybe, the risk wasn’t quite what they thought.

Women are cancelling mammograms and lumpectomies. Men are baffled and even more afraid of a prostate exam. The fear goes way beyond the snap of the glove and “Is it really ok to let a man touch my bum—and what if I like it?”

What’s a human to do?

Combine this with the inverse economic incentive in healthcare: the more machines a hospital invests in the more radiologic services they have to sell. The more screenings we do the more cancer we’ll find. Yep. But what if some (a lot or a little) of what is found isn’t really a threat.

After age 50 we all have cancer cells in our bodies. So do we all “have cancer”? Do we all need treatment?

Language and the way the question is framed drive all of this. The best words I have read recently are Robert Aronowitz in his New York Times op-ed called, “Addicted to Mammograms” published November 20, 2009. What he shows us is that the way the argument is framed pre-determines the possible answers.