Every time I pick up a medical journal, the topics of over-treatment and over-diagnosis grab my attention.
There has been a lot of news on these subjects lately. And I'm glad the medical community is finally taking notice. It's been a long time coming.

But we are still falling short when it comes to sharing these concerns with the general public.
As a Functional Medicine physician, excessive treatments and the over use of diagnostic testing really rub me the wrong way. I don't like hearing that a new patient has had three CT scans in as many months. Or that someone is taking Plavix, Warfarin and aspirin to thin their blood.

No matter how you look at it, its overkill. And it's not doing anything good for your health.
Truth is there is a point where you need to take many health care decisions into your own hands. And the best way to do that is to be informed. You might be inclined to think the more testing and treatment you get, the better off you will be. But that's not always the case.

CT scans, for example, deliver huge doses of radiation to your body which increases your risk of cancer in later years. And many other testing procedures come with their own dangers.
They may show things that don't exist and set you on a course for a whole boatload of further testing. If not performed carefully some invasive procedures can perforate organs or arterial linings. And many of them come with other, less serious risks.

So today I'm starting a two-part series to let you know about some of the most over used diagnostics and treatments in medicine today.
Let's start off with start off with some modern-day cancer screening techniques being used for both men and women. And they may just leave you worse off than you were to start with…

Two of today's most common cancer screening tools have been in the news more than any others when it comes to both over-diagnosis and over-treatment.
This includes the use of mammograms to detect breast cancer in women and PSA testing in men for prostate cancer. Neither of them is reliable. And both can lead to damaging, disfiguring and unnecessary surgeries and treatments.

When we hear the word cancer our minds automatically think, it's the BIG C… as in my health is Collapsing because I am a Casualty of this Catastrophic killer disease called Cancer.
That's a huge burden to swallow.

But here's something I'll bet you didn't know. Today many cancer diagnoses would never result in any cancer symptoms at all, and would never lead to death.

Let's start with PSA testing. This is a screening tool used for prostate cancer. If PSA levels are high, you may need further testing that will show if cancer cells are present. And this is where the big problem comes in.
You see, testing may show the presence of cancer cells. But there is no way of telling whether those cells are dangerous ones that need treatment, or relatively harmless ones that will never progress into a health threat.

And this revelation isn't just coming from me. It turns out that around 70% of men diagnosed with prostate cancer actually have a very low risk. About 90% of them will be treated. But the larger portion would never require therapy. Not even over the long term.

That information comes from a study back in 2007 and it really caught my attention at the time. It basically reported what I already knew in my gut. And it didn't take long until further research placed another black mark on the use of PSA testing.

A study from early last year simply reinforced what I already surmised. It involved a large group of men. 76,685 to be exact. And it showed PSA screening didn't make any difference when it came to deaths from prostate cancer. The important thing to note on this research is that if followed the men for 13 years. After all of that time the death rate was 3.7 deaths per 10,000 person-years in the PSA group. In the meantime, the non-PSA group had 3.4 deaths per 10,000 person-years.

In other words, there was no significant difference at all between the two groups!
And then there's the real humdinger. A more recent report included 731 men with early-stage prostate cancer. 364 of the men had their prostate removed. The remaining men were placed under observation. After 12 years, those who had immediate surgery didn't live any longer than the men who had their cancers monitored.
In the meantime, men who choose to have surgery or radiation run the risk of ending up incontinent and impotent. And that's a shame.

I could go on and on about this travesty, but I'd like to dedicate some time to the women out there. And I know what their big question is:
What about mammograms and breast cancer? I'll give it to you straight, and you probably won't like it.
A recent study finds that nearly one-third of all women who have mammograms are over-diagnosed with breast cancer. In the past 30 years, it's estimated about 1.3 million women in the U.S fall into this category. These are women who have tumors growing so slowly they would never develop into cancers.
Because there is no way to tell that these tumors aren't dangerous, these ladies end up undergoing aggressive treatment. And it's not limited to the horror of losing a breast or two.
It also involves chemotherapy, radiation treatments and hormone therapy – all for an abnormal reading that would never have caused any problem at all!
Now I'm not saying anyone – male or female – should take the risk of cancer lightly. However, there are just a few things you might want to take into consideration before jumping the gun…

It's very important to understand what your options are when it comes to PSA testing and mammograms.
I'll be the first to admit that I don't have all of the answers. But knowing the facts – and what you may be in for – is a very important step in making crucial decisions that may affect your well-being.
Here's some food for thought…
Men:
  1. Unless you are at high risk of prostate cancer, I don't recommend testing. You fall into this high risk category if you have a father or brother diagnosed with prostate cancer at a young age. African American men also fall into this category. Additionally, men over forty on long term BHRT, (Bioidentical Hormone Therapy) who have longstanding high levels of DHT(Dihydrotestosterone) and estradiol may be the newest candidates at risk for prostate cancer.

  2. If you do opt for PSA testing and your levels are high, you don't have to rush into surgery. Look, if we're going to use PSA's as a screening tool, maybe we could actually use them in a better way… For instance, if your PSA is deemed to be somewhat above a normal range (whatever that means) and you and your doctor are concerned, repeat the test every 2 to 4 weeks for 3 or 4 times. It's a simple blood test, so it's easy to do. 

    If the numbers increase significantly… rapid elevation over multiple samplings, then you indeed may have a problem best served by intervention. Talk to your doctor, get a second opinion and educate yourself on the risks. You may opt for surgery, or you might decide to go into "active surveillance." This means you will be monitored to determine if and when treatment is needed.

  3. Prostate cancer typically grows very slowly. It can take as long as 30 years before it becomes life-threatening. Thus there may not be any long-term benefit to undergoing surgery or radiation therapy. Again, active surveillance may be suggested. But ultimately the choice is yours.
Women:
  1. Mammograms have there faults. But I still suggest women who are at a high risk of developing breast cancer get tested regularly. High risk women have two or more close relatives (mother, sister, grandmother, aunt) diagnosed with breast cancer or ovarian cancer. If you are not high risk I recommend weighing the pros and cons before deciding on regular screenings.

  2. While over-diagnosis is a very big problem with mammograms, there is also an equally disturbing problem. Mammograms miss about one out of every five breast cancers. Because of this, it's a good idea to give your self a breast exam every month at home. This will help ensure you don't miss any unusual growths or lumps.

  3. Mammograms often result in a false-positive reading. This isn't quite the same thing as over-diagnosis. It means the reading shows something that later turns out to be harmless. The problem is you'll be on edge and filled with worry while you go through additional testing to make sure there is nothing wrong.

  4. There is no way of knowing if a tumor is harmless or life-threatening. Either way, you will be treated aggressively if a tumor is detected. This means going through surgery, radiation and chemotherapy. I don't say this to scare you. I just want you to be prepared for the reality of the situation.
In the meantime, the best thing you can do to reduce your risk of prostate and breast cancer is to do everything you can to avoid it in the first place…

Eat your fruits and veggies. 
Research has repeatedly shown that plant-based foods have a protective effect against cancer. I recommend a variety of fruits and berries along with both green leafy vegetable and brightly colored ones. I especially like cruciferous vegetables such as broccoli, Brussels sprouts, arugula, collard greens, bok choy, kale and cauliflower. These contain indoles that have proven valuable in the fight against both prostate and breast cancer. They direct the metabolism of many hormones into the anti-carcinogenic pathways.

Watch out for estrogens 
in both the foods you eat and the products you buy. There is a close link between cancers and estrogen levels. This includes both prostate and breast cancer. And you could be disturbing your estrogen balance without even knowing it. For example, commercial meats and poultry are often pumped full of hormones. So it's a good idea to buy grass-fed and cage-free.
Plus, many plastic containers and wraps often contain two estrogen mimickers; bisphenol A and phthalates. Deodorants, perfumes, soaps and other personal care items may have both phthalates and parabens, so start reading labels to reduce your exposure to these endocrine disruptors.
Exercise regularly. Studies of men with prostate cancer who walk more than 90 minutes a week have a 46% lower risk of dying. And those who participate in vigorous activity for at least three hours a week have a 61% lower risk of prostate-related death.
The same goes for women. In the Long Island Breast Cancer Study Project women who exercised the most had about a 30% reduced risk of breast cancer.
Be sure to read the next issue of Advanced Natural Medicine where I'll share my thoughts on other over used medical procedures you may want to think twice about.
To your good health,
David Blyweiss, M.D.
Advanced Natural Medicine Bulletin
 


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