I often write about the false promises of high-tech medicine. Not because I’m against technology. But because I’m against false promises.
For decades, the mainstream promised us the next high-tech breakthroughs were just around the corner. Government researchers made these false promises to garner more research and development funding. And corporate researchers made false promises to inflate stock prices of their often dubious companies.
But the false promises end up hurting the patient. And the whole system.
For example, for decades, the National Cancer Institute and pink ribbon parade promised women that annual mammograms starting at age 40 would save lives. They said early screening works.
But that’s simply not true.
Researchers from Harvard and Dartmouth recently looked at the efficacy of mammograms. The study reviewed cancer registry records from 547 counties across the U.S.
Instead of preventing deaths by uncovering breast tumors at an earlier, more curable stage, mammograms mainly found small tumors that would not have caused any problems if left alone. Plus, they found zero connection between screening rates and mortality.
In other words, mammograms find smaller, harmless cancers–the kind the pink ribbon Komen crowd like to crow about. But more screening doesn’t translate into more lives saved. And “catching it early” is an empty promise.
The situation among women with metastatic breast cancer, the real breast cancer that kills, is even grimmer. Metastatic breast cancer mortality hasn’t budged in 40 years–leading some women to see red about all the pink ribbons. Some have even formed their own advocacy group called MET UP. (I’ll tell you more about this group in an upcoming Daily Dispatch.)
Mammograms don’t reduce mortality for the population as a whole–which is the ultimate goal of any treatment. And for those who put all their faith in the pink ribbon parade’s promises, it’s a major wake-up call.
Fortunately, a new technology called digital breast tomosynthesis (DBT) may provide a more accurate picture of breast tissue than does traditional mammography.
DBT is a three-dimensional x-ray technique. As the name “tomosynthesis” implies, the technique takes multiple images of virtual slices of the breast from different angles. (Tomo comes from Latin, meaning to slice; as in modern Spanish, tomar, to cut.) Then, a computer assembles these virtual “slices” into a three-dimensional picture of the interior of the breast.
In a recent study, researchers screened 7,500 women aged 40 to 74 for breast cancer with DBT. As with any screening technique, there were some false positives. (A false positive result is where cancer is detected as being present, but it’s not really there on further examination.) The rate of false positives leads to risks of additional procedures and complications as well as all the needless worry about having cancer.
Regular mammography has a really high false positive rate of up to 20 percent. And the younger a woman starts getting mammograms, the greater her chances of suffering a false positive. Researchers say further work is needed to determine the false positive rate of the new technique in comparison.
But this new technique already has a few things going for it…
First, DBT is much more comfortable for women, as it requires only half the amount of breast compression. Second, the new technique uses lower amounts of radiation, which reduces one important risk of breast cancer screening.
The reduce risk, decreased discomfort levels, and improved ease of use should encourage women who need the new screenings to get them. As I often say, the best cancer screening techniques are the ones people will actually go out and get.
I also reported on an innovative breast cancer screening called thermography in the June 2015 issue of my Insiders’ Cures newsletter. This largely ignored technique uses no painful mechanical pressure or dangerous radiation. It’s a form of thermal (infrared) imaging, so it doesn’t damage or hurt the sensitive breast tissue as mammograms can.
Mainstream medicine, public health officials, and the radiology devotees should stop wasting time and money defending old, failed traditional mammography–and figure out how to deploy the other available technologies that do work.
I favor medicine that works. In whatever form it comes.
For example, back in 1998, I wrote in the Annals of Internal Medicine about the terminology of “alternative/complementary” medicine. As I said then, there is really no such thing as “alternative medicine.” There is only medicine that works. And what works is good medicine.
My friend and colleague, Dr. George Lundberg, past editor of the Journal of the American Medical Association for 20 years, expanded on this theme about good medicine in the preface to the new, 5th edition of my standard textbook, Fundamentals of Complementary & Alternative Medicine.
Sometimes, a new drug or a new high-tech procedure does actually work better. In my textbook, I tell you about these rare examples. Although, true advances are still all too rare. Especially when you consider how much we spend on health and medicine. Ironically, the elites in power seem to ignore the best, new innovations, as they do with thermography and DBT.
So stay tuned to my Daily Dispatch and my Insiders’ Cures newsletter. I’ll continue to separate the winners from the losers.
- “Breast Cancer Screening, Incidence, and Mortality Across US Counties,” JAMA Intern Med (http://archinte.jamanetwork.com) 7/6/2015
- “Performance of one-view breast tomosynthesis as a stand-alone breast cancer screening modality: results from the Malmö Breast Tomosynthesis Screening Trial, a population-based study,” Eur Radiol. 5/1/2015