The political brouhaha that followed the new guidelines on mammograms has now died down, maybe enough so that patients can start to absorb the quiet truth about breast cancer and the role of mammogram screening. The National Breast Cancer Coalition has worked since 1991 to get Congress to fund research and appropriate treatment for this….
Continue ReadingTesting
Mammograms: Understanding the Risks and Benefits
The new breast cancer screening guidelines demonstrate yet again why savvy patients need to understand the numbers behind risk/benefit studies before making the very personal decision about whether and how often to get a cancer screening test. The recommendations of the U.S. Preventive Services Task Force that women hold off on routine mammograms until age….
Continue ReadingA True Story of Why We Need Report Cards on Doctors
I took a deposition a few days ago that underlined for me why we need to have public report cards on primary care doctors so that patients can separate the mediocre practitioners from the really good ones. I wrote an article explaining the idea. Read my entire piece on Huffington Post, which I called “One….
Continue ReadingBroken Alarms and False Alarms in Medical Testing — the Swine Flu Problem
Swine flu testing is the latest example of an important issue for informed patients. Patients need to understand that some medical tests are valuable if there is a “positive” finding, but not much good at all if they are “negative.” The problem is that the test is “insensitive,” which means a negative result can miss….
Continue ReadingBreast Cancer Screening: A Provocative Balance Sheet
Imagine if every 50-year-old woman thinking about whether to have a mammogram received the following “balance sheet” showing the “credits” and “debits” as understood by the latest research: For every 1,000 women who have a yearly mammogram over the next ten years: Credits 1 woman will avoid dying from breast cancer Debits 2-10 women will….
Continue ReadingCancer Screening: Not All It’s Cracked Up to Be
Everyone has seen the ads: for cancer of the breast, prostate, colon and now thyroid cancer — urging Americans to get a test to see if they have cancer and can get early life-saving treatment. The new thyroid campaign says: “Don’t forget to check your neck.” However, it’s a rare disease that kills about 1,600….
Continue ReadingMore Evidence for a Good Health Habit: Reading Your Medical Record
Evidence continues to pile up for why patients need to read their own medical records. A new study finds it is distressingly common for primary care practices, especially big ones, to fail to inform patients about abnormal test results. The study was published in the Archives of Internal Medicine and was reported by Nicholas Bakalar….
Continue ReadingTest for Early Detection of Ovarian Cancer Relapse Doesn’t Help Prolong Life
The received wisdom of cancer treatment in the United States is that early detection and early treatment save lives. But this is not always true with some types of cancer. Sometimes the early detection of a cancer just means the patient lives longer with the knowledge of having cancer, but their life span is the….
Continue ReadingShould Pregnant Women Have a Thyroid Test?
If you are pregnant and experiencing fatigue, dry skin, sleep loss, or weight loss, it may be worthwhile to find out whether you are a candidate for a thyroid test – these symptoms, while common in pregnant women, may be caused by underactivity (hypothyroidism) or overactivity (hyperthyroidism) of the thyroid gland. If untreated during pregnancy,….
Continue ReadingMammogram Benefits Exaggerated?
Widely hailed for saving lives through early detection of breast cancer, mammography may in fact “do more harm than good,” writes Roni Rabin of the New York Times. Rabin reports that British health care advocates and experts complained in a letter to The Times of London that candidates for mammography receive informational fliers that exaggerate….
Continue Reading