November 7, 2002 (Ira Pilgrim)
There is no test and never will be a test that can predict, for a chronic disease like cancer, that the patient will die of the disease on a certain date or will always be cured by treatment "X". The complexity of the tumor/host conflict preclude such accurate predictions. We are fortunate that our predictions work as well as they do.
Donald F. Gleason, 1992
October is over and I'm glad. Whoever decided that October was Breast Cancer Awareness Month was probably a radiologist. Breast Cancer Awareness Month was a continuous series of commercials for mammography.
A breast cancer awareness month is one thing that the country doesn't need. As it is, many women are terrified that they might get breast cancer and die of it. Most people know someone who has died of breast cancer. Being terrified is something that no one needs. What is needed is a genuine awareness of what causes breast cancer, how to detect it and how it can be treated. Every woman should know that, within limits, the sooner a woman with breast cancer gets treatment, the better her chances of a cure. When I say "within limits," what I mean is that the best study to date indicates that a competent breast examination is as good, and probably better than a mammogram. It can pick up some cancers that are not detected by mammography. While a mammogram can pick up a cancer sooner than an examination, doing so doesn't lead to fewer deaths.
There is no question in my mind that mammography by itself is no substitute for a competent examination. A local radiology laboratory has been offering mammograms at reduced rates. If it does not include a competent breast examination, it is no bargain. (For more information, go to www.mcn.org/c/irapilgrim/brca01.html)
Not once in the time that I have watched TV, listened to the radio or read the newspaper, has it been mentioned that x-rays can cause breast cancer. There is ample evidence that x-rays and gamma rays can, and do, cause breast cancer. Mammograms are made using x-rays. Not only are they x-rays, but they are soft tissue x-ray, which means that more x-ray is absorbed with a mammogram than with an x-ray of teeth or a fractured bone. Therefore, mammography can cause breast cancer.
In the early days of mammography, I mentioned to a radiologist that x-ray can cause breast cancer. His reply was, "So what? If we detect it early, we can cure it." Having had breast cancer, I can testify that curing breast cancer is hardly a substitute for never having it. If that radiologist had had the surgery, as I have, he might have changed his mind.
This month is National Diabetes Month. I don't know what next month will be. Maybe it will be National Hemorrhoid Month.
What is the purpose of these campaigns? I suspect that their purpose is the same as any other commercial campaign: MONEY.
And where will the money go? The breast cancer money will mostly go to the American Cancer Society and the diabetes money to the National Diabetes Association. And what will they do with that money, aside from paying their executives? Damned if I know! I assume that enough will go to research so that they can say that that they are supporting research. However, most of the money for cancer research comes from the National Cancer Institute. And where does the National Cancer Institute get its money? From the people who pay federal taxes. In other words, if you pay taxes, you are supporting cancer research as well as research on a large number of other diseases.