April 19, 2002 (Ira Pilgrim)
Those responsible for telling the public about cancer have chosen to use the weapon of fear. They have portrayed cancer as an insidious, dreadful, relentless invader. With religious fervor they have fashioned a devil out of cancer. They have bred in a sensitive public a fear that is approaching hysteria. They have created a new disease, cancerphobia, a contagious disease that spreads from mouth to ear. It is possible that today cancerphobia causes more suffering than cancer itself.
George Crile, 1955
Surgeon George Crile cited a case of a patient of his who was believed to have had a stroke. Some nodules were found in his thyroid and a test was done to rule out the remote possibility of thyroid cancer. When a relative was told that the test for thyroid cancer was negative, he said "Thank God it isn't cancer." Crile points out that, if it was thyroid cancer, it would have been easily curable, whereas the stroke was not.
Several years ago, at a seminar on mammography, I heard tell of a woman who went to a number of radiology labs and had mammograms at all of them. She believed that the likelihood of a mistake was lowered by using a number of x-ray labs and radiologists. She was, of course, right. The problem is that the more mammograms she got, the greater the likelihood that she might get breast cancer from the X-rays.
For most people, some fear of cancer can do them some good. A person who quits tobacco, or one who never starts, has done something substantial toward prolonging his life. It not only lowers the likelihood of lung cancer, but the likelihood of emphysema and heart attack. But the fear itself can be painful.
For a woman, regular breast examinations and self-examinations increases the likelihood that, if she gets breast cancer it would be discovered while it is curable. A man who checks his testicles may do the same thing with regard to testicular cancer.
At the turn of the century few doctors did a vaginal examination on women. As a consequence, cervical cancer was major killer. The success in greatly reducing deaths from cervical cancer can be attributed to regular vaginal examinations and Pap smears. What is done is to remove suspicious lesions before they turn into cancer.
Prostate cancer is very common in old men, but the majority of them do not spread. Many physicians believe that in very old men, the treatment can be worse than the cancer. There is a blood test that indicates how much either cancer or non-cancerous prostate tissue is present in the body. A high PSA(prostate specific antigen) is a good reason to take a closer look(a biopsy); it may or may not be cancer. A man with a very large, but not cancerous, prostate can have a very high PSA. A high PSA is not something to lose sleep over. There has been much talk about a mass screening program. There wasn't much enthusiasm over it because many physicians believed that it would cause more suffering than it would do good.
As a person grows older, the probability of getting cancer increases. So does the probability of heart attack or stroke. Twice as many people die of heart attacks as do from cancer, yet few people run around in terror at that possibility.
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