Comments on: Sitting on the Other Side of the Table

By: JCK

JCK — Wed, 16 Dec 2009 05:52:35 +0000

I am sending good thoughts and prayers to your friend. And grateful that you survived and can write so passionately and honestly about your experience.

It is confusing – this new study out, about doing mammograms at 50 and over rather than 40.

By: ruthpennebaker

ruthpennebaker — Mon, 14 Dec 2009 20:12:17 +0000

Susan — I don’t entirely disagree with what you say about a positive attitude, but do think cancer survivors — especially women — are already under entirely too much pressure to be optimistic. I think it’s healthier and more realistic to feel what you really feel, which will include anger and other darker emotions, instead of faking what will please everyone else or make their lives easier. Which is where support groups can be quite helpful. Sometimes, I felt no one but other cancer survivors understood me.

By: Susan Remson

Susan Remson — Mon, 14 Dec 2009 16:29:38 +0000

If you haven’t already seen Barbara Ehrenreich’s latest book “Bright Sided: How the Relentless Promotion of Postive Thinking has Undermined America” you should. One of her chapters deals with this issue. Ehrenreich had breast cancer and she writes about her response to those who told her she shouldn’t be angry and needed to “just think postive and you’ll get better.” Your comment about “rah-rah” attitudes and pink ribbons is right on – although even for me, a skeptic at heart, there does need to be some of that postive attitude. Even if it doens’t cure you, it sure makes it easier for you and those who are trying to support you during a difficult time. Of course, I would also like to see better detection methods, with fewer false postives. As someone who used to work in breast cancer research, I know we can do better.

By: M A

M A — Sun, 13 Dec 2009 04:14:45 +0000

Amen to the part about diabetes…

By: Alisa Bowman

Alisa Bowman — Fri, 11 Dec 2009 00:09:58 +0000

I think the fear of going under is partially about death but also about losing control. I have an allergy to many things, so I also have a fear of being allergic to the anesthesia and no one noticing. And there are always those horror stories you hear about people going in to have an ingrown toenail removed and waking up to learn that someone has amputated their arm. So those fears tend to haunt me, too.
I have found that I am more comfortable with the idea of death now than I’ve ever been. But I have a horrific fear of leaving my daughter motherless. That scares me more than the idea of not being here.

By: Tessa

Tessa — Thu, 10 Dec 2009 22:30:05 +0000

Here in Ontario. mammograms are provided free to women over 40 every two years. Because I’m taking part in a cancer prevention drug trial, I’m given a mammogram every year. Never having had breast cancer, I’m utterly bitched and bewildered by all the conflicting advice on mammograms versus BSE. Because I have dense, lumpy breasts, I never really mastered BSE and gave up trying years ago. Hopefully my husband will let me know if he notices anything different.
I hope your friend comes through, Ruth. Your experience, as much as your friendship, may give her some comfort when she’s looking around, as you did, for signs of what might be ahead of her.

By: Cindy A

Cindy A — Thu, 10 Dec 2009 18:05:55 +0000

As an American Cancer Society employee and a woman who had a stressful false positive on a mammogram this year, I feel compelled to pass this along from Cancer Update, a publication for lawmakers that I manage.

American Cancer Society Stands By Mammography at Age 40
In November, the United States Preventive Services Task Force (USPSTF) announced that it no longer recommends routine screening for women between the ages of 40 and 49. Because so many women are diagnosed with breast cancer in their forties, this stance caused a firestorm of controversy.

“With its new recommendations, the USPSTF is essentially telling women that mammography at age 40 to 49 saves lives—just not enough of them,” said Otis W. Brawley, MD, Chief Medical Officer for the American Cancer Society.

“The American Cancer Society’s medical staff and volunteer experts overwhelmingly believe that the benefits of screening women aged 40 to 49 outweigh its limitations,” said Dr. Brawley. “Our experts make this recommendation having reviewed virtually all the same data reviewed by the USPSTF, but also additional data that the USPSTF did not consider.”

Like the USPSTF, American Cancer Society experts found that mammography has limitations—some who are screened have false alarms, some cancers are missed, and some undergo unnecessary treatment—and these occur more often for women in their forties when compared to older women. Despite these limitations, the Society recognizes the lives saved and recommends mammography to start at age 40.

“As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: this is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member,” said Dr. Brawley.

The USPSTF reports that screening 1,339 women in their 50s to save one life makes screening worthwhile in that age group. Yet USPSTF also reports that screening 1,904 women ages 40 to 49 in order to save one life is not worthwhile. The American Cancer Society believes that in both cases, the lifesaving benefits of screening outweigh any potential harms.

Approximately 17 percent of breast cancer deaths occur in women who are diagnosed in their 40s and 22 percent occur in women diagnosed in their 50s.

By: Joyce

Joyce — Thu, 10 Dec 2009 15:23:44 +0000

Awfully glad you’re still here, chica. And I’m keeping Deanna in my thoughts and prayers. I’m counting on that pioneer stock to pull her through this scary time.

By: Meredith Resnick - The Writer's [Inner] Journey

Meredith Resnick - The Writer's [Inner] Journey — Thu, 10 Dec 2009 06:00:59 +0000

This post was very moving to me. I really -got- how you were there, really there, in the moment with your friend. Though the details may be different, many many women can and will relate.

By: Duchess

Duchess — Thu, 10 Dec 2009 05:10:11 +0000

Those recommendations are based on studies from the “new” field of “evidence based health care”. Mammograms 3 yearly after the age of 50 and none before are what is offered in England under the National Health Service. I always thought it was a cost saving measure and was interested to find that it might instead be good clinical practice.

Meanwhile, as the controversy raged, I heard someone interviewed on NPR saying it was “going to be very difficult to get Americans to accept evidence based health care”. And I wondered why anyone would not want their health care to be evidence based.

That’s what I want my care based on. But I want to be pretty sure no one is doctoring (as it were) the evidence for either political or fiscal reasons. Just the evidence, please. Then we can decide whether the screening is worth the cost — in false complacency, overtreated cancers, or scarce resources. Those are different debates.

Maybe the evidence, like the disease, is too complicated. But it is good to ask the questions.