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The threat of cancer -- a war of nerves
© St. Petersburg Times Last week it happened again. Let's call it the Conversation, a dialogue between two women that, at least at a certain age, has become part of our daily lives. The Conversation can take place anywhere -- at lunch, at the gym, across a conference table when both client and professional are women. A friend tells you she has had a bad mammogram. Something was found that shouldn't be there. It could be nothing. It could be cancer. Of course she fears it's cancer. She has been told to have it taken out, surgically excised and biopsied, but beyond that she doesn't have a clue. And, in the meantime, how is she supposed to stand it until she knows how bad it is? Finding the right surgeon, getting an appointment, the delay time between examination and surgery, and then the wait for the lab report take forever. In reality, probably weeks. Most of us lose those weeks to a half-life of terror. When it happened to me, the first night I woke up in a cold sweat, the vision of my daughter in a resplendent white gown walking down the aisle with no mother at her wedding. Actually, in a case like mine -- a woman in her 50s who has had regular, normal mammograms since she was 40 -- seven out of 10 biopsies are benign. And, in this same group, a first questionable mammogram not yet followed up with more mammography and ultrasound, 94 percent will turn up normal or benign. Those are very good odds. Mine was benign. You can hardly see the scar. Still, when it's you, numbers don't mean much. And even with a perfect outcome, this is not a process any of us would choose to go through again. Now, new studies in Denmark and Canada tell us that mammograms are, well, useless -- or worse. Gina Kolata has written about it for the New York Times. A Danish scientist concluded that mammograms do not decrease the risk of dying from breast cancer or the probability of having a mastectomy. Further, early detection could lead to debilitating, life-threatening treatments that may not be necessary. So what's a woman to do? It's bad enough having the mammogram (not for me, but some friends liken it to medieval torture), the follow-up, the surgery and the scare. Now we have to worry about whether we're doing the right thing at all. The American Cancer Society and the National Cancer Institute urge mammograms. Radiologists say we need them despite false negatives. They're like smoke alarms, one radiologist explained. You want it to go off every time you burn something, not just when the house is burning down. Another pointed out that cancers and benign lumps can start out looking exactly alike, so all need to be followed. Not to worry, we're not going to stop having mammograms, because we're scared. Inordinately so, an internist once told me, when so many other things actually kill us. Only 1 to 3 percent of women die from breast cancer. But I don't know anyone with heart disease! I responded. I know plenty of women with breast cancer. My college roommate. A friend who bravely underwent a life-threatening stem cell transplant. The college professor at the gym who could lift up her arm just a week after surgery on her lymph nodes. The wife of my husband's college roommate, who is now going through radiation after a lumpectomy. A colleague, struck with a virulent form of breast cancer when she was pregnant with her second child, and who died while he was still a baby. There are more. You have your own list. - Sandra Thompson is a writer living in Tampa. She can be reached at tampa@sptimes.com. City Life appears on Saturday.
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Times columns today Lucy Morgan Gary Shelton Sandra Thompson From the Times Metro desk Sandra Thompson |
