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Day 5 – Questioning the medicine

April 6, 2013

In my Day 4 post I mentioned that it bugged me (raised alarm bells actually)  me that I might need to have a major operation for something that was caledl pre-cancerous.

I’ve been thinking some more about this as the nagging thought that this seems extreme hasn’t gone away. I did some research today on the web, trying to find some fact based answers to some of my questions:

  • What’s the risk of developing cancer if DCIS is left untreated?
  • What’s the time to development if cancer does ensue
  • Why perform a masectomy if the calcification is non-invasive, and not guaranteed to lead to cancer?

I’ve come across varying conflicting information about DCIS.What is frustrating is trying to find factual information based on statistical studies etc. It’s all very well sites quoting % risk rates, but very few back it up by providing the source of that statistic. For example one site reports a 10-25% risk rate of developing cancer if DCIS is not treated. But no source information is provided. Where does this figure come from? I couldn’t even find verifiable factual information on government health sites. They talk about the rate of reocurrence following treatment, but not the risk of actually developing cancer in the first place.

Well, why avoid the risk of getting cancer at all you might say? If there was clear evidence that having DCIS results in a high risk of actually developing cancer I would concurr. But in trying to find out this simple bit of information I’m finding myself questioning the established approach to treatment as I’m finding few facts to support this.  This has been compounded by some seemingly reliable information I have found.

The only statistic I could find regarding the risk of cancer development with DCIS is in an article on the website   healthy.net. They write:

In the hard-hitting article ‘Epidemiology versus scare-mongering’, UK cancer expert Professor Michael Baum attacked health professionals for scaring women into unnecessary treatment. Baum has 30 years of experience as a breast-cancer surgeon at the Royal Free Hospital and, in his view, if left untreated, as many as 80 per cent of all DCIS cases will never become cancerous (Breast J, 2000; 6: 331-4).

This is backed up by American research aimed at quantifying the true risks of DCIS. Cancer statistician Dr Virginia Ernster, at the University of California at San Francisco, looked back over the death statistics of about 7000 women who had been diagnosed with DCIS, both before and after screening had become widespread. She found that, before the advent of screening, only 3.4 per cent of the women died of breast cancer, with the figure dropping to 1.8 per cent after its introduction. In either case, the ‘risk of death was low’, commented Dr Ernster (Arch Intern Med, 2000; 160: 953-8).[1]

And the Journal of the National Cancer Institute has a  very interesting article about DCIS. Although the general conclusion seems to be that DCIS will lead to cancer (again no real % risk rate is given) the article says:

The clinical relevance of a diagnosis of DCIS is uncertain. Although DCIS is a benign disease, women with DCIS have an increased propensity to develop invasive disease, and so therapy for DCIS is ultimately therapy for the prevention of invasive cancer. Unfortunately, the natural history of DCIS and the likelihood that DCIS will progress to invasive disease is unclear; consequently, the risk–benefit ratio of instituting potentially toxic therapy to treat DCIS needs to be considered carefully…At present, management of DCIS remains controversial, as is reflected in the various treatment options offered to patients.[2]

Links to both these sources are given under ‘References’ below so you can check them out and make up your own mind – I think they make for extremely interesting reading.

This interview with Michael Baum, also gives food for thought. Haven’t done any research on it, but if what he says is true, it’s pretty worrying.

 

 

References

[1] What doctors don’t tell you (n.d), ‘Special Report: Breast Cancer When It’s Not Cancer At All‘ [online], available at http://www.healthy.net/Health/Article/Special_Report_Breast_Cancer_When_Its_Not_Cancer_at_All/2661/4

[2] Leonard G, Swain S, (2004), ‘Ductal Carcinoma in Situ: Complexities and Challenges‘ [online] , JNCI, vol.96, no. 12, pp906-920, available at http://jnci.oxfordjournals.org/content/96/12/906.full

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One Comment
  1. I don’t think it should be treated and I have been studying this for years now, since my mother’s dx in 2002. The treatment is nutrition and toxin removal.I am a Medical Anthropologist and bra removal can resolve this issue. Bras are a tourniquet on the lymph system, this is your cellular sewer system and if you allow it to work without creating a dam with a bra many breast issues naturally resolve. Bras turn your breasts into stagnant cess pools that are a happy breeding ground for cancer, toxins stay in and oxygen stays out.

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