Thursday, 1 November 2012

Settling arguments of breast cancer screening?


So at last we have it the results of the much heralded (in my world at least!) breast screening evidence review. It has been anticipated by the breast cancer community, in the hope that finally this is the one that settles the arguments. So does it? The UK breast cancer charities have looked at the outcome and feel ,yes, this is good news for women. The review has shown that breast screening can save lives-around 1300 a year in the UK, that’s around 130 here in Scotland.
But there are some downsides to screening reported in the review. The data suggests that 1 in 5 of those diagnosed through screening is over diagnosed. So some women are diagnosed and treated for a cancer that is at such an early stage it may not have caused them harm in their lifetimes. The problem is we don’t know at the moment which cancers will grow and become harmful so all women in this situation will be offered treatment.

But let’s not forget that also means 4 in 5 women who have a cancer diagnosed through screening are having treatment for a cancer that will cause them harm if left untreated, and may not have been found without screening.
But I guess a big question is how do women make sense of this report? What do you do if your screening appointment drops through the door this week? It’s vital to read the information to enable you to decide to attend screening –or not-armed with the facts and confident in your decision. In Breakthrough Breast Cancer we will continue to work with governments to get the leaflet as clear as possible and also provide and update the information ourselves to enable  informed choice at all times. And in the future work to ensure research offers us the ability to know which cancers will spread and which won’t ,therefore reducing the risk of over diagnosis. Does it settle the argument? Probably not, but it does move on the debate and offers access to updated information and that has to be a good thing.
At the heart of this debate is what’s at the heart of person centred care. It’s about giving people the right information, asking them the questions that help to explore what is a good outcome for them personally and then supporting them with that decision. Traditional approaches of - doctor knows best -has no place in modern health care.
As medicine becomes even more complex, with an increasing ability to look at individual’s risks, the skills of the healthcare professional need to evolve too. From my personal experience as someone who found making a decision on treatment this time around ,very complex and stressful, I know the value of a team who gave me the information,  tried as far as they could to explain my risk and supported me absolutely to make my own decision.

They also gave me time to make that decision. Often with a cancer diagnosis we panic and think there is no time..that’s not always the case so people should be given the time they need. To be honest sometimes I revisit that decision and think “did I get it right?” But I know it was right at the time and that’s ok. This blog apppears in the Holyrood Journal and the column is called Living with the C Word and the short answer is it is hard to do that at times and the recent controversy can make it harder.

 Some people may well now will feel stressed ,doubting their decisions or having difficulty making a decision that holds their life in the balance. Newspapers should remember that when they chose their headlines….
Reasons to be cheerful! The pup is getting out for walks. So trips to Cramond beach and Inverleith Park are making the transition to winter so much easier. But hello? What has happened to those ears!

4 comments:

  1. So glad you posted this Audrey and appreciate you sharing your perspective. Reading the media reports it can be very confusing when trying to understand the complexities of screening. Marie

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  2. This article was very helpful as there has always been talk about women being over diagnosed (personally i think that this is silly!) I attend regular health screening in cornwall as there is history in my family and I think it is important to be checked regularly.

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  4. Breast cancer mainly happens in women and sometimes also seen in men at breast area of the body. The size, stage, rate of growth, and other characteristics of a breast cancer determine the kinds of treatment. Treatment may include surgery, drugs (hormonal therapy and chemotherapy), radiation and/or immunotherapy.
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