Linda and Ella, not so many years ago.
She was never happier than with a baby.
CBC radio broadcasts something called “White Coats, Black
Arts”, which I’ve never heard.
Apparently this program dissects various aspects of medical science, successes
and failures, leaving warts and wrinkles in full view. To me, this approach sounds like a welcome
change from the way it often is done on
U.S. television – you know, Dr. Nancy Snyderman perched across the table from
Brian, solemnly telling us something we already knew, or strongly
suspected. This strikes me as definitely better. Yes, CBC is Canadian. Face it, the Canucks are ahead of us, again.
The star of the show seems to be a Dr. Brian Goldman. Dr. Goldman trained as an ER doc, has written
a book on that subject, and apparently is a popular fixture on Canadian media. In this article he takes on the efficacy of
cancer screening. He lobs us an 80 lb.
medicine ball – a real downer. Here it
is:
In this article he reports on a new study published in the International Journal of Epidemiology and
authored by some people at Stanford - which concludes that, in general,
currently available cancer screening methods simply don’t work.
(It should come as little
surprise that one of the authors is our old friend John Ioannidis – see, for instance: http://ljb-quiltcutie.blogspot.com/2014/04/metrics-scourge-of-sloppy-science.html,
and several other articles mentioned therein.)
To write the blunt truth, after my experience of the last
few years I don’t find this surprising.
Ioannidis
and his crew define “work” as improving the chances of not dying. Some tests do help, but most don’t. Here is a paragraph that summarizes the
problem:
“There are several
possible reasons why these screening tests have performed so poorly.. The
screening test may not detect the cancer early enough to save a life. It
may be that no matter how early the cancer is detected, there is no good early
treatment that cures the cancer. In some cases, there is a treatment but
the risks of the treatment are so great that they cancel out the benefits of
early cancer detection. Or, early detection leads to treatment that cures
the cancer but the patient is more likely to die of other causes not related to
the cancer.” Tell me this isn’t a bummer!
However, Dr. Goldman’s piece does include
some silver lining for this particular dark cloud. Several new prognostic processes are
mentioned, including one currently being tested on ovarian cancer that involves
looking for the presence of a certain abnormal protein in the blood. It also might be useful for other cancers,
including breast cancer. Let us hope!
There’s more good stuff in this short
article; I recommend that you all read it.
And, when I get back to Bellingham, near the Canadian border, I’m going
to see if I can tune in on White Coats, Black Arts. Not much hope, here in Borrego Springs.
B
You can go to the iTunes store and subscribe to the podcast. There are lots of old ones to listen to. (Free.)
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