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Many Women With Breast Cancer Treated Needlessly

One in 3 woman with carcinoma detected by a X ray is treated unnecessarily as a result of screening tests found slow-growing tumors that area unit basically harmless. That’s consistent with a Danish study, revealed in Annals of medical specialty, that has revived dialogue over the worth of early detection.

The study raises the uncomfortable chance that some girls WHO believe their lives were saved by mammograms were truly injured by surgery, radiation and even therapy they didn’t want, said Dr. Otis Brawley, chief medical practitioner of the yankee Cancer Society. He wrote associate degree related to editorial however wasn’t concerned within the study.

Researchers progressively acknowledge that not all breast cancers cause a similar risk, though they appear a similar underneath a magnifier, Brawley same. whereas some early tumors transform deadly monsters, others stop growing or maybe shrink. however presumptuous that every one little breast lesions have the potential to show deadly is reminiscent of “racial identification,” Brawley wrote in his editorial.

“By treating all the cancers that we tend to see, we tend to area unit clearly saving some lives,” Brawley same in associate degree interview. “But we’re conjointly ‘curing’ some girls WHO don’t have to be compelled to be cured.”

Although consultants like Brawley have long mentioned the risks display by overdiagnosis, comparatively few girls WHO bear cancer screenings area unit conscious of the controversy. The yankee school of Radiology, that powerfully supports carcinoma screenings, acknowledges that mammograms lead some girls to be treated unnecessarily, however same the matter is far less common than the new study suggests. Another study from Denmark—where the national health program keeps elaborated records—estimated the overdiagnosis rate at solely two.3 percent. Brawley notes that almost all estimates of overdiagnosis place the speed between fifteen % and twenty five % of breast cancers.

“The quantity of overdiagnosis extremely is little,” said Dr. Debra Monticciolo, chairman of the yankee school of Radiology’s Commission on Breast Imaging. “Articles like this aren’t terribly useful,” she intercalary as a result of they leave girls confused regarding however and whether or not to be screened for carcinoma.

But treating girls for willcer unnecessarily can endanger their health, same Fran Visco, president of the National carcinoma Coalition, associate degree support cluster. Radiation will injury the guts or maybe cause new cancers. Visco notes that carcinoma activist Carolina Hinestrosa, a vp at the coalition, died at age fifty from soft-tissue cancer, a tumour caused by radiation accustomed treat early carcinoma. girls ought to perceive these risks, Visco said. Instead, girls typically hear solely regarding mammograms’ advantages. “Women are inundated with the early-detection message for many years,” she said.

The risks of overdiagnosis and false positives, which may lead girls with benign growths to bear biopsies and alternative follow-up tests, have caused some consultants to re-evaluate carcinoma screenings. though mammograms don’t realize all tumors, they scale back the chance of dying from carcinoma by twenty five % to thirty one % for ladies ages forty to sixty nine, consistent with the Agency for health care analysis and Quality, a part of the Department of Health and Human Services.

Medical teams currently provide differing recommendation on mammograms. The yankee school of Radiology takes the foremost aggressive stance, recommending annual mammograms starting at age forty. Tumors ought to be found once they’re “smaller and easier to treat,” Monticciolo same.

The U.S. Preventive Services Task Force, associate degree freelance skilled panel that advises the centralized on health, angry a firestorm of criticism in 2009 once it bucked that recommendation, recommending that girls get mammograms each alternative year starting at age fifty. The cluster noted that carcinoma risk rises with age, thus mammograms area unit additional possible to get cancer—as hostile benign growths—after age fifty.

The yankee Cancer Society conjointly scaled back its screening recommendation, recommending in 2015 that girls get annual mammograms from forty five to fifty four, followed by screenings each alternative year subsequently.

In the new study, Danish researchers calculable the speed of overdiagnosis by comparison the amount of early-stage and advanced breast tumors before and once the country started giving mammograms. If screenings work as supposed, the amount of little, curable breast tumors ought to increase, whereas reducing {the number|the quantity|the quantity} of huge cancers by regarding a similar amount.

Although mammograms in Danmark detected a great deal additional breast cancers, these were largely little, early-stage tumors, same study author Dr. Karsten Jorgensen, a man of science at the Nordic Cochrane Center in Danish capital, Denmark. the amount of advanced cancers didn’t fall.

The debate regarding overdiagnosis illustrates the boundaries of medical technology, Brawley same. though researchers will estimate the applied mathematics rate of overdiagnosis, doctors treating actual patients can’t definitively tell that breast tumors want treatment and which could be safely unnoticed, Brawley same. thus doctors tend to err on the facet of caution and treat all breast cancers with surgery and, in several cases, radiation and therapy.

An calculable 253,000 new cases of carcinoma are going to be diagnosed in U.S. girls this year, with nearly forty one,000 deaths, consistent with the yankee Cancer Society.

An additional sixty three,000 girls are going to be diagnosed with ductal malignant neoplastic disease in place, conjointly referred to as DCIS, that has some, however not all, of the standard traits of cancer. though DCIS cells have modified to seem malignant underneath the magnifier, they haven’t invaded close tissue.

The yankee Cancer Society defines DCIS because the earliest stage of carcinoma, {and girls|and ladies|and girls} with the condition usually bear a similar treatment given to women with early invasive cancers. though DCIS isn’t dangerous, doctors advocate treating it to stop it from turning into invasive.

Other consultants note that DCIS carries such low risk that it ought to be thought-about simply a risk issue for cancer. Researchers area unit conducting studies to live whether or not it’s safe to cut back the treatment of DCIS. however it’s unclear whether or not girls can get clear answers on screening and DCIS any time within the close to future. within the meanwhile, they and their doctors should build tough decisions while not knowing obviously whether or not it’s the proper factor to try and do.

This story was written for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation.

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THINGS YOU NEED TO KNOW ABOUT HEART DISEASE

For decades, doctors have concentrated on the “big five” causes of heart disease: elevated cholesterol, high blood pressure, diabetes, obesity, and smoking. But that is only part of the whole picture. Here are eight important things about heart disease you need to know right now

HEALTHY ARTERIES, HEALTHY HEART

Ideally, your arteries should be flexible, with a smooth, undamaged endothelium, a single layer of cells that line the inner surface of your arteries. When healthy, your arteries allow the oxygen and nutrient-rich blood to flow freely.

But over time, the effects of heredity, unhealthy habits, and simply growing older can damage arteries. When arteries become damaged— a condition called arteriosclerosis—blood flow can eventually be hindered or even completely blocked. Calcification can also cause damage to your arteries.

If you’re over the age of 60, you likely have deposits of calcium in your major arteries. As the calcium builds up, it can harden and reduce blood flow. Studies have found that arterial calcification may set you up for other cardiovascular problems, including high blood pressure, aortic stenosis (where the heart’s aortic valve narrows), cardiac hypertrophy (thickening of the heart muscle), and congestive heart failure.

TOO MUCH INFLAMMATION

The main culprit in heart disease is inflammation—it’s thought to be the root cause. Slight injuries to the vascular wall become inflamed, trapping oxidized cholesterol particles and other nasty compounds.

Free radicals create more damage, and inflammatory chemicals create more inflammation. Eventually, connections between cells in the artery walls loosen, making it easier for foreign substances to get stuck there.

Before you know it, you’ve got a “toxic brew” that can form into plaque. In fact, many health professionals now believe that any benefit that statin drugs may have is because they slightly lower inflammation, not because they lower cholesterol. And speaking of inflammation …

SUGAR: FOOD

ENEMY NO. 1 Sugar is a far greater danger to your heart than fat.

Sugar directly contributes to inflammation in the artery walls, and  foods that convert quickly to sugar in the body, such as cereals, breads, pasta, rice, and potatoes—drive up insulin, which tells your body to store fat and raises blood pressure.

High-carb, high-sugar diets also raise triglycerides, a fat found in the bloodstream that’s a serious risk factor for heart disease. “When sugar consumption rises, HDL decreases, and triglycerides increase,” says Mark Houston, MD, author of What Your Doctor May Not Tell You About Heart Disease. The most heart-healthy diets contain very little sugar.

SLEEP DOES A HEART GOOD

Sleep is essential for cardiovascular health. Studies show that the risk of a heart attack goes up significantly in those logging fewer than six hours—or, interestingly, more than nine hours—a night. The sweet spot? Seven to eight hours of shut-eye each and every night.

STRESS MATTERS

Seriously. Emotional stress produces hormones and biochemical activity that contributes to inflammation. In some cases, stress can precipitate a heart attack or cause sudden death, even in the absence of any clear risk factors and in the presence of relatively healthy arteries.

Stress weakens the immune system while raising blood pressure and heart rate. “The mind and body are not separate entities, but rather different aspects of a single unit,” says Houston.

MORE OMEGA-3s

Omega-3s are your heart’s best friend. They’re the “parent molecules” for many of the anti-inflammatory chemicals your body makes, while omega-6s (vegetable oils) are the parent molecules for our inflammatory chemicals. These anti- and pro-inflammatory chemicals are called thromboxanes, leukotrienes, and prostaglandins. We actually need both omega-3s and omega-6s, but we need them to be in balance.

A 1:1 ratio is ideal, but typical American diets are stacked 16:1 in favor of pro-inflammatory omega-6s, meaning that we’re Omega-3s are found in a variety of foods. The best sources include fish, grass-fed meat, flaxseeds/flaxseed oil, walnuts, seaweed, hemp seeds, chia seeds, and soybeans. Studies show that people who eat fish at least twice a week have a 30 percent lower risk of cardiovascular disease than those who rarely eat fish.

Look for low-mercury varieties such as wildcaught or Pacific salmon, sardines, anchovies, rainbow trout, and haddock. To find a list of sustainable seafood where you live, visit Seafoodwatch.com—they have a great “Consumer Guides” section, which includes information on the best/worst seafood choices.

TESTING, TESTING

Get the right tests. Besides the cholesterol particle test, several other tests can give you useful information about your risk for heart

disease. Chief among them is the HS-CRP test (high sensitivity C-reactive protein), a measure of inflammation in the body. CRP is a potent predictor of future cardiovascular health—high levels are associated with infections, high blood sugar, and excess weight.

Houston likes to see a CRP reading of under 2, while The Great Cholesterol Myth coauthor, Stephen Sinatra, MD, goes even further.

He likes to see a CRP reading of 1.0 or less. The point is, the lower the better. homocysteine causes your body to lay down sticky platelets in blood vessels. Some homocysteine is normal, but an excess can affect cardiovascular health. Homocysteine contributes to atherosclerosis (accumulation of plaque in arteries), reduces the flexibility of blood vessels, and slows blood flow.

“Too much homocysteine alters the environment inside the arteries and sets the stage for arterial disease,” says Houston. Homocysteine should ideally be under 10 and should not go above 12.

Other tests that give valuable information about artery health include interleukin-6 (an inflammatory

compound that stimulates the liver to produce CRP), and a carotid intima medial thickness test (CIMT), which uses ultrasound to measure the thickness of the

carotid arteries. “Thickening of the carotid arteries has been shown to be a strong indicator of cardiovascular disease and atherosclerosis,” says Houston.