‘Breast Cancer Screening -Better without mammograms?’

“Conclusions: The Dutch mammography screening programme seems to have little impact on the burden of advanced breast cancers, which suggests a marginal effect on breast cancer mortality. About half of screen detected breast cancers would represent over-diagnosis.”

Here is yet more evidence that more female citizens continue to be overdiagnosed (and overtreated) due to breast screening. Why is this allowed to continue if deaths related to over-diagnosed and over-treated cases exceed the number of deaths from breast cancer avoided by screening?

Breast Cancer Screening – Better without mammograms? Mette Kalager, BMJ Editorial.

BMJ 2017;359:j5625

http://www.bmj.com/content/359/bmj.j5224

Rapid response from Hazel Thornton, Honorary Visiting Fellow, Department of Health Sciences

http://www.bmj.com/content/359/bmj.j5625/rr-1

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Posted in Breast Cancer, breast screening, Campaigns, cancer, citizen safety, Compassion in healthcare, death, dying, harms, healthcare modernisation, informed consent, medicine's flaws, Over-medicalisation, overdiagnosis, overtreatment, personal autonomy, Public safety, Screening, Screening Mammography | Tagged , , , | Leave a comment

The ‘cancer drugs scandal’: decision-making and the need to involve patients at every level

When will there be the level of user involvement in healthcare necessary to ensure patients get the information they need to make the decisions they want? ‘Nothing about us without us’: patients need the opportunity to be included in multidisciplinary team meetings – a concept that has been trialled successfully in other countries.

Tessa Richards’ essay flags up issues that need resolving, rather than ignoring. Patients’ views and needs can transform healthcare. Patients are patient no more – the excuses are falling on deaf ears and it’s time for change. It all begins with respect – respecting patients as people.

The responses to the “cancer drugs scandal” must fully involve patients – an essay by Tessa Richards. BMJ 2017;359:j4956

http://www.bmj.com/content/359/bmj.j4956utm_medium=email&utm_campaign_name=201711307&utm_source=etoc_weekly

1 Blennerhassett M. What cancer patient need. In: Baker MR (ed.) Modernising Cancer services. Oxford: radcliffe Medical press; 2002, p.158.

2 Nothing Personal, disturbing undercurrents in cancer care, Winn, Medical Journalists’ Association Open Book Award 2009. Radcliffe Medical Press, 2008.

Posted in Campaigns, cancer, cancer drugs, citizen safety, clinical trials, Compassion in healthcare, diagnoses, dignity in dying, dying, healthcare modernisation, information, informed consent, medicine's flaws, multidisciplinary team meetings (MTDs), openness, Over-medicalisation, overdiagnosis, overtreatment, palliative care, patient safety, patient/doctor communication, patient/public involvement, personal autonomy, Public safety, rarer and uncommon cancers, speaking out | Tagged , , , , , | Leave a comment

New cancer drugs, survival, and quality of life –

A retrospective cohort study in the bmj to determine the availability of data on overall survival and quality of life benefits of cancer drugs approved in Europe concluded that

‘…most drugs entered the market without evidence of benefit on survival or quality of life…’ and ‘when there were survival gains over existing treatment options or placebo, they were often marginal’

“Availability of evidence of benefits on overall survival and quality of life of cancer drugs approved by European Medicines Agency: retrospective cohort study of drug approvals 2009-13”. Courtney Davis et al.

http://www.bmj.com/content/359/bmj.j4530

BMJ 2017;359:j4530

Editorial: http://www.bmj.com/content/359/bmj.j4528

Posted in Uncategorized | 1 Comment

Breast cancer screening – short video explains reality

TIME FOR HONESTY – This short video presents the true picture of breast screening programmes in a very easy to understand format. How shocking that this harmful ‘industry’ is allowed to continue (NHS BSP) and the age limit extended at both ends (due to massive charity pressures on parliament) – and the extension used as ‘the biggest randomissed controlled trial in the world’. How many women realise that – or what they are voluntarily subjecting their bodies to…all without full information or written consent? With GPs being paid to encourage women to attend breast screening…Sisters – spread the word if you value your breasts: Click on the gear wheel below the video for optional language subtitles: (or here’s the direct english link: https://www.youtube.com/watch?v=WokeeihfCnw)

Posted in biopsies, Breast Cancer, breast screening, Campaigns, cancer, citizen safety, clinical trials, Compassion in healthcare, harms, HCAIs, healthcare modernisation, information, informed consent, mastectomy, medicine's flaws, Over-medicalisation, overdiagnosis, overtreatment, patient safety, patient/doctor communication, Primary care, Public safety, Screening, Screening Mammography, speaking out, Uncategorized, video | Tagged , , , , , , | 5 Comments

Diagnostic shades of grey

How many patients (and doctors) are unaware of the range of variability in diagnoses that can derive from the same pathology sample? How much accepted ‘certainty’ is, in fact, ‘uncertain’? Read on, and you may never want to accept a diagnosis without getting a second opinion – or a third.

When Diagnostic Uncertainty Hits Home. Joann Elmore. BMJ Opinion, 28 June 2017.

http://blogs.bmj.com/bmj/2017/06/28/joann-elmore-when-diagnostic-uncertainty-hits-home/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+bmj%2Fblogs+%28Latest+BMJ+blogs%29&g=w_bmj-com

The article includes some useful links eg http://www.nejm.org/doi/full/10.1056/NEJM199412013312206

‘Variability in Radiologists’ Interpretations of Mammograms. Joann G. Elmore, Carolyn K. Wells, Carol H. Lee, Debra H. Howard, and Alvan R. Feinstein

N Engl J Med 1994; 331:1493-1499 December 1, 1994 – which calls for efforts to improve accuracy and reduce variability in interpretations of mammography.

Posted in biopsies, Breast Cancer, breast screening, Campaigns, cancer, citizen safety, diagnoses, harms, healthcare modernisation, information, medicine's flaws, Over-medicalisation, overdiagnosis, patient safety, patient/doctor communication, Public safety, Screening, Screening Mammography | Tagged , , , | Leave a comment

GP Payments

In my rapid response to this BMJ article I should have mentioned GP payments that were given for not referring patients. Does anyone else have the sense that there are also cut-off points for referral, diagnostic investigations or treatments at say age 75? Or above? That’s certainly the impression I’m getting from friends and colleagues.

Prescribing incentives feel grubby because they are. Margaret McCartney. BMJ 2017;357:j2695

http://www.bmj.com/content/357/bmj.j2695?

Posted in Campaigns, citizen safety, Compassion in healthcare, harms, healthcare modernisation, medicine's flaws, patient safety, Public safety, Uncategorized | 3 Comments

Are wealthier people at extra risk of harm?

In this New England Journal of Medicine paper, Welch and colleagues discuss whether wealthier people receive too much care – ie more than is good for them. “Excessive testing of low-risk people produces real harm, leading to treatments that have no benefit (because there is nothing to fix) but can nonetheless result in medication side effects, surgical complications, and occasionally even death.’

Income and Cancer Overdiagnosis – When Too Much Care is Harmful. H Gilbert Welch, Elliott S Fisher. N Engl J Med 376;23, 2208-2209. June 8 2017. http://www.nejm.org/doi/pdf/10.1056/NEJMp1615069

 

Posted in Campaigns, cancer, citizen safety, harms, healthcare modernisation, Over-medicalisation, overdiagnosis, overtreatment | Leave a comment