April 1997 The News Argus Page 8
FYI
Health Watch: Cancer Awareness
BY CHERYL CASH
Staff Writer
Are women 40 and under at a higher
risk of undetected breast cancer? A 3-day
government sponsored conference was
held at the National Institutes of Health;
The 12-member panel, which consisted
of doctors, scientists and women’s health
advocates, headed by Dr. Leon Gordis of
Johns Hopkins University School of
Hygiene and Public Health, was unable
to come to an agreement on when
mammogram screening should start.
The NIH ruled against
recommending routine mammogram
screening for breast cancer for women in
their 40s, wrote Susan Okie, Staff Writer
for the Washington Post. Okie wrote that
the NIH panel concluded not to
recommend routine mammograms for
women in their 40s, because the latest
scientific evidence on whether the X-ray
test prevents breast cancer deaths is not
strong enough to justify such advice.
Mammography does not detect small
cancers in women, especially younger
women who have denser breast tissue,
and it does not guarantee that a woman
will not develop a cancer after being
tested.
On January 23, 1997 the NIH panel
members concluded: “the available data
does not warrant a single
recommendation for mammography for
all women in their 40s. Each woman
should decide for herself whether to
undergo mammography.”
The NIH panel argued/noted several
issues concerning their decision. They
calculated that “2,500 women in their
40s would need to undergo regular
mammograms to prolong the life of one
woman diagnosed with breast cancer,
while the other 2,499 would not benefit
from the testing. They also found that 10
percent of the mammograms would be
read as abnormal leading to additional
tests and in some cases to biopsies or
surgery.”
However, strong opposition against
the NIH panels recommendations were
held by several attending the conference.
“I do fear that this document is
tantamount to a death sentence for
thousands of women, “ said Dr. Michael
Livner, a New Mexico radiologist.
One fourth of invasive breast cancer,
cancer that has spread from inside the
breast duct or lobule to invade other parts
of the breast, in women in their 40s are
not detected by mammography. The
accuracy of detecting “invasive” breast
cancer in women in their forties is lower
than detection of cancers in women in
their 50s. The reasons which are multi
faceted include: studies have been too
small to advance the theory that cancer
which strikes younger women is more
aggressive and harder to treat; and the
social-economic status of women who
are unable to obtain health insurance
which will pay for a mammograph,
mostly African-American and Hispanic
women.
NIH panelist said, “Having a
normal mammogram might falsely
reassure a woman with cancer causing her
to ignore a breast lump or delay
treatment.”
Other concerns of the NIH panel was
the possibility of radiation from
mammograms being harmful to younger
women. William E. Mitchell, M.D., a
general surgeon at Piedmont Hospital in
Atlanta, stated that “Mammograms
should not be done on women under age
30 because the younger you are, the more
vulnerable your breast is to radiation (the
breast tissue has more density). “
African -American women in their
40s have the same incidence of breast
cancer as white women, but at a 50
percent greater mortality. Research
shows that white women annually have
mammograms. Why aren’t Black and
Hispanic women?
Dr. Patricia Zekan at Winston-Salem
Health Care said, “The black
community has not had as good screening
as the rest of America. The American
Cancer Society is trying to work out
programs for high risk groups, to
inform them and help provide easier
access to screening facilities.”
In a 1992 National Health Interview
Survey, several reasons were given why
Black and Hispanic women do not have
annual mammograms. Some of the
reasons included 1) Misconception that,
without symptoms, there is no need to get
screened; 2)Lack of physician
recommendation; 3) Cost and/or lack of
health insurance; 4) Lack of access to
mammography facilities. The study also
indicates that fear of cancer detection and
language barriers may also exist.
Velma Couch, coordinator of Henry
General Breast Cancer said “people say
we’ve educated to death but if we’ve
educated, why do we have only about 40
percent of the women complying with the
American Cancer Society's
recommendations?”
According to information released
from the Breast Health Center at
Piedmont Hospital, in Atlanta, 90 percent
of all breast cancer lumps (cancerous and
non-cancerous) are discovered by women
themselves. Possible signs that women
should look for are changes in breast such
as lumps, skin dimpling, nipple discharge,
thickening, swelling, skin irritations,
distortions, retraction, scaliness, pain or
tenderness of the nipple. Breast self-
examination seems to be the best solution
for all women.
Is this confusing to women?
Probably yes because. The American
Cancer Society on March 27, 1997,
responded to the National Cancer Institute
recommendation on screening
mammography by saying that they
“accept the recommendations of the
National Cancer Advisory Board on
screening mammography, and as a result
will recommend that women in their 40s
should be screened every one to two
years; women aged 50 and older should
be screened every one to two years; and
women who are at higher than average
risk of breast cancer should seek expert
medical advice about whether they should
begin screening before age 40 and the
frequency of screening.”
The American Cancer Society’s data
shows that “the number of breast cancer
cases in women ages 20-39 has been
essentially stable over the past 10 years.”
The most significant increase has been for
women over 50.
Several factors increase breast cancer
risk in younger women such as 1) family
history - if a mother , daughter or sister
has been diagnosed, b)Pregnancy in
women who have children after the age of
30 or who have no children, c) menstrual
history for women who begin
menstruating before age 12 or completed
menopause after 55, d) oral
contraceptives, e) alcohol increased the
risk of cancer for women who drink one
to two drinks or more a day, f) Atypical
Hyperplasia which is a type of non-
cancerous breast disease characterized by
a growth of abnormal cells within the
ducts and, g) being 40 percent
overweight. The risk is higher in pre
menopausal women with a biopsy-
confirmed diagnoses are at increased risk
for developing invasive breast cancer.
Black Men Have Highest Rate of Prostate Cancer
BY JERMEL WIGGINS
Sports Writer
Many African-American men today are affected by
a disease that is being overlooked by many African-
American people in their communities. The disease is
prostate cancer and studies show that African-American
men have the highest rate of prostate cancer in the
world.
According to a study in the New England Journal
of Medicine about 41,(X)0 Americans of all races die
from prostate cancer each year. African American men
tend to develop prostate cancer at an earlier age than
men of otherraces. ' ' ' ^ ‘ ^ '
Statistics also show that 1 out of 9 Black men will
develop prostate cancer. Prostate cancer is the most
common cancer among men and the second cause of
cancer death in the United States. Prostate cancer cannot
be prevented, however; if the disease is detected early,
treatment can be more successful.
The prostate is the sex organ located at the base of
the male urinary gland. Prostate cancer is a disease in
which cancerous cells compress and destroy normal
body tissue. These cancerous cells can also break away
from one tumor in the prostate and spread or travel to
other parts of the body where they form more tumors.
After spreading, prostate cancer can affect a man’s
bladder, lungs, liver and bones such as the pelvic bone
and lower spine.
Symptoms of prostate cancer include back pain, hip
pain, frequent or weak urination and blood in the urine.
Many limes prostate cancer is discovered during a
routine examination, when no symptoms are present. It
is recommended that men over the age of 40 have a
rectal exam when they have their yearly physical.
Doctors usually advise therapy based on the stage of the
disease and characteristics of the cells. Treatment for
cancer that has spread depends on the site of the first
tumor as well as the site of the secondary tumors. The
cure rate is very high and the disease can also be treated
with hormone ther^y.