Posting in Cancer
Our risks of disease are unique to each of us. Some are environmental, like exposure to toxins. But many are also genetic, as in the case of a North Carolina man denied a test for breast cancer. Both his parents died of it, and it should have been given.
The denial of a free breast cancer screening to 45-year old Scott Cunningham has highlighted a key fact of our time.
(Picture from the CBS Early Show.)
It's not nearly as common in men as in women. There are 100 cases of breast cancer in women for every one in a man. But Cunningham's case was unique. Both his parents, his father as well as his mother, had died of the disease. And he was having symptoms.
(The best-known male breast cancer sufferer so far? KISS drummer Peter Criss (the one whose make-up is that of a cat), 63. Male breast cancer often comes later in life,
The CDC, looking at the gross numbers, defends the idea of screening only women, but even that refusal reveals a truth the agency would likely want everyone to know.
Our risks of disease are unique to each of us. Some are environmental, like exposure to toxins. But many are also genetic, as in Cunningham's case.
You don't need a genetic screening to estimate your risk, although it can help. But a complete health record, including data on past screenings and tests, can also help.
The move toward electronic health records is vital in this regard. In some cases, like breast cancer, population studies show we are over-diagnosing and over-treating. There is also a radiation load from CT scans and other tests that can itself raise risks.
All these questions respond to data, and getting better data is the point of the current health IT revolution. Data will tell us some people need more tests, and some need fewer. Data will let us balance risks and rewards. Data will save lives, even while data saves money.
Screenings represent data, but they are just one type of data. Risk data from your life is data (Cunningham's picture indicates he may be at risk for skin cancer). Genetic data is also vital.
Don't cry privacy. Get the data. Save your life.
Apr 9, 2010
The goal of the data is to tell us who needs to be tested. It is a rare disease in men. That's why some laugh it off -- it's not a rare disease in women. And the severity of the disease in women varies. I would note here that Martina Navratilova only needed a lumpectomy, not a complete mastectomy. All breast cancers are not created equal. But those which are not discovered quickly are more equal than others.
I had a family friend who also breast cancer later in life. Fortunately, he was cured. To this day, whenever I mention it to someone the response is almost always disbelief or laughter. I'm not sure the biggest obstacle to diagnosing breast cancer in men is more data. It's much more likely to be getting past the idea of it occurring in men to begin with. This is true even with the doctors who treat men, most of whom will see very few cases of male breast cancer in their careers. Like any rare disease, diagnoses requires systematic testing and an open mind.