Buy this today! | Should I Be Tested for Cancer?: Maybe Not and Here's Why

Cancer screening probably does more harm than good | Should I Be Tested for Cancer?: Maybe Not and Here's Why | H. Gilbert Welch M.D. M.P.H.

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	• Should I Be Tested for Cancer?: Maybe Not and Here's Why H. Gilbert Welch M.D. M.P.H. University of California Press, 2006 - 234 pages average customer review:based on 16 reviews view larger image
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highly recommended

courageous and insightful

This is a great book!!! I encourage all adults who want to be more informed about the health care industry to read it. You will be able to make better decisions about your own treatment. A great challenge to the conventional wisdom about routine testing.

Buy this today!

If I could give this book 10 stars, I would. This is possibly the most valuable book you will ever read regarding your health. Dr. Welch has impeccable bona fides, and his arguments are well-reasoned and well documented. He is a wonderful writer who makes sense of complicated, nuanced statistical analysis for the rest of us.

Of particular importance to this 53 year old woman is his detailed analysis of mammography and breast cancer. He completely debunks the hysterical coercion of women to have this test, and points out why declining to have one is a completely reasonable decision. This is of particular importance now in light of Elizabeth Edwards doing public penance for "letting down" the country and her family by skipping a mammogram! Elizabeth, honey, read this book! It is doubtful that mammography would have made any difference in your outcome.

Welch's dicsussion of DCIS, which is probably the most horribly overtreated fake "disease" in the history of modern medicine should be required reading for every woman over the age of 20.
Just buy it - I plan to give a copy to every person I love. It's that good.

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Cancer screening probably does more harm than good

This is a great little book. In a little over 200 pages Welch reviews the science and data about cancer screening and concludes that it is not worth doing it. Cancer after cancer (prostate, skin, breast...) he shows that screening has very little benefit if at all in terms of life expectancy (I recently saw a scientific article defending mammography on the basis that it added 3 days of life to women having one regularly...) .
The main justification for cancer screening is the belief that a cancer caught early is not lethal. The problem is that a lethal cancer is in general not caught early. A lethal cancer is usually very aggressive and by screening time it has already spread (unless as Welch points out you are willing to be screened every other day...).
What screening is very good at is catch cancers (and Welch explains that the definition of cancer is not clear cut) that are growing slowly if at all and will probably never kill you... Have you noticed the epidemic of breast cancers or is it just me?
The only thing missing from the book is the broader implication of generalizing cancer screening. By devoting so much money to an irrational health policy the general population is deprived of many services that could really impact its health and improve the sorry health statistics of the United States.

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A Real Eye Opener!

This book is truly an eye opener. Millions of people are being screened for cancer every year, but is it really necessary? Is it really making a difference? Are people harmed by these tests in anyway?

Dr. Welch explains brilliantly, in my opinion, what these cancer screenings really mean. He argues that we are taking healthy symptom-free individuals and looking for cancer.

What most people do not know and I did not before reading his book is that:

1-There is no evidence that these screenings have actually saved lives. In fact despite increased detection of early stages of prostate cancer and breast cancer, the death rate for prostate cancer has stayed the same and the rate of late stage breast cancer has increased over a 25 year period.

2-Autopsies of people who have NOT died from cancer have shown cancer in the lungs, thyroid, kidney, etc. This means millions of people are living with cancer and die of other causes and not even know they had cancer.

3-If the screening finds cancer, it does not necessarily mean that it is the type that will grow rapidly.
a-It could regress on its own as our immune system eliminated abnormal cells, including cancers regularly.
b-It may stay the same for many years and never cause a problem
c-It may grow so slowly that cause no health problems and the person dies of something else before it does

4-Studies conducted by John Hopkins, Harvard, and others have shown that different pathologist give different diagnosis for the same tissues. They may look at the same tissue and some think it is cancer while others think it is not. Especially when it comes to the a few abnormal tissues found from screening a healthy individual.

5-Also between screenings it is possible to develop a fast growing cancer. So how often do we need to do mammograms and colonoscopies?

6-The statistics, such as the five year survival rate, are not always reliable and maybe calculated in a misleading manner.

So you have a mammogram, PSA test, colonoscopy, fecal occult test, etc done. This is what may happen:

1-You end up with a false positive, depending on the test, 10 percent false positive is the average.
2-You get the cancer scare unnecessarily.
3-This can begin a cycle of retesting, biopsies and other tests. Some can be very unpleasant and have side effects.
4-If they find an abnormal tissue, what does it mean it mean? May the pathologist made a mistake; maybe it has been there for many years; maybe it is a slow growing one; maybe it will go away on its own; maybe it is a fast growing one! Of course, your doctor can't take a chance with your health, and also does not want to get sued for malpractice, so most likely she recommends the most safest (which could be the most aggressive) course of action!

Here you were living a relatively healthy symptom-free life and now you are told you need surgery, radiation, and/or chemotherapy.

BUT once you or I know about they have found cancer, it is hard to know what to do, not to speak of the emotional toll. That's why Dr. Welch believes sometimes it is better not to know. However, as Dr. Welch cautions: If you have any unusual symptoms and your doctor recommends screening for cancer, make sure you are screened.

After reading the book I decided I do not need any screening. As long as I am symptom free and healthy, why put myself through tests that may or may not extend or save my life. I think as long as we don't do anything to harm our immune system, such as smoking, and do the things that enhance the immune system, such as exercise, there is no need to become a patient.

We all need to make the decision for cancer screening based on our priorities, family history of cancer, and other factors. Perhaps a good course of action is to read the book and consult your doctor for best options.

Thank you Dr.Welch for an excellent expose: Well researched and well written.

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A different idea about cancer testing

Before reading this book, it had never occured to me that there were pros and cons re cancer testing. Welch has excellent credentials.He is on the staff of Dartmouth Medical College and writes articles for JAMA. In this book (which was also favorably reviewed in JAMA) Welch succinctly explains the perils of cancer testing in asymptomatic patients. He provides ample numerical data to support his contentions.The book is short and interesting and easy to read.

Getting tested to detect cancer early is one of the best ways to stay healthy--or is it? In this lively, carefully researched book, a nationally recognized expert on early cancer detection challenges one of medicine's most widely accepted beliefs: that the best defense against cancer is to always try to catch it early. Read this book and you will think twice about common cancer screening tests such as total body scans, mammograms, and prostate-specific antigen (PSA) tests.
Combining patient stories and solid data on common cancers, Dr. H. Gilbert Welch makes the case that testing healthy people for cancer is really a double-edged sword: while these tests may help, they often have surprisingly little effect and are sometimes even harmful. Bringing together a body of little-known medical research in an engaging and accessible style, he discusses in detail the pitfalls of screening tests, showing how they can miss some cancers, how they can lead to invasive, unnecessary treatments, and how they can distract doctors from other important issues. Welch's conclusions are powerful, counterintuitive, and disturbing: the early detection of cancer does not always save lives, it can be hard to know who really has early cancer, and there are some cancers better left undiscovered.
Should I Be Tested for Cancer? is the only book to clearly and simply lay out the pros and cons of cancer testing for the general public. It is indispensable reading for the millions of Americans who repeatedly face screening tests and who want to make better-informed decisions about their own health care.

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reviews: page 1, 2, 3, 4

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