Breast cancer screening useless

I hate to say ‘I told you so’. I hate to say it about so many things I have said since I started this ‘mission’ in cancer 10 years ago. The problem is that when you come afresh, with no baggage, no vested interests, no politics, you see things more clearly.

Now here’s another. I told you so. ‘Breast cancer screening fails to cut deaths from breast cancer’. I have been absolutely consistent about this. Why? Because research has been saying this for nearly 10 years and I read and use research. But for some reason the powers that be have consistently ignored it.

Be clear: This is not my conclusion but that that of a ‘landmark study’. To quote: ‘25 years of breast cancer screening has failed to significantly reduce deaths from the disease, according to a landmark study’

While the number of women who die from breast cancer has decreased over the last 20 years, there is “no evidence” to suggest this is because of screening programmes according to researchers from Oxford University (Journal Royal Society of Medicine).

After research from America and the Nordic Cochrane Centre showed that screening mammograms caused more harm than good, we also presented research that if women had DNA mutations the last thing they should have was an annual mammogram. Several months ago, the Department of Health review also found that for every case of breast cancer ‘diagnosed’ at least three women underwent treatment for cancer which would never have harmed or killed them!

Despite all this Cancer Research UK and the powers that be have been insisting in recent months that screening mammograms save roughly 1500 lives a year. There is simply no evidence for this. It borders on quackery.

The new study even showed that the largest drop in mortality has been in women under the age of 40, who are not routinely screened for the disease.

Toqir Mukhtar, of the Department of Public Health (http://www.nlm.nih.gov/medlineplus/news/fullstory_137712.html), who led the latest study said, “We found in our study that the unscreened age group had the greatest reduction in breast cancer mortality, which shows you that screening has not delivered the desired effect at a population level.”
About 1.6 million women are tested each year under the NHS breast screening programme, with women aged 50 to 70 automatically invited for screening every three years by their GP. The programme, which cost £75 million in 2011, is being extended and will apply to all women aged 47 to 73 by 2016.

The new study examined 39 years’ worth of data on breast cancer deaths for different age groups. 20,000 medical records from Oxford were studied, with each listing breast cancer on the death certificate. This was then compared with general data for England on deaths where breast cancer was specifically marked as the underlying cause.

If the screening programme had been responsible for lowering death rates, the scientists explained, they would expect to see the largest decrease among women who would have been offered at least one screening test. They did not.

At the national level it seems better treatment from drugs and complementary therapies are likely to be contributing to the better survival rate. 20 years ago hardly any women used a complementary therapy. Now almost two thirds use one or more.

To read the sorry ten year tale click on http://www.canceractive.com/cancer-active-page-link.aspx?n=1420

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Beating cancer with chemotherapy and better drugs

The mythology of cancer sees many claims. One of which is that we are beating cancer due to earlier diagnosis and better drugs. Let us consider the available research on chemotherapy – for almost every cancer patient treated with drugs is still, inevitably, given at least one round of good old chemotherapy.

Available research evidence does indeed point to chemotherapy having a positive effect for some cancer patients.

Let’s start here:

(1) The Department of Oncology at North Sydney Cancer Centre in 2004 published a report evaluating chemotherapy over the years and concluded that ‘it only made a minor contribution to survival’. The figures they came up with were 2.3% in Australia and 2.1% in America. In Britain there are 320,000 people diagnosed with cancer a year. About 60 per cent have chemo (although some of these people do not actually have cancer and were misdiagnosed by mammograms etc). Being generous and assuming no misdiagnoses, that would mean that chemotherapy had an effect on about 3,600 people. I cannot tell you from the research whether ‘effect’ means they were cured or whether they reached 5-year survival, or what. Sorry, I didn’t find the research very clear on that point.

(2) Somewhat alarmingly, last year we had the report from the Fred Hutchinson Cancer Center in Seattle that concluded ‘Chemotherapy can cause cancer to return’. Note that they did not say, ‘we know cancer can return after chemo’, which is how Cancer Research responded to this study. They said CAUSE – apparently chemotherapy can cause healthy cells to produce a protein WNT16B and this is taken up by cancer cells – it helps them re-grow and even protects them from the next round of chemotherapy.

You may feel that all this misses an important point and that drugs have moved on – chemo is past it; old hat: Drugs like Tamoxifen, Aromatase Inhibitors and Herceptin are not really chemotherapy agents, and you’d be right. In 2012 a couple of reports shed some light on the current state of play.

(3) Firstly, one study (lead by Professor Carlos Caldas – reported in Nature) had Cancer Research all excited. A ‘landmark study’ from their Cambridge Institute showed there were 10 different ‘clusters’ of breast cancer types. ‘No longer does one size fit all’ they cried at CRUK. (It would be churlish of me to mention that CANCERactive have been saying that for ten years, but what the heck). In the future CRUK are suggesting they can more accurately develop treatments for each cluster. The problem at the moment is that there are only treatments for two of the clusters, the Tamoxifen/AIs one and the ‘HER-2 targeted therapy using Herceptin’ cluster. So here’s a real improvement: 2 out of 10 is better that 2.3 per cent.

(4) Unfortunately, the excitement was crushed somewhat when three research studies reported on the existence of Cancer Stem Cells at the heart of tumours. A couple of UK cancer centres (Bart’s Hospital and the Blizzard Institute, London) have even isolated these nasty little cells. Apparently, if you don’t kill them off, they can re-grow.

In one of the three studies (from the University of Texas South Western Medical Centre), there were statements such as ‘Cancer Stem cells are in charge of tumours’, and the lead researcher, Dr Louis Parada and the other researchers added, ‘In the past we have tried to get rid of the entire stew of cancer cells. But shrinking a tumour by 50% is irrelevant. No current drugs tackle cancer stem cells – but at least we now know what to go after’.

(5) We are by no means ‘against chemotherapy’ at Junk Science UK, we just think the mythology and the hype needs to be calmed down. Perhaps the final words should therefore go to Duke’s University Medical Centre in Carolina who in their 2012 report concluded that ‘Patients with cancer are largely being mislead into believing that the drug they are being offered is somehow going to cure them’.

Oh dear.

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Everybody is missing the point on screening mammography

A debate has sprung up over the last few weeks. It is not a new debate; it concerns mammography. Recently there has been research that shows 4000 people in the UK are unnecessarily treated as a result of ‘Over-diagnosis’ by screening mammograms. The ‘pro’ side immediately says ‘1300 lives are saved and have to be set against this’. And then journalists from the Telegraph and BBC jump in on the act. Unfortunately, few know their facts. I won’t be updating our article on mammography at CANCERactive because, as usual, we were well ahead of this debate. What I thought you might like to read is the essence of my piece to the Telegraph, and why I think everybody seems to be missing the important issue:

Firstly, there is no confirmed research data that mammography saves 1300 lives a year in the UK. Until recently the Cancer Research UK website admitted that fact. There are various studies and reports, for example, showing the figures of 1300, 850 and zero. Take your pick.

Secondly, whilst people have been debating issues such as over-diagnosis and unnecessary treatment and distress, the debate has missed the fact that mammography can likely cause breast cancer. For example, about 25 per cent of breast cancers are linked to inherited genes where the person usually has one of the pair defective, and only one operating correctly. American research is quite clear that these people are at greater risk of developing breast cancer if sent off from an early age for an annual mammogram ‘to be safe’. The cumulative radiation is statistically far more likely to damage a single gene than a pair.

Thirdly, some ‘diagnosed’ women consider having double mastectomies. The idea of a double mastectomy is palpable non-sense with no evidence whatsoever in terms of numbers over who might have been prevented from developing cancer! Cancer is an all over body disease with symptoms like cancer markers, low blood oxygen and poor immune response evident throughout the body. If you have a BRCA1 or 2 problem, it will cause poor immune recognition or DNA replication control everywhere in your body. If a woman has toxic chemicals in her body, they will not only collect in the fatty breast tissue but in other such tissue too.

Fourthly, to add to the confusion, about 50 per cent of the ‘irregularities’ detected by mammography are lobular, and 50 per cent ductal. While Christies, Manchester were warning some 5 years ago that DCIS could be extremely dangerous and were looking at trials to see which drug might be used to prevent an aggressive cancer developing, at the annual Breast Cancer Symposium in America a paper was presented showing that DCIS was caused by calcium deposits, and 80 per cent never became cancers. The finding that women with the highest blood levels of vitamin D and omega-3 do not develop breast cancer may be linked to their effects with calcium.

European research has shown that depending on the density of the tissue, screening mammography may be only 65 per cent accurate at best. Other studies have shown that in order to detect the cancer it has to be of sufficient size – a size produced by about 20 cell divisions. At 40 you are dead. Screening mammography is neither accurate nor early detection.

How many of the 4000 women who are then unnecessarily treated die as a result of the chemotherapy drugs provided? How many have impairment to their heart and/or lungs as a result of radiotherapy? Is it is more than the 1300? But surely even this question is off the point: Why are we using such an outdated and inaccurate system which can lead to quite barbaric consequences (double mastectomy?).

Surely, the energy, time and the money would be better spent developing blood tests that are already coming through from private companies in Nottingham and America that can spot cancer in the pre-cancer stages.

This argument about screening mammography is completely off the real point and is propagated by vested interests. How many hospitals and cancer centres would be stuck with an expensive machine if an accurate blood test were available tomorrow? (Although I should point out that mammography is the current gold standard once a cancer has been confirmed and further information is required.)

The real question we should be asking is this: ‘How do we develop a simple, accurate and early diagnosis test for cancer?’ The answer has nothing to do with mammography.

For a fuller report see:

http://www.canceractive.com/cancer-active-page-link.aspx?n=1420&Title=Breast cancer screening and cancer risk

http://www.canceractive.com/cancer-active-page-link.aspx?n=666&Title=False Positive Mammograms

http://www.canceractive.com/cancer-active-page-link.aspx?n=671&Title=Mammograms and Obese Women

http://www.canceractive.com/cancer-active-page-link.aspx?n=2644&Title=The Development of Thermal Imaging

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Puzzling prediction of falling cancer death rates made ahead of fund raising drive

According to ‘experts’ at the charity Cancer Research UK, cancer death rates in the UK are set to fall by almost 17 per cent by 2030. And better diagnosis and treatment is the main reason (sic) for the change.  The figures were released in the run-up to Stand Up To Cancer, a fundraising partnership between Cancer Research UK and Channel 4.

This is all rather puzzling because in 2011, when claiming cancer death rates were falling in breast cancer and colon cancer, they predicted an increase in the number of cancer cases and deaths from cancer as the population ages over the next twenty or so years.

The ‘experts’ also claim that the improved outlook reflects the fact that fewer people are smoking. So is ‘prevention’ really the key? Or could it even be something else?

To quote from the CRUK press release, ‘In 2010 an estimated 170 people in every 100,000 members of the general population died from cancer. By 2030 this is forecast to fall to 142 per 100,000.

Ovarian cancer is expected to see the biggest drop in numbers of patients dying, at 42.6 per cent. Incidence of the disease is expected to reduce from 9.1 women per 100,000 to 5.3 per 100,000 by 2030. Death rates for breast cancer are predicted to fall by 28 per cent, for bowel cancer by 23 per cent and prostate cancer by 16 per cent.

A few cancers show a reverse trend, with larger numbers of people dying. Death rates for oral cancer are likely to rise by 22 per cent, as incidence rises from 2.9 to 3.5 per 100,000 people. For liver cancer, death rates are predicted to go up by 39 per cent, with incidence increasing from 4.2 to 5.9 per 100,000’.

Professor Peter Sasieni, Cancer Research UK epidemiologist at Queen Mary, University of London, said: “Our latest estimations show that for many cancers, adjusting for age, death rates are set to fall dramatically in the coming decades. And what’s really encouraging is that the biggest cancer killers, lung, breast, bowel, and prostate, are part of this falling trend.

“Because old age is the biggest risk factor for cancer and more people are living longer, they have a greater chance of developing and, unfortunately, dying from the disease. But overall the proportion, or rate, of those who die from cancer is falling.”

Why this is puzzling is because the absolute numbers of cancer cases has doubled in the last thirty years and a team of oncologists working with MacMillan had predicted it would double again in the next twenty years. That would mean about 4 million people with cancer in Britain.

According to the 2011 census, the population for England and Wales has increased by 3.7 million from 2001; and (to quote) ‘buoyed by increased life expectancy, sustained immigration and robust fertility levels, the number of residents jumped 7.1% from 52.4 million in 2001 to 56.1 million in 2011’. If that continues, in twenty years time we will have about 65 million people in England and Wales in 2031. According to figures about 350,000 ‘older’ people are retiring abroad each year, while about 650,000 younger foreign people are coming into the country.

And it should be noted that Cancer Research ‘experts’ are not talking about total numbers of cases of cancer, nor total numbers of deaths. But the rate per 100,000 of population. So if the number of people increasing the population by 7 per cent due to ‘sustained immigration and robust fertility levels’ continues you might expect a decline in cancer death rates anyway. Especially if the average age falls across the population.

The other claim that is interesting is that the main reason is due to better diagnosis and treatment. Three years ago CRUK said it was all down to better diagnosis and treatment and I chided them at the time. They conveniently ignore the fact that over two thirds of cancer patients now build their own integrative treatment programmes, search the Internet for alternative treatments, visit complementary centres that are independent (like Maggie’s, The Haven and Penny Brohn) or part of the Hospital (like the Butterfly Centre and the Rainbow Centre). Some people even take themselves off abroad for life-extending treatments. Then there has been an explosion in coverage of what people can do to help themselves from the utterings of the Daily Mail to charities such as CANCERactive. Only recently the American Cancer Society stated that there had been an ‘explosion’ in complementary research since 2006 and that there was ‘overwhelming evidence that complementary therapies like diet, weight control and exercise could increase survival and stop a cancer returning.

It seems that Cancer Research UK think your personal efforts count for little.

Better diagnosis? It is definitely coming with a possible avalanche of private companies and blood tests, but up to now …  mammograms and PSA tests? The Nordic Cochrane has said that mammograms do ‘more harm than good’, with up to 30 per cent being misdiagnosed (of course you are ‘cured’ if misdiagnosed). The American Preventative services Task Force said much the same about the PSA test.

Better treatments? Well if you read the recent articles on the new breed of biologics, or ‘designer drugs’, such as the article we printed by Professor Karol Sikora, you’d be more than a little underwhelmed. There are alternatives coming – like localised hyperthermia (Ablation, HIFU) but the ‘old school’ is none too happy about the possibility of becoming redundant. And anyway it can’t work on blood and lymph cancers.

And this is another little area that needs attention. Blood and lymph cancers account for about 80,000 cases in the UK currently; twice the number of breast cancers diagnosed. But they are divided into about ten different types – there are four different lymphomas. Yet no one divides breast cancer by ductal or lobular in the overall numbers. It’s also an inconvenient truth that at current growth rates lymphoma could become the number one cancer in the next twenty years.

Old age the biggest risk factor and an ageing population? Recent research shows that the historical 80 per cent of cancers in the over-65 age group is less and less the case. 40 per cent of breast cancers are now developed by women below 60 years of age. Prostate cancer has multiplied six-fold in the forty-something age group; oesophageal cancer has boomed amongst forty-somethings; some child cancers have tripled.

And I just loved the bit about ‘age-corrected statistics’. I really must have my age corrected one day.

If smoking reduction is such a big factor, how come cancer cases are set to double in absolute terms despite a fall in smokers? If prevention is so important why aren’t we doing more about the 50 per cent of cancers that aren’t your fault? Look up most blood or lymph cancers on American web sites. They will tell you about the links to pesticides, toxic ingredients in everyday toiletries and household products, heavy metals, environmental toxins beyond asbestos.

Perhaps the European REACH project, if 1000 toxic ingredients really are cut from personal care, toiletry and household products in the next 15 years, will see a great reduction in cancer levels.

Stand up to Cancer fund raising? Of course if you can convince people that you really are succeeding in beating cancer by doing what you are doing, they may well give you more funds.

Cancer Research UK is a great charity and I am sure it does its level best to help people. It is sad that, if the numbers of people with cancer are going to double in the UK to four million, anybody tries to claim that somehow we are beating cancer because of better diagnosis and drugs, however the numbers are massaged.

I am at this point reminded of MD Anderson’s quote that ‘All the exciting new developments in cancer are coming in areas other than chemotherapy’. I think I will file the press release and bring it out again in 1930 to see what really did happen. Somehow I fear the current strategy will just see more cases of cancer and more deaths whatever spin is put on it. And I haven’t even talked about whether the country can afford it or not!

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Junk Science Number 12. The Nordic Cochrane Institute: Screening Mammograms cause net harm. Confirmed!

When the Nordic Cochrane Centre concluded from a meta-study on (largely synthetic) vitamins that they seem to do no good and may even cause harm, it was front page news in the National papers. However, when the same prestigious Institution tells the world that a thorough analysis of mammography research shows that mammography definitely does cause harm, you are lucky to find a passing mention in the press.

 Yet, their research conclusions have now been confirmed by an independent study. We are not surprised. At CANCERactive we have been telling you this for nearly 9 years!

 The Nordic Cochrane Institute have just produced a leaflet on the benefits and harm of screening mammography. I will just give you the top line.

If 2,000 women are regularly screened for 10 years,

 * 1 (one!) woman will benefit, and she will avoid dying from breast cancer.

* 200 women will get false positives.

* 10 of these women will be treated with surgery (lumpectomy or full breast removal) and chemotherapy and radiotherapy, increasing their risk of heart and lung problems.

Are they right in their claims? Researchers at Southampton University set out to ‘assess the claim in a Cochrane review that mammographic breast cancer screening could be doing more harm than good’.

The findings published in the British Medical Journal, December 2011 agreed with Cochrane and stated that mammograms indeed have ‘caused net harm for up to 10 years after the start of screening’.

James Raftery, lead researcher at Southampton added, “The default is to assume that screening must be good; catching something early must be good, but if a woman has an unnecessary mastectomy, or chemotherapy or radiation, that’s a tragedy. It’s difficult to balance the gain of one life against 200 false positives and 10 unnecessary surgeries”.

Back to Cochrane, who say that nowadays with women much more ‘breast aware’ and with a new generation of diagnostics and treatments, the need for mammographic screening has simply become outdated.

“It therefore no longer seems reasonable to attend for breast cancer screening. In fact, by avoiding going to screening, a woman will LOWER her risk of getting a breast cancer diagnosis.”

The fact is that screening creates breast cancer patients out of healthy women who would never have developed symptoms. And treatment of these healthy women increases their risk of dying from both heart disease and cancer itself.

See our full article on mammograms at http://www.canceractive.com/cancer-active-page-link.aspx?

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Junk Science? ‘Mammograms are safe and save lives’. 

Mammograms shown to increase risks of breast cancer. Twice!

1 Life-saving research supporting mammograms found to be flawed

You may have read research from the Nordic Cochrane Center in Copenhagen before. It is usually the ‘expert and prestigious centre’ sited for the latest vitamin bashing study in the tabloid press. However, when it concludes something against the cancer industry, its findings are barely reported.  So don’t be surprised if you have not read the following before:

A major plank of support in the ‘mammograms save lives’ debate has been a 2005 study where a drive to screen women in Denmark with mammography was claimed to have reduced breast cancer deaths in Copenhagen by 25 per cent.

Now scientists from the Nordic Cochrane Center in Copenhagen and the Folkehelseinstituttet in Oslo have re-examined this study along with additional data and found it flawed. In fact the corrected conclusions are exactly the opposite: ‘Deaths from breast cancer were lower in areas where women didn’t undergo those screening tests’.

This time the researchers used a control group of non-screened women and analysed the malignancy data for ten years before and ten years after the screening programme was introduced.

The results showed that deaths from breast cancer declined by 1 per cent in women between the ages of 55 and 74 in the screening areas but 2 per cent in non-screening areas! In younger women, breast cancer mortality went down by 5 per cent each year in the screened areas but over 6 per cent in the non-screened areas.

The ‘highly respected, prestigious and expert’ Nordic Cochrane Center in Copenhagen concluded ‘We were unable to find an effect of the Danish screening program on breast cancer mortality’ (British Medical Journal).

Chris Comments: We have told you before of the risks of screening mammograms and we have a full review on our web site on the subject (Screening mammograms –increasing the risk of cancer?). One focal study (published in the Journal of the American Medical Association’s Archives of Internal Medicine) showed that an increased incidence of breast cancer occurred with the advent of screening mammograms in Europe. Cancer experts immediately rushed to comment, ‘Look how screening mammograms help find these early stage cancers’. You may feel they are talking rubbish.

We have also covered Norwegian research in icon that showed, across a six year period, a group of women who had regular screening mammograms had significantly more cancers than the identical control group having none. (Far from concluding that mammograms were dangerous, the researchers concluded that, left alone, early cancers could heal themselves!!?)

Then we told you about research by Johns Hopkins (Journal of the National Cancer Institute) on women with breast cancer genetic issues – the very group who are told by experts that they have to be extremely watchful and should be screened regularly. This group actually develops higher rates of breast cancer if they have regular screening mammograms that the at risk girls that don’t. So much for screening as a prevention tool.

We have also covered recent research that shows most mammograms only pick up a tumour when it has reached a size corresponding to at least 20 cell divisions. At around 40 divisions, you lose your fight with cancer. So 20 divisions is hardly ‘early diagnosis’ (We are hopeful that mammograms may soon be replaced by new simple blood tests that catch a cancer in its very first divisions). Now the Nordic Cochrane Center in Copenhagen say one of the major planks of the ‘mammograms save lives’ argument is false.

But that’s not all. It has long been understood that radiation causes cell damage and can increase mutation and cancer risk. Now read on….

2 Radiation increases breast cancer risk

Researchers at the Lawrence Berkeley National Laboratory in America (a US Government facility) have shown that radiation both changes the environment around breast cells, and increases the risks of mutation in them; a mutation that can be passed on in cell division.

“Our work shows that radiation can change the microenvironment of breast cells, and this in turn can allow the growth of abnormal cells with a long-lived phenotype that have a much greater potential to be cancerous,” said Paul Yaswen, a cell biologist and breast cancer research specialist with Berkeley Lab’s Life Sciences Division, adding “Many in the cancer research community, especially radiobiologists, have been slow to acknowledge and incorporate in their work the idea that cells in human tissues are not independent entities, but are highly communicative with each other and with their microenvironment.”

The results, (published in the on-line journal Breast Cancer Research), showed that a culture of healthy breast cancer cells stopped dividing four to six weeks after exposure, causing premature cell aging and allowing pre-cancerous cells caused by the radiation to infill the spaces around them. Normal healthy cells generate substances that prevent this in-fill. Thus radiation negatively effects the environment around breast cells.

Research has also shown that radiation can increase breast cancer malignancy by affecting a tumour-suppressing gene (p16).

Chris Comments: When you read all this it is no wonder women are becoming increasingly scared about the risks of screening mammograms. Especially when the cancer authorities and charities bang on claiming ‘the screening programme saves lives’. Personally, I would not squeeze my private parts between two cold metal plates and have them irradiated in the vague hope that someone might spot a 4-year old cancer. Bring on the advanced diagnostic blood tests and send these screening machines to the scrap heap.

http://www.canceractive.com/cancer-active-page-link.aspx?n=651&Title=Breast Cancer

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