FREE Thesis EvaluationMedical / Radiology
The trend today is to order cancer screening tests, based on age or on risks factors, but a recent report made by the San Francisco Veterans Affairs Medical Center says that these tests may not be the best for seniors or elderly persons (American Medical Association). Age, according to the report, is one of the most important factors to consider in ordering such tests. A patient with other illnesses and has only a life expectancy of five years will not benefit from a breast cancer screen test, for example, because patients do not benefit from screening for at least five years (AMA). They can suffer unnecessarily from discovering early cancer and undergoing surgery or another invasive treatments.
The message of this report applies in the case of prostate cancer, which is the second most commonly diagnosed cancer among American men, lung cancer being the first (Ferrini). Screening detects this type of cancer in its early stage, but the cancer may not be the cause of the man's eventual death. In addition, treatment of prostate cancer has not proved to be effective, either. Controlled trials of surgery, radiation and other modalities are not as yet complete. The bottom line is that men with less than 10 years life expectancy seldom benefit from radical prostatectomy, the surgical approach to prostate cancer (Ferrini).
Both screening and treatment appear to be deleterious. A positive screening requires repeat testing and a more invasive diagnostic test, like needle biopsy, which carries a possibility of infection, sepsis or bleeding. Radical prostatectomy and radiation therapy carry possibilities of serious complications, including urinary incontinence, erectile dysfunction and strictures, all debiting on a man's quality of life.
Further weight was added by the finding of still another research team, led by Dr. William Black. The team findings concluded that, while early cancer detection generally benefits the patient, it is altogether different when the patient is a senior. Screening patients who are 75 years old or older for breast, colon or cervical cancer may add only a few days to his or her life, according to the team leader, Dr. Black. Dr. Black's group found out from statistics that these screenings are valuable only to those who are 70 years old or younger (Reuters Health 2000). He suggested that a limit be established as to when to stop getting a screening to complement the limit as when to begin getting one.
He stressed that cancer screening is not only aimed at detecting tumors, but also at eliminating needless or additional anxiety caused by false positives and subjecting oneself to the surgical risks of a biopsy and similar procedures (Reuters Health). Life expectancy and the risk of death from cancer, in Dr. Black's view, should be placed in the overall context. A 90-year-old man, for example, who discovers a prostate tumor is likelier to die of a cause other than cancer, he said. Neither does screening accrue to the overall chances of extending life in the elderly, such as in cancer of the pancreas and leukemia (Cancer.gov).
Screening for breast cancer, on the other hand, was reported to have no effect on overall mortality (Cancermail). Public health institutions consider screenings to be beneficial in saving lives of persons through early detection, but again, this applies to those less than 70 years old, 50-70 year-old females in particular. The most common screening technique is mammography, and the estimate is that 1 out of 2 lives will be extended among women aged 40-49 per 5,000-10,000 mammograms (Cancermail).
| Prewritten #15 | |
| Title: | 14 Medical/Radiology. |
| Category: | Nursing, Healthcare / Illness (Diagnosis, Treatment) |
| Filename: | 15 Medical Radiology Cancer.doc |
| Pages: | 6 |
| Bibliographies: | 5 |
| Format: | |
| Price: | US$53.70 |
