Friday, June 11, 2010

the devil & the deep blue sea

i recalled a statistic when i was a med student doing surgery ward rounds. the lecturer said 1 out of 14 women will eventually develop breast cancer.

1 in 14.

if there are 14 lottery tickets & 1 of them will hit the jackpot prize, don't you think the chances are high?

that's about 30 years ago. with a change (deterioration?) of lifestyle & diet, wouldn't the odds be terrifyingly higher now?

women above 40 have been advised to carry out monthly breast self-examination as well are regular mammograms for early detection of that dreaded disease (a term used in many insurance policies) & some studies have shown that these screening procedures have reduced significantly the mortality from breast cancer. check out the academy of medicine website  & read the Management of Breast cancer pdf.

but here's the twist...

there are recent reports that the annual mammograms themselves subject the women to a cumulative amount of radiation that MAY cause breast cancer!!

"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," says Paul Yaswen, a cell biologist in his report here. this is substantiated by a Cornell University report & a US National Centre for Biotechnology Information report.

so, where does that leave us? should the women continue with mammograms or not? it's down to risk-benefit issue again. is the benefit of early detection worth the possible risk of irradiation?

would you rather face the devil or the deep blue sea??


Loshini said...

in japan the screening method's US, though it's due to the struct of the Japanese breast and not because they're worried about the radiation from XR. only those with changed echogenicity go on to XR.

a possible alternative we could consider perhaps? :)

Bengbeng said...

i read yr comment on adino's blog abt self indulgence on his latest post and came over :)

reading cases highlighted on yr blog keeps reminding me of how God has been protecting my family. mayb it is also due to mrs bb's cooking habits.

benghui has been developing well as a Christian,very well mayb putting lots of adults to shame with his simple faith

alas for me, i have temporarily stopped attending cell grp. i mentioned that i look upon heaven n hell as concepts n not figuratively n was told to either accept everything or none at all.

i have left to take a breather.kinda sad development though

iml said...

Had a pea size lump removed last oct after going for a mamogram and a biopsy. Though all's well, but it seems that I'm on the high risk and need to diligentlly have the mamogram done yearly. So this is double whammy?

ilene said...

Aiyo DOC faster advise as I'm due for my full medical check-up soon! To include the mammo or not to? I have also been receiving lots of emails on this and have been confused since then! Is there any truth or basis for their findings?

doc said...


for women less than 40 years, for fear of radiation exposure, ultrasound is an alternative, but it does not provide a detailed picture like a mammogram. the FDA in USA does not recommend ultrasound as a sole screening tool for breast cancer.

read here:

doc said...


it's the events that unfold in hospital that prompted me to share why we should all be content with what we already have.

your boy is growing up nicely in the Lord's way & despite all your claimed shortcomings, you must have done something right.

after you've sorted out your situation, i hope you'll go back to the original path. you need a CG's support for spiritual growth. taking a breather is ok, but don't stop breathing for too long!!

God bless!

doc said...


double whammy was the original title of this post but i thought it sounded a tad crude.

rightly so, all breast lumps should be removed because even the benign ones will eventually turn malignant.

in the light of this new finding, you will have to discuss your situation with your doctor & decide what's best for you.

doc said...


this recent finding concerning radiation exposure refers to REPEATED mammograms. so if you've not had one done before, then i think you should go for one. there's ample evidence that mammograms detect early breast cancers & do save lives.

after you've had the med check-up, then you should discuss with your doctor what you should do next year.

Yan said...

All in a day, and all's well. I am blessed with a sister's status update in her facebook yesterday - ALL IS WELL. I thought - that should be the message from Up Above. It's all in caps - ALL IS WELL. Thanks, Connie Ding.

I did leave message somewhere, should be your blog, of the fact that I was generally unwell.

So, I went for a blood test. The test results came back yesterday with CA125 at 138, which is over by 4 times. A doc friend in Singapore said with authority -

You have low grade inflamation somewhere - not too serious.
Repeat CA125. Do a gastronoscopy and HP test. (because I was vomitting and no appetite etc).

I asked, actually trying to bargain - when to repeat CA125, when to do gastronoscopy.

He ordered in a short command - do CA125 repeat tomorrow. If still high, do CT abdomen scan. Do gastronoscopy this week.

Tomorrow means today. This week also means today.

So, alone, I checked into a gastroenterologist's clinic in a hospital. Blood repeated, gastroscope done. Seen a gynae, ultrasound done - ALL IS WELL.

One not done - the CT scan of abdomen which is scheduled on Monday. CA125 is now 74.

Bengbeng said...


ilene said...

Thanks DOC for the advice. Actually, I've been doing so every alternate year and I'm due to do so again this year! Perhaps I shall skip and keep for next year's!

I've already asked those medical officers and they said it's all untrue. Of course la they need to make money for the hospital! ;)

zewt said...

damn if you do.... damn if you dont...

hey... i think with this surgery... it made me treasure the ability to walk... perhaps God was preparing me for all the walking in singapore!

doc said...


CA125 is an unreliable tumour marker, & can be high even in benign conditions like an infection, so your Sing Dr. is right.

all will be well.

doc said...


you're welcomed!

doc said...


you're welcomed. don't put off those mammograms for too long.

doc said...


i'm certain you're destined for great things, if you give Him control of your life.

missyc said...

title of this post has been bugging me the past days.. Prof S was a bit 'dissapointed' with me when I brought up the FEAR subject of being 'unnecessarily' exposed to radiation, CT scan due Sept.

I've had 3 Mammos since 40 & maybe it could be radiation exposure or hormonal changes as last year something showed up but the radiologist was not concerned after ultrasound test. I still have jitters.

I've asked the radiologist regd radiation risk "Will you do it if you are in my shoes" & always gets a hesitant answer Yes/No sigh...

Doc, what about your wife? Mammo yes no ? annually or once every 2years ?

Yday cancer talk @IMU, we were told its 1 in 6 chance for both men/women to be diagnosed with CA. Two years ago I never imagined I will hit the 'jackpot'. Do or don't either way we will die eventually.

doc said...


the fact that your radiologist hesitated over the radiation risk suggests that he/she is also uncertain about the risk/benefit of annual mammos.

i personally discouraged my wife from ANNUAL mammos. better to do self-exam with/without ultrasound. mammos maybe once in 3 years, or earlier if in doubt.

1 in 6 sounds about right for ALL cancers.