Cancer: Not Always Bad

CancerI found this article in the New York Times interesting, because it looks like there is scientific proof now behind something that a crackpot once told me.  This was years ago, when I was commuting to a job in downtown Seattle by bus.  The crackpot plunked himself down in the seat next to me and wouldn't shut up.  I had my headphones on, so I just pretended that I couldn't hear him.  But he went on at length regarding his personal theory that we actually get cancer all the time, and recover from it without ever having known that it happened.

The crackpot was hanging this theory on a condemnation of "the medical establishment," and used it to explain how doctors try to convince you that you're sick, so that they can sell you medicine.  Those evil doctors!  But if we stop short of that tangent, it looks like the crackpot was actually right.

About six months ago I read Barbara Ehrenreich's essay, "Welcome to Cancerland," which details her experience with breast cancer.  In it she explores the United States' penchant for mammograms.  We get far more mammograms than the rest of the world, and yet it appears that this more frequent scanning does us no good.  

No more harmful breast cancers are discovered this way - in fact, it is more likely that testing will detect a cancer that would have gone away on its own.  But since it was detected, the oncologist has an obligation to treat it, thus subjecting the poor woman to a battery of toxins, surgery, and a really rotten time all around.

The real proof in the pudding, so to speak, is that the incidence of late stage cancer and breast cancer deaths has not declined as a result of increased breast cancer screening.  If breast cancer screening "worked," we would expect to catch most if not all serious breast cancers, and stop them before they became fatal.  But sadly enough, this is clearly not the case.

The same thing seems to be true of prostate exams, although there is a clearer case in favor of prostate exams compared to mammograms.  It seems that malignant breast cancer usually flares up so quickly that even frequent testing can't catch it in time.  But this is not quite the case with prostate cancer exams.

At any rate, it certainly seems that, as the doctor quoted in the article puts it, "cancer is not a linear process."  This does not mean that you should avoid getting treatment for cancer, should it be discovered, of course!  And strangely enough, I am not comforted by the fact that "Cancer cells and precancerous cells are so common that nearly everyone by middle age or old age is riddled with them."  But it does serve as a reminder that our bodies are pretty remarkable systems.

This discovery also exists at an awkward juncture of medical policy and public debate over health care reform.  Cancer treatment is expensive, and the increased rate of cancer treatment is certainly driving up our health care bills.  But are we really ready to take a "wait and see" policy towards breast or prostate cancer?