Dr. Otis Brawley,
chief medical officer of the American Cancer Society told the New
York Times on Wednesday, October 21, 2009, We don’t want
people to panic, but I’m admitting that American medicine has overpromised
when it comes to screening. The advantages to screening have been
How does your
personal physician communicate confidence and comfort to you now?
I am sorry I recommended a mammogram that resulted in an unnecessary
amputation of your breast? How consoling do these words feel,
It is a shame you havent had an erection in the past
10 years due to the PSA test I insisted you get, that led to debilitating
prostate treatments I hope you and your wife understand I
was just following orders from the American Cancer Society?
Tens of millions of women and men have been irreparably damaged
by the universal and enthusiastic recommendations for early
detection programs, also known as screening, from
their personal physicians, neighborhood breast and prostate clinics,
community hospitals, national medical associations and medical societies
over the past four decades. Now, all that the faithful patients
get is a timid apology from the American Cancer Society, evoked
by an article in the October 21, 2009 issue of Journal of the
American Medical Association, titled Rethinking Screening
for Breast Cancer and Prostate Cancer. Since, in my opinion,
this admission of guilt is insufficient, what would be fair retribution
for the harms done?
evidence to stop mass screening programs has been readily available
to your personal doctor for more than three decades. A flick of
the on button of his or her computer, and a ten-minute
search at the National Library of Medicine (www.pubmed.gov)
would have revealed the truth. In 1976 Pietro M. Gullino presented
his findings on the natural history of cancer, showing early detection
is really late detection, at the Conference on Breast Cancer:
A Report to the Profession, sponsored by the White House, the
National Cancer Institute, and the American Cancer Society. He explained:
If the time required for a tumor to double its diameter during
a known period of time is taken as a measure of growth rate, one
can calculate by extrapolation that two-thirds of the duration of
a breast cancer remains undetectable by the patient or physician.
Long before a breast carcinoma can be detected by present technology,
metastatic spread may occur and does in most cases. This report
was subsequently published in the journal representing the American
Cancer Society (Cancer).
In more familiar
words, Dr. Gullino and many other researchers have clearly told
everyone listening: mammography, breast self-examination, PSA and
digital rectal exam are really late detection methods and cannot
be expected to save lives by catching cancer before it spreads.
Unfortunately, there is no profit in telling this truth. So, 386,560
people in the US are diagnosed annually with breast cancer (194,280)
and prostate cancer (192,280); many of them through screening.
the Most Successful of All Medical Enterprises
businesses using two modern technologies the mammogram and
the blood test, prostate specific antigen (PSA) have captured
more customers than all other efforts combined. Campaigns have been
so effective that about 75 percent of men have had a routine PSA
test and about 70 percent of women older than 40 report they have
had a recent mammogram. More than $20 billion is spent annually
on screening for these two diseases.
There are two
customary ways a doctor-patient relationship is established. The
traditional means is that you become ill and you seek out the advice
of a doctor. In this case you initiate the relationship. The worth
of the evidence supporting the doctors treatment does not
need to be very solid. Your doctor is acting in his or her professional
capacity to offer you the best available remedies without any real
guarantee of the outcome. Remember, you asked for the help.
means of establishing a doctor-patient relationship became common
with the introduction of programs looking for early
cancer (screening). In this scenario the doctor comes looking for
you. Life is good you are enjoying your family, hobbies,
and work. Then a knock sounds at your front door by way of a radio,
TV, or magazine advertisement. Just as likely, during an office
visit for an unrelated issue, such as a virus cold, your doctor
admonishes you for failing to have your annual mammogram or PSA
test. Through screening programs millions of people have become
patients. When the doctor turns unsuspecting men and women into
customers then the evidence that the outcome of this campaign will
be far more good than harm must be unquestionable.
21, 2009 the public was told by the American Cancer Society that
this has not been the case for breast and prostate screening. Why
now? The evidence has not changed the only change is that
now a few more people are willing to tell the truth. Why the delay?
Annually, there is $20 billion at stake for screening alone and
hundreds of billions more for the tests and treatments that follow.
The ivory towers of your towns cancer centers have been built
from the blood of men and women subjected to harmful screening programs.
MD [send him mail],
a board-certified Internist, is the founder and medical director
of the nationally renowned McDougall
Program, a ten-day, residential program located at a luxury
resort in Santa Rosa, CA a place where medical miracles occur
through proper diet and lifestyle changes. He has been studying,
writing and “speaking out” about the effects of nutrition on disease
for over 30 years. Dr. McDougall is the author of 11 national bestselling
books, writes a monthly newsletter, and co-founded Dr. McDougall’s
Right Food’s Inc., a producer of high-quality vegetarian cuisine.
You may subscribe to the free
McDougall Newsletter. This
article is the first chapter to Dr. John McDougall’s upcoming book.