No Mammogram Needed

My wife, age 55, has not needed a mammogram for the past three years, in spite of having two aunts who died of cancer. As a Registered Nurse, she is aware of a simple lab test known as CA-125. Any woman who passes it does not need to worry about breast, uterine, cervical, or ovarian cancer. It is much more sensitive than a mammogram, typically picking up cancers as much as two years sooner.

Why are doctors reluctant to order this test? I have asked several local doctors, all of whom knew about it. Their answers are that it produces a lot of false positives or that it is too sensitive and that it does not tell them where the cancer is located. BULL!!!!

The real reason doctors do not order this test, unless you ask for it, is that lab tests do not generate referral fees. Yep, your doctor gets a kick-back on every mammogram he orders. Gone are the days when dedicated doctors accepted a chicken in payment for an office visit. Today’s money hungry docs work every angle they can.

Do you have any information on this lab test? I'd look it up but I'm feeling particularly lazy right now.

Hmmmmmm, the CA-125 (yes I had to look it up) is primarily used to monitor ovarian cancer treatment. A mamogram is essential for diagnosis of breast cancer. Some women will not have an elevated CA-125 level so its not always used for treatment.

also of note:

Because CA-125 can be high in many normal or benign conditions (for example, pregnancy, menstruation, endometriosis, pelvic inflammatory disease), it is not useful as a screening test in large populations.
www.labtestsonline.org...

Now while cancer in general can spike a CA-125 level (according to the Mayo clinic) its more common in ovarian cancer. Using a non specific test as a catch all in a person with a known family history of breast cancer seems a bit risky IMHO

Tumor markers, such as cancer antigen (CA) 125, are substances that can often be detected in higher than normal amounts in the blood, urine or body tissues of some people with certain types of cancer. Currently, the main use of tumor markers is to assess how cancer is responding to treatment.

CA 125 isn't specific to just one type of cancer. But women with ovarian cancer often have elevated CA 125 levels.

Not all women with elevated CA 125 levels have cancer. Many other conditions can cause elevated CA 125 levels, including:
www.mayoclinic.com...=2765

[edit on 11/12/05 by FredT]

www.nih.gov...
www.womenscancercenter.com...
pathology2.jhu.edu...
www.medicinenet.com...
www.labtestsonline.org...

None of these refer to breast cancer, although it is an esterongenic CA and, according to my wife, well known to generate excessive CA-125.

Im not saying it wont work, Im just saying that with a family history of breast cancer, it seems like an unnesssary risk.

Women with a prior history of breast cancer, strong family history of breast cancer, and women with prior thoracic radiation are at increased risk of breast cancer. Women with a history of invasive breast cancer, ductal carcinoma in situ or lobular carcinoma in situ are at increased risk for breast cancer, which is approximately 0.6% to 1.0% per year.[14] Women who have received thoracic radiation, especially under the age of 30, may have a risk of breast cancer of 1% per year, starting 10 years after the irradiation.[15] Women with a family history of breast cancer, especially in first-degree relatives, are at increased risk. (Refer to the PDQ summary on Genetics of Breast and Ovarian Cancer for more information concerning the role of family history.)
National Cancer Institute

Nor could I find any reference to its use as a primary diagnostic tool for breast cancer. For fun, I just spoke with a Oncology fellow on the adult side of the hospital here (Im at work) and asked about this. Mind you we are a big teaching hospital and the docs here do not get kickbacks from the radiology department or the lab for that matter and he also agreed that it was risky to rely on this test even without a history of it in the family.



[edit on 11/12/05 by FredT]

I do not know where to get any information on the following as I am sure it has been supressed but I remember that there was a cancer organization that tried to say that too many women were getting too many mammograms. This was several years ago and was the first time that I heard about the referal fees. The recomendation was short-lived as they were threarened wth some sort of retaliation.

I am sorry that I do not remember any more details but maybe someone else does.

I've requested the test myself and most Drs. don't seem to know about it, even though it appears as one of the preprinted items they can circle on the form to order lab work.

However, to my knowledge, it is really only a good indicator for Ovarian Cancer, I have never seen it discussed as a screening method for Breast Cancer. I think it is something that really should be in addition to the other nasty tests us gals have to get, not in lieu of. (Unfortunately)

I have to agree it is a good "in addition to" test, not an "instead of" test. All tests have their limitations. I can't imagine with a family history of breast cancer NOT having a yearly mammogram. Why risk it?

Don't be misled by the internet. It is a good "in addition to" doctor's explanations and recommendations, not an "instead of".

I wouldn't bet my spouse's life on internet info. Much of which is dubious at best

Here is a link on tumor marker tests: www.findarticles.com...
www.tc-cancer.com...
www.cancure.org...

The more I read, the more I believe that it would be unwise to forgo the mammogram for a CA-125 which doesn't even target breast cancer tumors. Not like a mammogram is that big of a deal.

Originally posted by llpoolej
Not like a mammogram is that big of a deal.

Okay, let's not go that far - have you ever had one?

Originally posted by Relentless
Okay, let's not go that far - have you ever had one?

No but i have seen one on TV Im kidding, but I think the point he was making is that yes it is a test, but not as bad as some, and certainly no worse than say a prostate exam . Also given the benifit of catching any cancer early it does seem like a small price to pay

Don't be misled by the internet.

My wife is a Registered Nurse. Her information did not come from the internet.

The more I read, the more I believe that it would be unwise to forgo the mammogram for a CA-125 which doesn't even target breast cancer tumors.

It targets the CA125 antigen, which is normally present in the body but increases in the presence of tumors which feed on estrogen. This can indicate any tumor of this type.

Not like a mammogram is that big of a deal.

You obviously have never had to stand topless in a refrigerator while your breasts are crushed between two glass plates. My wife says that the pain is so intense that she has to fight the urge to vomit.

with a family history of breast cancer, it seems like an unnesssary risk.

“Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are "sporadic," meaning there is no direct family history of the disease.” www.clevelandclinic.org... asp?index=3986

An antigen marker is far from a comprehensive clean bill of health, or a positive indicator for any kind of cancer. It's one of many tools used in diagnostic, and therapy management.

The continuing "gold standard" for diagnosing breast cancer (beyond a doubt, and a specific type) is a biopsy. There are more than one type of breast cancer, and there are varying degrees of malignancy within each cell type category.

www.breastcancer.org...

www.breastcancer.org...

A Breast Self Exam (BSE) is the first, best step, after that an annual mammogram for women over 40, or women with a family history. The test mentioned (CA-25) in this thread has no medically recognized place in the diagnostic, or treatment phases of breast cancer.

As far as kickbacks go, that is erroneous as well. It's a Federal Felony to provide any form of compensation to a referring physician for medical tests, exams, or treatment. Period. If your wife is a nurse, she should be well aware of that, as well as being aware that the global fee for a routine annual mammogram is typically $50-$75 US Dollars... Hardly the princely sum that would generate any kickback percentages. As a matter of fact, most hospitals and imaging centers lose money on mammograms, and only provide the service to be able to offer "complete imaging services." There's just no money in it, and it has an extremely high risk factor as far as litigation is concerned.

I’ll conclude this with the necessary medical disclaimer, that no one should use the internet, or any other medium as the final word in the assessment of any condition, or in the treatment of the same… Only your physician can provide you with the best, safe course of action regarding any healthcare matter, especially one as serious as breast cancer.

Mammo Monkeys, not just for a little squeeze anymore...

Originally posted by FredT
and certainly no worse than say a prostate exam

.

Okay, I have to say this. knives4less has described a mammogram. It is that bad for a lot of women. I admit to finally being harrassed into a baseline at 40, and now have had to fend them off for the past 5 years. I will get one this year, but my personal choice is that annually is excessive. Okay, I don't advocate other women follow this routine (every 5 years), it is a personal choice and I know the chance I am taking. But I find it unacceptable that nothing has advanced in this area for decades.

I beg to differ that one could compare it to a prostate exam, and in fact a proper complete pelvic exam includes pretty much the same thing that occurs in a prostate exam on top of everything else. Sorry boys, but this is a pet peeve of mine. Woman are expected to endure more annually from puberty than what you boys don't even have to face till 40 or 50, and then they throw in the mammogram on top of it at 40.

It rots, and they should develop and/or use newer technologies that don't hurt. The CA-125 may not be a reliable substitute for a mammogram or even a pap. It certainly SHOULD be included in an routine since ovarian cancer can be missed on the ususal tests performed without it. It is essentially the female equilvalent for ovarian cancer of the male PSA test for prostate cancer. But there have just got to be better ways for the rest of it. I firmly believe if men had to have all the things women are expected to endure annually for the better part of their lives, there would be much better (patient friendly) tests developed.

As for false positives on the CA-125, what's the big deal, it's just a blood test, rerun it prior to jumping the gun. How many women have had a false positive on a mammogram and had to repeat it, as well as then have their mammograms increase in frequency just to be sure. I know a LOT.

I think the time of the month deems how unpleasant it is. I had one at 35(for a reason) and it wasn't bad. My chest wasn't sore at the time though. Had it been, it would have been a different story. I have a low pain threshold and, it wasn't a big deal.

Now, I might not say that had I been PMSing as my chest gets sore enough that looking at them makes me punch my husband.

I have had far more unpleasant medical procedures though. My grandmother has had a double masectomy and with just that history in my family, I won't chance it to a *blood test* that may or may not indicate cancer.

I truly hope your wife is not advising her patients to forego mammograms. If she said that to me, I would let the doctor know her advise, as I totally disagree with it. It isn't a fun test, but believe me, there are far worse. Advanced breast cancer is definitely worse.

I am all for knowing all the information out there. I am very in charge of my health care and sometimes I think doctors suck(some truly do) So, do not think I blindly follow medical things. Really quite the opposite.

My advice is to schedule mammograms during the first half of your cycle when your breast are not as sore. I am sure it is an awful procedure when they are sore. I went into mine about to have a meltdown and left really surprised how non painful it was. Maybe I had an excellent tech.

I still think the CA-125 is a good test to have but really, it targets ovarian cancer. One that is very hard to detect. I am going to start having it done by age 40, as I am in a higher risk group for it. Thankfully, my GP orders tests I ask for as I tend to have a good reason for them.

Funny this thread comes up as I just got a "You need your annual mammogram" notice in the mail. I probably won't do one again this year. My baseline came out fine without even any possible problems. My sister worked in a cancer center and believe me, cancer can be missed on most tests. NONE are definitive unless there is an obvious mass that biopsies as cancerous.

[edit on 11/13/2005 by llpoolej]

Well you could just use a simply pregnancy test to check for cancer..... Your either pregnant or you have cancer ( or if your really unlucky some combination if your female.).

The way they manage to rip us off....

Stellar

Stellar - what type of cancer causes a positive pregnancy test? This is a new one on me, and certainly not breast cancer?????

Originally posted by Relentless
Stellar - what type of cancer causes a positive pregnancy test? This is a new one on me, and certainly not breast cancer?????

This thread is killing me or rather some of you if you are using this type on nonsense for health prevention.....

A pregnancy test checks levels of human chorionic gonadotropin. Some tumors in RARE instnaces can eleveate level. RARE. SO yes it may be possible to detect a cancer, but only on rare occasion and usualy only in RARA cases of placental and or lung cancer.

[edit on 11/13/05 by FredT]

Originally posted by FredT
This thread is killing me or rather some of you if you are using this type on noncense for health prevention.....

I agree Fred, I have some pretty unorthodox tendencies when it comes to medical care, but this thread is really throwing me for a loop.

Please people, listen to Fred on this one. It's getting a tad precarious here.

Originally posted by FredT

This thread is killing me or rather some of you if you are using this type on nonsense for health prevention.....

Well i stated what i knew and expect people to ask for more information if they have never heard of my claims... No one should use material without checking the basis and i rather sure that with the paranoid crowd here no one is going to get hurt.

A pregnancy test checks levels of human chorionic gonadotropin. Some tumors in RARE instnaces can eleveate level. RARE. SO yes it may be possible to detect a cancer, but only on rare occasion and usualy only in RARA cases of placental and or lung cancer.

[edit on 11/13/05 by FredT]

While here is what my claims ( to be honest their not even mine!) are based on

"CHAPTER FIVE — CANCER: THE ONRUSH OF LIFE

"An explanation of the trophoblast thesis of cancer; a description of a simple urine test for cancer; an appraisal of BCG vaccine as an anti-cancer agent; and a review of the vital role played by the pancreas in the control of cancer" (p. 75).

Griffin writes

In 1902, John Beard, a professor of embryology at the University of Edinburgh in Scotland, authored a paper published in the British medical journal Lancet in which he stated there were no differences between cancer cells and certain pre-embryonic cells that were normal to the early stages of pregnancy. In technical terms, these normal cells are called trophoblasts. Extensive research had led Professor Beard to the conclusion that cancer and trophoblast are, in fact, one and the same. His theory, therefore, is known as the trophoblast thesis of cancer (p. 75).

Apparently, when a trophoblast cell develops in the body without the controlling forces in pregnancy, its behavior pattern is to grow, spread, and multiply, becoming cancer.

Griffin explains: "Before we can hope to conquer cancer, first we must understand how nature conquers cancer — how nature protects the body and controls the growth of trophoblast cells. One would suppose that this would be the primary question that determines the direction of cancer research today. Unfortunately, it is not. Most research projects are preoccupied with exotic and toxic drugs or machines that deliver death rays to selected parts of the body" (p. 79).

One would assume that white blood cells, which attack harmful cells that cause infections, ought to attack cancer cells. Why don’t they? There is a protein coating with a negative electrostatic charge surrounding trophoblast cells; white blood cells also have a negative charge. Therefore, they repel each other.

How does nature destroy trophoblast cells? Pancreatic enzymes, when in the small intestine, dissolve the protein coating, allowing white blood cells to kill the trophoblast cells.

Griffin explains that a false assumption is that cancer cells are foreign entities and should all be destroyed. He declares that in the right balance trophoblast cells are a natural part of pregnancy and healing. Cancer occurs when an imbalance is present in the process. "

www.vitaminb17.org...

That one sums up the basis claims so we can at least establish that i am not entirely crazy and that idid not come up with this theory in my basement under my tinfoil hat....

Anyways!

Stellar