Wednesday, December 9, 2009

McDougall on Mammography

I certainly don't agree with John McDougall's dietary philosophy, but I do agree with his recent article on Huffington Post "ACS Chief Sends Mixed Messages On Mammography."

A choice observation he makes:

"The burden of proof of 'the benefits outweighing the harms' rests with those making the recommendations--the American Cancer Society and its Chief Medical Officer in this case. Dr. Brawley has voiced doubt about the benefits of mammography, and now appears conflicted by communicating two opposing stands in less than a month. The American Cancer Society, on the other hand, has remained steadfast in a position that enhances the profits of breast cancer-related businesses, regardless of the effects on women."

As he points out, a typical breast tumor has been growing for ten years (going from one cell to 1 cm in diameter) before a mammogram can detect it:

"Adequate scientific evidence to stop mass screening programs, such as mammography, has been readily available for more than three decades. 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 1977 Jun;39(6 Suppl):2697-703)."

The drive for so-called "early" detection does serve people who have invested in expensive radiologic equipment. If your physician recommends early mammograms, you might want to find out if s/he has investments in or business ties with radiology centers.

It also leads to a lot of unnecessary medical intervention:

"Just as tragic is the devastation to the lives of millions of women with indolent cancers (the latent forms) that would have never appeared in their lifetime if no one had been busy looking for them with screening programs. Once found, these nonthreatening lesions are aggressively treated with life-changing surgeries, radiation treatments, and/or chemotherapies."

Having studied it for about 20 years now, the "science" of cancer treatment in the U.S. has about as much "science" to it as the lipid hypothesis. I can only conclude that it has more commercial than scientific basis. And all dissenters, such as Max Gerson, who produced evidence of cancer reversal with dietary intervention, are labeled nutcases, etc.

Imagine if it became commonly known that cancer can be cured by dietary interventions. What would happen to all those cushy jobs for those searching for cures? The ACS etc. have perverse incentive. So long as the cure is elusive, they continue to have cushy jobs and lots of donations.

Why is this relevant on a paleo blog? Because cancer is a disease of civilization, largely caused by neolithic foods and insulin levels, and we have evidence that paleo diets can prevent and probably reverse some if not all cancers.



For decades those few brave souls who vocally opposed trans fats were labeled nutcases. According to Dr. Enig it wasn't until research from Europe couldn't be ignored any longer that the US government, who for years had said trans fats were safe, changed their position. Now who is the nutcase?

Don said...


So true. Put-downs often cover up a inactive mind lacking curiosity or in a comfy position the holder wants to defend.

sandra said...

I'm not sure I agree... I was diagnosed with stage 3 breast cancer at 38. Tumor was fast growing - perhaps not growing for 10 years before detectable. Wouldn't I have been better off to treat this earlier? Some doctors used to recommend base line mammograms at 35. perhaps this was pure greed, but if my tumor had been detected 3 years earlier perhaps the cancer would have been stage 1 instead of 3. Frankly, I would be fine with some selfish jerk making obscene profits if it meant I could have heard the news that my cancer was "only" stage 1! On the other hand, if I hadn't found out about the tumor until age 50 in keeping with new recomendations, well...

Don said...


We have a better and safer technology for earlier detection of possible cancer: Thermography. But there is so much investment in mammography, that the old guard fights the spread of this technology.

How did you first detect your tumor?

sandra said...

I found a lump during a self-exam. Didn't do them often as I thought my risk was low: no family history, young (enough), skinny, breast fed 3 kids, etc.

I agree that my cancer was probably caused by diet... I overdid carbs big time as I remained thin on a high carb diet.

Unfortunately, the possible sugar/carb - cancer connection is not well known. My oncologist had me meet with a psychiatrist because (after doing research)I starting restricting sugars...

Women will continue to get breast cancer because of this lack of information. Other technologies may work better than mammography (and they should be used!), but it doesn't follow that mammograms do not work AT ALL.

Perhaps for older women it may make sense to stop some grandma was diagnosed in her 70's, refused chemo (she didn't want to lose her hair!), and she died at 93 of a stroke. Tumors in younger women tend to be more aggressive though, so why not screen? False positives stink, but actually getting diagnosed with a late stage cancer stinks worse (a lot worse...).

Don said...


"I found a lump during a self-exam."

As I expected. Most breast cancer is discovered by self-exam, not by mammograms (don't have the reference handy). Mammograms are superfluous. Thermograms give a far earlier detection of abnormality without exposing the breast to carcinogenic radiation.

Ed said...

Is cancer caused by hyperinsulinemia, or by hyperglycemia? Hyperglycemia would cause hyperinsulinemia (except for type 1 diabetics).

Joanne at Open Mind Required said...

I went to the VA hospital to have blood work so I could know my lipid panel and nutrient status. They did the lipid, vitamin D, and iron tests. They refused the rest because it was costly.

Then the nurse seeing me wanted to schedule me for a mammogram and pap smear. I declined the offer and she basically tried the "Shame on you" approach.

Okay, so you won't test my vitamin status because it's costly, but you want to schedule these costly procedures and shame me into participating?

I just can't see the benefit of crushing my breast and exposing them to radiation and chemo. Chemo has a VERY LOW success rate with breast cancer, or so I have read. I wouldn't submit to it anyway. I'll just keep making dietary changes to improve my overall health.