Living with the ‘C’-word

Helping women to make an informed choice about breast screening

by Nov 05, 2012 No Comments

So at last we have it – the results of the much heralded (in my world at least!) breast screening evidence review. It has been much anticipated by the breast cancer community, in the hope that finally, this would be the one that would settle the argument. So does it? The UK breast cancer charities have looked at the outcome and feel, yes, this is good news for women. The review has shown that breast screening can save lives – around 1300 a year in the UK, that’s around 130 here in Scotland.

But there are some downsides to screening reported in the review. The data suggests that 1 in 5 of those diagnosed through screening is over diagnosed. So some women are diagnosed and treated for a cancer that is at such an early stage it might not have caused them harm in their lifetimes.

The problem is we don’t know at the moment which cancers will grow and become harmful so all women in this situation will be offered treatment.

And let’s not forget that also means 4 in 5 women who have a cancer diagnosed through screening are having treatment for a cancer that will cause them harm if left untreated.

But the big question is – how do women make sense of this report? What do you do if your screening appointment drops through the door this week? It’s vital to read the information to enable you to decide to attend screening – or not – armed with the facts and confident in your decision. At Breakthrough Breast Cancer, we will continue to work with the Government here to get the leaflet as clear as possible and also provide and update the information ourselves to enable informed choice at all times. And in the future, we will work to ensure research offers us the ability to know which cancers will spread and which won’t, therefore reducing the risk of over diagnosis. Does it settle the argument?

Probably not, but it does move on the debate and offers access to updated information and that has to be a good thing.

At the heart of this debate it’s about personcentred care. It’s about giving people the right information, asking them the questions that help them to explore what is a good outcome for them, personally and then supporting them with that decision. And traditional approaches such as ‘doctor knows best’ have no place in modern healthcare.

As medicine becomes ever more complex, with an increasing ability to consider individual risks, the skills of the healthcare professional need to evolve too. From my personal experience, as someone who found making a decision on treatment this time around very complex and stressful, I know the value of a team who gave me the information, tried as far as they could to explain my risk and supported me absolutely to make my own decision.

They also gave me time to make that decision.

Often with a cancer diagnosis we panic and think there is no time. That’s not always the case so people should be given the time they need. To be honest, sometimes I revisit that decision and think ‘did I get it right?’ But I know it was right at the time and that’s ok. This column is called Living with the C Word and the short answer is it’s hard to do that at times and the recent controversy can make it harder. Newspapers should remember that when they chose their headlines…

Reasons to be cheerful The pup is getting out for walks. So trips to Cramond beach and Inverleith Park are making the transition to winter so much easier.

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