Yes I agree - while mammograms have their failings, they also save a great many women an awful lot of trouble surely? Of course we must be aware of their fallibility!
I think the ‘over-treatment’ issue is to do with the balance of risks. It’s not easy and everyone has a different attitude to risk!! (Doctors have a burden of responsibility that must surely tend to make them risk averse?!) Add to that - some people want an expert to make decisions for them while others want to feel they have some agency. It must be difficult being a doctor who’s never met their patient! (And that’s even the case with our GPs these days - they have to assess more than just the ailment within the 10 minute slot.)
It would appear to be clearer with prostate cancer where some men have such very slow growing cancer, that there are more obvious risks entailed in removing it than in monitoring it. I’m thinking that they’re easier to detect with blood tests etc and therefore also much easier to monitor?
For myself - I really wanted to play some active part in my treatment decisions…but there’s no right or wrong here, as long as I get that choice!
Yes I think you’re right - pouring derision on the screening programme and saying that BC doesn’t need to be found at an early stage certainly sounds like a very old fashioned and sexist attitude to me . It doesn’t seem to make any kind of sense - aside from getting treatment it gives us a wake up call and to change our diet / weight / lifestyle etc for the better . I think it will probably be quite a few years before we are able to fully assess the effect of the programme .
I’m sure that it must be more financially viable in the long run as well to be able to treat people at an early stage rather than a later one . We just need the treatments to catch up to that and maybe find a better test ( sorry the mammo didn’t get yours @blue80 ).
@Geeps I’ve learned quite a bit about prostate CA too because aside from the aforementioned friend who has it , I lost a lovely friend and colleague to it in 2022 . The current PSA test hasn’t been rolled out as a national screening programme as it’s not that reliable and often needs to be repeated to find a trend . It can be affected by exercise and ejaculation amongst other things - I believe they’re rolling something out next year though. My friend who is living with it puts on a brave face but I know it’s hard for him - that feeling we all have before surgery that something is growing inside us , he has been dealing with that for 5 years now and I know he’s had his moments with it . I wish there was an easy answer for him 
- he was a good support for me when I was diagnosed.
Joanne
Interesting. I think I remember something about how there may have been over-treatment when the test first came out? My friend’s husband has just had prostate surgery and it’s obviously changed their lives. But don’t our priorities change when we get these diagnoses?! Support from fellow-sufferers is SO helpful - because no one else can QUITE understand what goes on in our head!?
I’m in the US and one of the things I’ll add in regards to surveillance was that if I was in the UK, I’d more than likely be dead or at the very least had a much tougher battle. We do mammograms every year here and have mostly switched to 3-D mammograms. There is a lot of debate over whether every year is too much and for the majority of breast cancer patients it probably could be less and they’d still be okay. But then there are people like me who have unpalpable grade 3’s in large dense breasts that went from nothing one year to more than three centimeters the next. If I had to wait every three years for a mammogram no telling where I would have been. But because I could get one every year with the best technology available, it was caught at an early stage. Anyway, something to think about. Not everyone has grade 1 or 2’s and can afford to wait for a mammo every three years. Especially when breast cancer rates are increasing.
This is indeed the problem with our system. There are ways to include payment/insurance with a free-on-need health system that work in other countries. In Wales we have free prescriptions for everyone - this is a false economy because that payment could relieve pressure elsewhere. Employed people could pay something for doctor appointments (like in NZ) which would stop no-shows which waste money and time! Many people are just having to pay for ops. My friend just payed £15,000 for his hip replacement. (Trouble is, at our age now, no one would give us medical insurance!!) NHS dentistry is non existent and dentistry is horrendously expensive. Children are going without dental care which I find scandalous in a rich country. I grew up when we had school dentist visits! Now we are paying for hospital treatment for kids having rotten teeth removed. Cruel and false economies.
What I like about the American system, from what I understand of it, is the patient is a partner in his/her care rather than being the recipient of handed down wisdom. You get more information about histology, prognosis, treatment options and locations than we do, presumably because if you’re not getting the service you want, you can go elsewhere. The struggle I had to get my histology report was real yet you get handed yours by law. Asking oncology questions to understand my choices was painful too. So the partnership model I like.
I used to have occupational private health insurance but have self-insured since retirement and the irony is, the vast majority of the specialists that you see privately are NHS doctors - and, consequently, you have to see them in the evenings or at weekends! It used to be that people paid for speed of appointments but that has gone down the Swanee since lockdown.
Well, we are where we are.
Indeed. All any of us can do is the best we can and no system is perfect. But I will say at least with breast cancer I am relieved to have been here in the US. I’ve had some out of pocket costs and they have been substantial but I’m not dead and actually have a good prognosis. It would have been different for me in the UK.
And dentistry should be paid for in regards to your system. Studies show that healthy teeth mean quite a bit as far as cardiovascular health. I had no idea you all didn’t have that included. It’s not included as much here in our insurance policies as it should be but most companies include it in their health plan.
The difference in attitude all along the line struck me when I saw a consultant privately once. From reception to being met and ushered into his room by the consultant himself! I felt this should be possible to achieve a bit more in parts of NHS - even taking into account its pressures - after all, a lot is down to INDIVIDUAL politeness and consideration! When I was in NZ, the local GP came out of his office to call me and introduced himself as he showed me in. At our small country practice you watch notices on a moving display board till your name pops up on it with a room to find. Then you trot down a corridor looking for the room! Sometimes the doctor introduces him/herself (always a different one!). Quite often, receptionists seem like they couldn’t care whether you were there or not. Yet now the dentist and optician are private, they all sound like they really care about me (even if they don’t!) It does work in NHS sometimes - at the cancer centre everyone was SO polite and considerate that it was touching and helped hugely at a scary time. Appointment times were surprisingly accurate and when there was a wait you were warned - acknowledgement and a kind smile go a long way!
Don’t get me wrong, I know we’re still lucky to get diagnosed and treated so fast, it’s just that we could go further with personal interactions (from reception upwards!) and recognition that we should be allowed to be involved in our own care. I work in a shop sometimes and know the value of engaging with customers. We both enjoy the experience more when we think we actually care!!!
There are apparently still the odd dentists doing some NHS work, but they are rare as hen’s teeth.(!) When we moved 20 years ago we couldn’t find a dentist taking new patients at all - NHS or private - so we had to travel 50 miles back to our old one for several years till a new dentist came here! He started as NHS but had to give it up and go private because the costs were higher than the remuneration.
A friend works as a dinner lady in a high school - she found she was the only kitchen employee to have herself and kids registered at a dentist!
If anyone works on the minimum wage they couldn’t afford any dentistry - I had to pay £89 for an emergency appointment and my very necessary treatment will be hundreds of pounds. The cheapest would be to have your tooth out but even that would take a day’s wages for some!
Our largely wealthy govt ministers seem to have no interest or empathy.
Mmmm. Teeth are important. They are finding the health of our mouth is linked to the health of our bodies in studies. Take care of your teeth.
Hi. I don’t know if you’ve had your result from your mammogram but hope everything is ok. I was a bit freaked out last week when I had a phone call offering me a much earlier appointment but they said everything is ok.
Hi, how did you get on with your appointments? Everything still OK?
My first annual mammogram was clear, hooray! I have had these weird bruise/like pains - not scar related. So I saw the surgeon who said Give up caffeine and the pains will go! Can’t for the life of me remember the exact reasons how or why - why do we go blank sometimes at appointments?? So much to take in…and probably I was so horrified at the thought of giving up my coffees!! 5 weeks on it hasn’t all gone yet but I’m living in hope! X
Funny isn’t it ? I feel like I couldn’t give up caffeine but for some reason coffee doesn’t seem to agree with me at the moment anyway so I’m barely having any though I’m still drinking tea .
Great news that your mammo was clear and hope that the bruised sensation goes to make it worth giving up your coffee ! Xx
Strangely, although I really didn’t want to give up coffee, I now don’t feel I want to go back to it! I have found a Whole Earth coffee substitute which is really nice and I actually feel more alert WITHOUT the caffeine! I don’t sleep as well as I used to, ( I think that’s an age thing!) but I have slept better since giving up ALL caffeine - I don’t drink de-caffeinated and I’ve never drunk tea. I also used to feel sleepy in the afternoons and fell asleep if I sat down in a comfy chair - and now I never do! Maybe caffeine is a roller coaster of highs and lows?? Some but not all the ‘bruises’ have gone. Trouble is, when you’re out, there aren’t many alternatives to coffee and tea and they’re usually really sweet. Today I had my first hot milkshake in Costa!
It’s an interesting experiment!
xx
Yes… I’ve tried a few variations at Costa and Starbucks and decided they aren’t for me . If you go anywhere where they have herbal tea sachets I can recommend Twinings lemon and ginger which is both warming and refreshing . I’ve got some of that chaga mushroom " coffee" to try because my friend swears by it for brain fog - I look at it every morning and vow to try it the following day . Xx
I’m going to try that! X