Should I Be Tested for Cancer? : Maybe Not and Here's Why

Rating:
Summary: Should I be Tested For Cancer,Maybe Not and Here's Why
Review: "Should I be Tested For Cancer, Maybe Not and Here's Why." by Dr. H. Gilbert Welch is an eye-opening and empowering book for anyone facing the decision to undergo cancer screening and possibly become caught in the medical testing quagmire. I discovered Dr. Welch's book at a time when I was facing this medical dilemma myself. The book brings to light many problematic issues regarding the usefulness and validity of cancer screening and testing, which I believe most of us as consumers are not aware of. In particular, Dr. Welch makes the point that, for a variety of reasons, cancer screening/testing may not always be as beneficial as we the consumer have been lead to believe.
Dr. Welch's book provides a rational perspective to our society's fear of the threat of cancer. He offers the reader a wealth of information that I believe will help others to make a better informed decision when faced with the issue of cancer screening /testing and possible subsequent treatment.
I found his book to be very helpful in alleviating my feelings of fear and helplessness when faced with my own cancer scare. After reading this timely book, my wife and I feel we can be in a position to have a partnership in any future decisions we make with our physicians regarding the choice to undergo cancer screening and/or testing and treatment..

Roo Harris
Little River, CA


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Summary: Cancer Testing Is A Two-Edged Sword
Review: Dr. Welch has performed a great public service by writing this book. In response to the pervasive message that testing for cancer is always good for patients, Dr. Welch explains that the truth is not so simple. In fact, most people will not benefit from cancer testing, and there are serious risks of over-diagnosis and over-treatment associated our most common cancer screening tests. This book is clear, well written, and eye-opening. For anyone who wants to make an informed decision about getting a mammogram, or a PSA test, this book is a must-read.

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Summary: Cancer Screening is Not Always a Good idea
Review: For decades, the American Cancer Society and others have relentlessly campaigned for early cancer detection. And the campaign has been successful - the Journal of the American Medical Association recently reported that only 2% of Americans felt that there are too many cancer-screening tests. Despite this enthusiasm, expert panels of physicians and scientists, after careful reviews of the evidence, do not always endorse screening. Facing these conflicts can be distressing, particularly when confronting issues as serious as cancer.

This book offers insights that clarify the issues for patients and physicians alike. As the subtitle suggests, Welch is skeptical about screening, and his text challenges the establishment. However, Welch is not a medical outsider. He is a practicing physician, a Professor at the Dartmouth Medical School, the former editor of a medical journal, and a researcher who has helped reshape professional thinking in articles in the New England Journal of Medicine, Journal of the American Medical Association, Annals of Internal Medicine, and other key medical journals. Using the traditional medical literature, Welch raises some very challenging questions for anyone considering cancer screening.

Welch's book provides the reader with a new way to think about testing. He tells how cancer tests may identify disease for which there is no effective treatment, or for which the consequences of treatment are worse than the consequences of the disease. Welch explains why it may sometimes be better not to know you have cancer. In fact, many of us have conditions that will never affect us. In one section, he uses data from the pathology literature to demonstrate how fuzzy the definition of early cancer realy is - that different pathologists can examine the same specimens and come to different conclusions about whether cancer is present. Another section offers easy rules that clarify misleading reports of cancer rates. By walking us through the meaning of cancer statistics for individual patients, Welch clarifies what numbers should be important to individual patients.

The bottom line is that this book takes on a difficult topic with remarkable clarity. Dr. Welch provides tools that will help patients play a more active role in their own health care decision making.

Robert M. Kaplan is Professor and Chair of the Department of Family and Preventive Medicine at the University of California, San Diego School of Medicine.

Rating:
Summary: Cancer Screening is Not Always a Good idea
Review: For decades, the American Cancer Society and others have relentlessly campaigned for early cancer detection. And the campaign has been successful - the Journal of the American Medical Association recently reported that only 2% of Americans felt that there are too many cancer-screening tests. Despite this enthusiasm, expert panels of physicians and scientists, after careful reviews of the evidence, do not always endorse screening. Facing these conflicts can be distressing, particularly when confronting issues as serious as cancer.

This book offers insights that clarify the issues for patients and physicians alike. As the subtitle suggests, Welch is skeptical about screening, and his text challenges the establishment. However, Welch is not a medical outsider. He is a practicing physician, a Professor at the Dartmouth Medical School, the former editor of a medical journal, and a researcher who has helped reshape professional thinking in articles in the New England Journal of Medicine, Journal of the American Medical Association, Annals of Internal Medicine, and other key medical journals. Using the traditional medical literature, Welch raises some very challenging questions for anyone considering cancer screening.

Welch's book provides the reader with a new way to think about testing. He tells how cancer tests may identify disease for which there is no effective treatment, or for which the consequences of treatment are worse than the consequences of the disease. Welch explains why it may sometimes be better not to know you have cancer. In fact, many of us have conditions that will never affect us. In one section, he uses data from the pathology literature to demonstrate how fuzzy the definition of early cancer realy is - that different pathologists can examine the same specimens and come to different conclusions about whether cancer is present. Another section offers easy rules that clarify misleading reports of cancer rates. By walking us through the meaning of cancer statistics for individual patients, Welch clarifies what numbers should be important to individual patients.

The bottom line is that this book takes on a difficult topic with remarkable clarity. Dr. Welch provides tools that will help patients play a more active role in their own health care decision making.

Robert M. Kaplan is Professor and Chair of the Department of Family and Preventive Medicine at the University of California, San Diego School of Medicine.

Rating:
Summary: Clear Expose of The Cancer Industry
Review: H. Gilbert Welch, MD, MPH, has written an unusually understandable revelation of the folly of testing for cancer in people with no symptoms. He explains how only a few people will benefit from common tests such as PSA, fecal blood, mammograms and others. He is enough of an insider to be able to explain the flaws in clinical trials being used by "authorities" to recommend extensive testing, and the lack of trials in some cases. The unneccessary biopsies, surgeries, radiations, chemotherapies for slow-growing cancers or even non-malignant ones are presented bravely. The uncertainty of testing is exposed where a positive for cancer may be wrong 1/3 of the time. And it is up to the patient to get second opinions.
The financial and legal pressures on MDs to test excessively are brought out. There is advice on talking or writing to your MD to indicate your unwillingness to undergo too many tests, and not to hold your MD liable if a cancer was "missed" - that is the big thing.
The deaths caused by cancer treatment are aired. This is something very few people, even MDs, know. Even when a treatment can cut the deaths from a particular cancer in half, most current treatments create non-cancer deaths, many of which will be improperly reported.
Welch is a special expert on the misleading nature of 5-year survival rates how they can rise because of early detection, yet with no change in the cancer plus cancer treatment mortality rate.
There are good explanations of how 5-year survival rates are calculated, how age-adjustments are made, how randomization for trials is done, and other things not even taught in medical school, but reserved for medical researchers. And quite easy to comprehend with clear figures and tables.
No errors that I can find; a really excellent book.

Rating:
Summary: Clear Expose of The Cancer Industry
Review: H. Gilbert Welch, MD, MPH, has written an unusually understandable revelation of the folly of testing for cancer in people with no symptoms. He explains how only a few people will benefit from common tests such as PSA, fecal blood, mammograms and others. He is enough of an insider to be able to explain the flaws in clinical trials being used by "authorities" to recommend extensive testing, and the lack of trials in some cases. The unneccessary biopsies, surgeries, radiations, chemotherapies for slow-growing cancers or even non-malignant ones are presented bravely. The uncertainty of testing is exposed where a positive for cancer may be wrong 1/3 of the time. And it is up to the patient to get second opinions.
The financial and legal pressures on MDs to test excessively are brought out. There is advice on talking or writing to your MD to indicate your unwillingness to undergo too many tests, and not to hold your MD liable if a cancer was "missed" - that is the big thing.
The deaths caused by cancer treatment are aired. This is something very few people, even MDs, know. Even when a treatment can cut the deaths from a particular cancer in half, most current treatments create non-cancer deaths, many of which will be improperly reported.
Welch is a special expert on the misleading nature of 5-year survival rates how they can rise because of early detection, yet with no change in the cancer plus cancer treatment mortality rate.
There are good explanations of how 5-year survival rates are calculated, how age-adjustments are made, how randomization for trials is done, and other things not even taught in medical school, but reserved for medical researchers. And quite easy to comprehend with clear figures and tables.
No errors that I can find; a really excellent book.

Rating:
Summary: Excellent and timely!
Review: This book has helped restore some sanity (namely, my own). After reading extensively about the value of mammograms and other widely used cancer screenings, I concluded that the benefit to myself as an individual was probably minuscule -- or perhaps even negative. But I seemed to be the only one who thought so. It all left me wondering: Am I missing something? Are my math skills really that bad? (Hey, I checked the numbers with my RPN calculator!) Am I just loony?

After reading this book, I was relieved to discover that the answer to these questions is no. Well, OK, maybe there are other grounds for answering yes to the last one, but never mind that.

I would recommend this book highly. It is exceptionally enlightening and useful, and very clearly written. It's also much needed now, with the drumbeat for testing growing louder every day. An ad in my local paper recently tried to terrorize women into getting mammograms by saying, "You may be dying and not know it." Subtle, eh?


Rating:
Summary: Highly recommended
Review: This is a superb book. I recommend it to all adults and all students. It is written clearly and is easy to read. It is interesting with well researched facts, but also enjoyable and exciting because of the author's personal voice. It is an important subject and an important book. Medical school instructors, and even daring college and high school biology instructors might even cover this book in their classes. I know most students will keep their eyes wide open during discussion. What a contribution to society!

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Summary: What everyone should read.
Review: This will be a short review as I am not an authority. Everyone in America should read this book, including all Doctors and Nurses. Taking what any one Doctor prescribes as indisputable is dangerous to your health. Second opinions should be the norm and not the unusual. This book could save a lot of stress and worry for people in need of health care. Dr. Welch performed a great service to the average citizen using todays health care.