National Breast Cancer Coalition

Sometimes I hear that there are no breast cancer advocacy groups who question the benefits of screening mammography.   Well here's a rather large one:


The National Breast Cancer Coalition (NBCC)* is a powerful voice, speaking for women and men across the country, demanding victory in the war against breast cancer. In 2003 it was named one of the twenty most influential groups in health policy based on a survey of congressional staff-the only grassroots group and the only breast cancer organization to make that list.


NBCC has grown to include hundreds of organizations, representing several million patients, professionals, women, their families and friends. Coalition members include cancer support, information and service groups, as well as women's health and provider organizations.




Check out what they have to say about the recent Preventive Task Force Services screening mammography recommendations 

http://www.stopbreastcancer.org/index.php?option=com_content&task=view&id=978&Itemid=179


And this

http://www.stopbreastcancer.org//index.php?option=com_content&task=view&id=976&Itemid=179

To Overhaul the System, ‘Health’ Needs Redefining

http://www.nytimes.com/2009/07/28/health/views/28essa.html?partner=rss&emc=rss

Great Essay 

ends with:

If you are one of the millions of Americans adversely affected by the unrelenting growth of health costs — an employer that can’t afford insurance or a patient who can’t afford prescription drugs or can’t find insurance at all — you have to take back responsibility for deciding what health really means, not surrender that decision to “experts” with strong financial incentives.

And even if you are one of the few who doesn’t need to worry about money, you still need to take back this responsibility. Your health may depend on it.

Crestor and the Jupiter Trial

http://www.msnbc.msn.com/id/36107368/ns/health-the_new_york_times//

A main steam news article talks about absolute risk reduction, this is almost unheard of!

So here's what the Jupiter trial showed, if you have an elevated CRP and have 1 risk factor for heart disease (what we formerly called "low risk") and you take Crestor for 2 years you might be the one person out of 500 taking the pill that had a heart attack prevented. Doesn't that sound less glamourous than "50% reduction"?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61965-6/fulltext#

The problem with that, among many, is that statins in general seem to raise the diabetes rate. This was shown in the Jupiter trial but that study was pretty short-lived. Other studies of statins show that taking the pill for 4 years will give you the chance of being the one person out of 250 that gets diabetes from taking the pill. Now maybe Crestor is a little lower or a little higher (it IS more potent that other statins so it's probably worse than 1 in 250 but no proof on that yet).

And this is just interesting with all the Vitamin D tests we're ordering now.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)68971-X/abstract

Again this all boils down to a highly lucrative experiment. We have no idea what taking Crestor for 3 years , 4 years or 20 years does to someone with a low risk of heart attacks. It's kind of despicable for a study that's supposed to be about heart attack prevention in relatively young healthy people to just run for 2 years. But it's par for the course.

It's really amazing to see the media talking about the down sides to these fads. The world is a changing my friends.

Quitting smoking

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000216

• Research shows that two-thirds to three-quarters of ex-smokers stop unaided. In contrast, the increasing medicalisation of smoking cessation implies that cessation need be pharmacologically or professionally mediated.

• Most published papers of smoking cessation interventions are studies or reviews of assisted cessation; very few describe the cessation impact of policies or campaigns in which cessation is not assisted at the individual level.

• Many assisted cessation studies, but few if any unassisted cessation studies, are funded by pharmaceutical companies manufacturing cessation products.

• Health authorities should emphasise the positive message that the most successful method used by most ex-smokers is unassisted cessation.

  
  

  
  

  Oh my goodness! So let me get this straight. Most people who quit smoking, do it without using ANY pharmaceutical products or "professional" help.

  So when folks want to quit smoking, we should tell them the best thing for it is for them to just do it. We can charge you some money but it is your efforts that will determine success.

  Change all the ads for Chantix to ads stating "most ex-smokers quit without paying a dime to the medical system"

  I guess that'd be bad for business.

  
  

  
  

Framingham Risk

http://hp2010.nhlbihin.net/atpiii/CALCULATOR.asp?usertype=prof

This is the starting point for anyone considering cholesterol lowering medications. It gives us the 10 year risk of having a heart attack. When the risk is in the single digits, usually you can stop thinking about cholesterol lowering drugs.

I've had family members placed on cholesterol lowering drugs or combinations of cholesterol lowering drugs inappropriately. We live in a medical culture that encourages "doing something". But the evidence of harms usually outweighs the evidence of benefit in the general, healthy , symptom-free population. We have to be very careful when doing things to the symptom free , general population. We have to have solid proof of benefit > harm before we start doing tests, procedures and prescribing preventive pharmaceuticals to healthy people.

Otherwise we will continue to do more harm than good.

Trans Fat

http://en.wikipedia.org/wiki/Trans_fat

Interesting stuff about the history of the chemistry of diet, marketing of a byproduct of industrial soy bean production, and health effects of lab manufactured fat.

Makes me want to eat a cup of crisco, yummy

My pal over at the Skeptic's Health Journal is to blame for this post :)

http://healthjournalclub.blogspot.com/2010/03/100-year-diet-revisited-trans-fats.html

Drug Companies Funding Patient Advocacy Groups

http://speakingofmedicine.plos.org/2009/10/28/drug-companies-and-patient-groups-uneasy-bedfellows/

Ever since Lenzer’s investigative report, I’ve come to realize that many patient support groups, which often claim to provide “independent” or “impartial” advice, have very deep ties with drug companies—ties that present real or perceived conflicts of interest.