S has been sick since Sunday night and doesn’t appear to be getting better. I don’t think she’s in any danger, but it is awful to see her miserable. Between Frozen and Ibuprofen, I think the former is more helpful in making her feel better. Now L and B both are feeling ill as well. L has her first gymnastics competition on Saturday morning. First of all, she’s trained very hard for it – about 8 hours per week since the summer. Second, it’s a qualifier for future competitions. All in all, I hope she’s well enough to do it. I was supposed to go down and see my sister and her just-turned-one-year-old. My sister is also pregnant. My throat is a little scratchy, and I don’t want to bring this sickness into their household, so I’ve canceled the trip. I was also supposed to go to LA for work next week, and if I’m sick, and I think I am, I’ll have to cancel that as well.
Lastly, I have a colonoscopy scheduled for Friday. I put that off from January, when my initial appointment was canceled due to Covid. (I find it ironic that in SW Virginia, where there were basically no Covid restrictions, my Dad was able to have a completely elective surgery on schedule in January, no issues, whereas here with Covid restrictions out the wazoo, my elective procedure was canceled. The governor in fact canceled ALL elective surgeries by executive order. But I digress.) In any case, I finally grudgingly rescheduled it and am dreading it so much. But with my family history, it needs to be done.
Have you had a mammogram? I have not. I would say I have normal risk – no close relatives have died of it or had advanced cancer, and I don’t smoke, etc. Here is where the recommendations stand:
- The US Preventive Services Task Force – basically the official US recommendation – states you should start at age 50 until 74. USPST says you should have mammograms every 2 years.
- The American Cancer Society says to start at age 45 and have mammograms every year until you’re 54, whereupon you should have them every 2 years until life expectancy is less than 10 years
- ACOG (American College of Gynecologists) says you should go every one to two years starting at age 40, or no later than age 50 until age 75. Upon reading the second link in more detail, ACOG is somewhat ambivalent about its recommendation to start before 50.
I read about this in detail in Mukherjee’s book The Emperor of Maladies. At the end of the day, everyone has to make their own decision based on their own family background and preferences. Reading Mukherjee’s book, which very quantitatively outlined the pros (reduced risk of death) and cons (increased risk of unnecessary treatment and surgery), convinced me that for me, the right choice is to wait. I believe that from a mental health standpoint, an early cancer diagnosis would be devastating, and if that early diagnosis didn’t save my life, the lost years due to anxiety would be worse than the small decrease in risk of death.
What are the guidelines like in other countries? For most women (without major risk factors):
- UK: Get a mammogram every *three* years starting ages 50 – 71
- Canada: Get a mammogram every two or three years ages 50-74
- Ireland: Get a mammogram every two years ages 50-69
- Australia: Get a mammogram every two years ages 50-74
- New Zealand: Get a mammogram every two years ages 45-69
- France: Get a mammogram every two years ages 50-74
- Sweden: Get a mammogram every two years ages *40*-74
- Norway: Get a mammogram every two years ages 50 – 69
- Germany: Get a mammogram every two years ages 50 – 69
- Spain: Get a mammogram every *three* years ages 50 – 69
It seems like all countries are in line with their recommendations: begin getting mammograms at age 50 and get them every two years. The US cancer society and ACOG are very out of family. After looking this up, I think for my personal situation, I feel very comfortable waiting until age 50.
The CDC lists risk factors here. Interestingly, being overweight or obese is NOT a risk factor until after menopause. However, having one’s first pregnancy after age 30 is. Funny how I barely know anyone who got intentionally pregnant before 30. Not breastfeeding is also a risk. Lastly, drinking alcohol, which I do nearly daily, is a risk.
As for colon cancer, the US Preventative Services Task Force recommends all adults get screened beginning at age 50 and continuing until age 75. It also recommends all adults get *offered* screening at age 45 – you get to make up your own mind. Personally, I wouldn’t do it unless I had risk factors or family history. Jonathan has had several, and it’s a pretty rough procedure.
On my Dad’s side, my grandmother died of colon cancer in her 60s. On my Mom’s side, my uncle died of colon cancer in his 50s (onset in his 40s). My grandfather nearly died of colon cancer in his 40s, and his quality of life was permanently affected. My aunt had colon cancer – surgery, chemo, etc. My other uncle had colon cancer – surgery, chemo, etc. Only my grandmother and my mother managed to avoid it. I guess I feel I should get the colonoscopy. I went to see a gastroenterologist many years ago, and she told me I could wait until 40, but here we are.
My father-in-law also died of colon cancer. He did colonoscopies, and they did not find the cancer. Why not? I don’t know. Why didn’t colonoscopies stop my uncles and aunt from getting advanced cancers that required surgery and chemo and ultimately killed my uncle? I don’t know. Apparently most colon cancers grow slowly, and these are the type that colonoscopies save you from. But some people have a genetic predisposition to fast-growing cancers.