ďDonít give up; Donít ever give upĒ
Almost 17 years ago a retired basketball coach and sportscaster, Jim Valvano, passed away. He will be remembered always by his enthusiasm for life, his David versus Goliath victory – North Carolina State beating Georgetown to win the NCAA national championship – and seven words of ultimate encouragement: Don’t Give Up, Don’t Ever Give Up!
Mr. Valvano died from the ravages of bone cancer, within a month of diagnosis the disease had metastasized throughout his body. He physically succumbed to the disease; but he started a foundation to find a cure for cancer – The V Foundation.
Coach Valvano sought to create a foundation that would carry on his fight long after he was physically able. He succeeded.
This month – November – is Prostate Awareness Month. Last month was Breast Cancer Awareness month. These dreaded diseases attack us, our families, and our friends with little warning. This is why we get screened for these diseases on a proactive basis.
Prostate cancer affects 1 in 6 men. Two-and-a-half million women currently have or have had breast cancer in the United States alone. Suffice to say that a majority of these cases have been diagnosed in women over the age of 50. Men also face the risks of prostate cancer growing as they age as well.
Just this month, the U.S. Preventive Services Task Force (USPSTF) is recommending sweeping changes in its breast cancer screening guidelines.
They have made these recommendations:
Routine screening of average-risk women should begin at age 50, instead of age 40.
Routine screening should end at age 74.
Women should get screening mammograms every two years instead of every year.
Breast self-exams have little value, based on findings from several large studies.
Why is the Department of Health and Human Services providing these new guidelines? It’s stated purpose is to limit the number of false positives and reduce stress among women who have findings that are inconclusive. Of course, any procedure has its risks, but what is the extent of risk compared to the proper and early detection of breast cancer.
Could the elimination of screenings for a decade prior to the age of 50 and the elimination after the age of 74 have anything to do with costs?
Let’s review the recommendations.
First, according to the American Cancer Society, 3% of women develop breast cancer before the age of 50. Not all of these women have familial history to prompt for early screening. They should not be held to an arbitrary age restriction. Three percent is a low percentage but a large number.
Second, for women over the age of 74 why should they forego screenings? Are their lives less valuable? Is the risk that much higher?
Third, limiting the screenings to once every other year seems the most appropriate of the recommendations, but only in the low risk patient.
Lastly, the fourth point regarding dismissing self examinations is ridiculous. Who knows their own body better than one’s self? It costs virtually nothing using the FDA approved Breast Exam aid. It costs nothing without it.
Will the future hold that men shouldn’t be examined for prostate issues until age 50 even though the risks for that age group are small?
Will recommendations to discontinue screenings for prostate in men over the age of 74 be next? After all, how much life is there after 74?
The industry does not need another reason to cut services to its insured customers.
Our system of healthcare is for the time being a private industry with major governmental influence. If the government produces recommendations like this that start to limit services to patients, then we are headed in the wrong direction.
As Jim Valvano fought to defeat cancer, we should say enough is enough. We have the freedom to choose our own physician and – based on our own history – we should be able to get the appropriate level of screening that we and our physician decide.
Decisions like this will make it harder to get these procedures paid through our health insurance plans.
“Don’t give up, Don’t ever give up!”
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Excerpt from Jimmy Valvano’s speech at the 1993 ESPY Awards, March 4, 1993
“…I just got one last thing, I urge all of you, all of you, to enjoy your life, the precious moments you have. To spend each day with some laughter and some thought, to get you're emotions going. To be enthusiastic every day and [as] Ralph Waldo Emerson said, "Nothing great could be accomplished without enthusiasm” – to keep your dreams alive in spite of problems whatever you have. The ability to be able to work hard for your dreams to come true, to become a reality….…"Don't give up, don't ever give up." And that's what I'm going to try to do every minute that I have left. I will thank God for the day and the moment I have left…”
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Note: The USPSTF, which is a group of independent health experts convened by the Department of Health and Human Services, reviewed and commissioned research to develop computer-simulated models comparing the expected outcomes under different screening scenarios.