Over the past couple weeks you’ve probably heard about the heated debate between the “government task force” and the American Cancer Society’s recommendation on mammograms. Basically the ACS says to get one every year as soon as you hit 40 years old while the government says to get one every-other year starting at age 50. Obviously a big discrepancy. Now whether this is because of the government findings showing the benefits are less and the harms are greater when screening starts earlier, or it’s a coincidence coming out at the same time as the health care overall – who knows. I’ll let you make your own conspiracy theory out of it; I’ve got enough of my own to deal with.  Here are my thoughts:

Everybody is an individual and if you have a family history of breast cancer and/or other cancer and your health is poor, then sooner than later may be in your best interest. If you don’t detoxify estrogen well or if you take any hormone replacement therapy (natural or synthetic), then sooner may also be better for you.  There is a very strong correlation between poor estrogen metabolism and breast cancer. How do you know if you don’t break down estrogen well? One main symptom is breast tenderness – particularly during the end of your cycle (PMS). Breast tissue is loaded with estrogen receptors so the estrogen is attracted to that area as much as Southerners are attracted to the Waffle House. So when you’re not breaking the estrogen down in your liver it goes and hangs out in the breast tissue, pulls fluid with it, and the tenderness follows (so does some size increase). I consider this a risk factor for breast cancer, even though you won’t read about it in any mainstream medical report. There are also simple [urine] tests that you can do to see if you have more of the “good” estrogen as compared to “bad” estrogen. More bad than good would not only lead you to consider getting a mammogram sooner, but you'd also want to take the necessary steps to improve estrogen metabolism.

And that brings me to the topic of prevention. With all the back-and-forth of the health care overall and what is going to be covered and what is not going to be covered there’s this talk about “preventive” tests like mammograms and colonoscopies. Since when are these preventive? I thought preventive meant to slow or deter something – like a disease – like cancer? So if a mammogram or a colonoscopy detects a problem, what was prevented? These are diagnostic tests to show if there is, or isn’t, a problem. Sticking with the topic of mammograms and breast cancer, prevention is eating well, not smoking, exercising, lowering alcohol content, and not taking birth control pills or any other form of hormone replacement therapy, just to rattle off some examples. It’s about taking care of your entire self, not living recklessly so you go get your mammogram, find a problem, and then the prevention is what?...preventing yourself from dying is the answer. When was the last time you heard your dentist say he or she wanted to prevent cavities in your mouth so all you need to do is get annual bite-wing X-Rays? No - you brush, floss, and eat well to do that…the X-Rays are there to find a problem after the fact and resolve it to save the tooth.

So I got this letter from my health insurance company the other day, (stay with me here, I’ll tie it in), saying that if my family and I head on over to Walgreens then we get a free H1N1 vaccine. The kids were close by so expletives were kept within as I read that pregnant women, persons from 6 months old to 24 years and persons older than 24 with health problems should get the vaccine. As you hopefully know, from my recent e-newsletters, (search H1N1 in the upper right of the webpage), this is uncharted territory. But I think of all the people who will have the shot because their insurance pays for it. Guess what – just because it's covered doesn’t mean you should do it. Free is not necessarily good. Same case for the mammograms. If your insurance covers you every year starting at age 40 and you’re very healthy and don’t have estrogen metabolism issues then using this free service will most likely pose greater risk than benefit to you. The damage to the breast tissue as well as the radiation endured during each mammogram should always be a concern.

So think about your own health. Think about preventing these problems every day by what you eat, what you drink, what you do. That’s what it’s all about. If you want to do something for your health that's free go walk outside and get some sunshine. The exercise and vitamin D is free and it will prevent cancer more than any test available anywhere.

-Dr. Gangemi