Mammogram that proves better for women with dense breasts barely used in the United States

A large study shows that one particular mammogram can find more cancers for women with dense breast tissue.

According to a recent story by Roni Caryn Rabin in The New York Times, the study, which compared various types of scans, "has found that mammography enhanced with iodine-based dye can detect three times as many invasive cancers in dense breast tissue as ultrasound."

Women with dense breast tissue are at an elevated risk for breast cancer. Because insurers often decline to pay for scans such as the contrast-enhanced mammograms, many women stick with basic mammograms that often miss tumors buried in dense breasts.

Dr. Fiona J. Gilbert

Rabin quotes Dr. Fiona J. Gilbert, lead author of the study that was published in The Lancet and a professor of radiology at the University of Cambridge's  School of Clinical Medicine, as saying that "contrast-enhanced mammography needs to become standard of care for women with dense breasts" — if they're at high risk of developing breast cancer.

She explained that "when you have lots of white normal breast tissue, it's hard to see the white cancers, but when you do the contrast, the cancers take up the iodine, and all you're seeing is this cancer lighting up."

The Times piece also quotes JoAnn Pushkin, executive director of the educational group DenseBreast-info, to the effect that the study showed contrast-enhanced mammograms could save lives. She said that researchers not only found more tumors but detected them when they were small and had not yet spread to the lymph nodes.

"These," she said, "were tragedies averted. If they had not been found, they would have grown undetected until they were horror stories."

Contrast-enhanced mammography has yet to be approved by the Food and Drug Administration for breast cancer screening, so it is barely used in the United States. It is, however, utilized in limited cases as a diagnostic tool after suspicious findings appear on a regular mammogram.

More information about screenings can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers. My other books are MysteryDates — How to keep the sizzle in your relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter.

Younger adults are missing early warning signs of colon cancer, writer reports in The N.Y. Times

Many adults in their 20s, 30s, and 40s are missing the red flags for colon cancer, a problem that's partially responsible for colorectal cancer rates rapidly rising in that age bracket.

A story by Roni Caryn Rabin in editions of The New York Times a while ago notes that the most common warning sign for the disease is passing blood in the stool.

Rabin's article explains, too, that "rectal bleeding is associated with a fivefold increased risk of colorectal cancer, according to the new analysis, which looked at 81 studies that included nearly 25 million adults under 50 from around the world."

Other common warning signs are abdominal pain, change in bowel habits, and anemia.

At the same time, the story says, rates have declined among older people, "who are far more likely to get colonoscopies that can catch cancers and precancerous lesions called polyps."

Despite the fact that "millennials born around 1990 are at almost twice the risk of colon cancer compared with people born in the 1950s, and have a risk of rectal cancer that is four times as high, young people without a strong family history of colon cancer aren't eligible for colonoscopies until the age of 45," the Times piece adds. 

Dr. Joshua Demb

According to Dr. Joshua Demb, cancer epidemiologist at the University of California, San Diego, and one of the lead authors of the paper that was published in the journal JAMA Network Open, because physicians are less likely to suspect malignancies in younger people, they may attribute a symptom like rectal bleeding to a benign condition like hemorrhoids, rather than cancer.

"We need to facilitate early detection," he was quoted as saying, "and one way is identifying these red flags."

According to Rabin, "from the time younger adults first go to a caregiver with a complaint about a symptom until thy receive a diagnosis can take four to six months on average [and] because the diagnosis is often delayed, younger adults tend to have more advanced disease that s harder to treat."

Colorectal cancer, the story also says, "has long been associated with obesity, smoking, a sedentary lifestyle, high alcohol intake, and diets that are rich in red meat, processed food, and sugary drinks."

More information about red flags can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Study at UC San Francisco finds 'alarming' hike in advanced prostate cancer across California

An "alarming" surge in advanced prostate cancer across California in the past decade may be linked to changes in guidelines that have reduced routine screenings for the disease.

At least  that's the conjecture in a story by Aidin Vaziri in recent e-editions of the San Francisco Chronicle about a new study at UCSF published in JAMA Network Open.

The study, which according to Vaziri analyzed nearly 388,000 prostate cancer cases between 2004 and 2021, "found that the number of advanced prostate cancer diagnoses statewide increased by 6.7% annually from 2011 to 2021."

Erin Van Blarigan

The Chronicle piece quotes Erin Van Blarigan, ScD, the study's led author and an associate professor professor at  the University of California, San Francisco, as believing "this overall rising trend is alarming and has occurred across age groups, regions of California, races, and ethnicities."

Prostate cancer is the most common cancer among men in the United States.

Although the U.S. Preventive Services Task Force in 2012 stopped recommending routine PSA testing for all men, citing concerns over  unnecessary treatments, "UCSF researchers suggest that the shift may have missed opportunities to catch aggressive cancers early, when treatments are more effective," the story indicates. 

California does not stand alone. Nationally, advanced cases of the disease have also risen since the screening guidelines changed. But the Golden State's annual climb is 6.7% as opposed to the countrywide percentage of 4.5. 

More information about screening guidelines can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, its author, aimed at male caregivers.