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Dr. Zorba Paster: Discuss with doctor whether cancer screening is necessary

The battle cry for cancer has been, “Get tested now.” We’ve been saying this mantra for so long we’ve come to believe that if we don’t test, we’re going to miss something – with the assumption that the “something” could be of great importance and give us the key to a longer, sweeter life.

But does it?

We know breast cancer and colon cancer screening for those in their 50s is worthwhile; the data certainly supports that. We know annual chest X-rays for smokers are worthless. We have standard tests to screen for lung cancer, which kills a staggering 150,000 people a year.

A recent article in the Journal of the American Medical Association’s Oncology publication found that one in seven seniors had unnecessary screenings for prostate and breast cancer. Why?

Guidelines from the U.S. Preventive Services Task Force have argued against screening for these cancers in older Americans because they have not been shown to increase longevity. We assume that if we catch cancer early enough we’re saved. But there are two counterarguments against this.

First is the idea that some cancers are so slow-growing they would never affect a person, so why get treatment? That’s especially true of senior citizens with prostate cancer.

And next, there is the fact that heart disease can strike at any time. So you might be saved from cancer, but heart disease gets you.

This is not an easy black-and-white question. I think it ignites a discussion we need to have with our doctors.

But there is a fly in the ointment. Physicians often are reimbursed based on screening rates. Generally, the more screening you do, the assumption is the better you are. And for the most part, that’s true.

The problem is that the guidelines set by Medicare and insurance companies often lag behind scientific discovery. It takes a while for the guidelines to catch up with the newest data.

To protect yourself, you should ask your doctor whether the screening is really necessary. It’s an important individual decision everyone should make with their health care provider after a robust discussion.

Hello, Dr. Zorba: I read your articles all the time. I have always, ever since I was a child, suffered from seasonal affective disorder. This year is the worst, by far.

I bought one of those “happy lights,” or whatever they’re called, but maybe I’m not using it right. I am 63, retired, have always suffered from depression anyway, and just don’t want to do anything.

I do drink here and there, and I hate to say, it helps somewhat. Please, any tips for me? – DK

Dear DK: The “happy lights” do work, but only so much. It looks to me like depression is also an issue for you, along with SAD.

I use the one-third rule when it comes to treating this: One-third of the people are helped with antidepressants, one-third with counseling and one-third need both.

Some need to have treatment throughout their lives, while others only need it intermittently. I suggest you talk to your doctor about this and get help.

The other side of the coin is lifestyle. Regular physical exercise, a Mediterranean diet and being with friends are crucial.

But there is another issue we can’t ignore: your drinking. I am not a teetotaler, but I don’t think drinking is OK all the time.

I suggest you stop all alcohol until you’re better. Even one drink a day can affect your mood, and you won’t know until you take a break.

Dr. Zorba Paster hosts a radio program at 3 p.m. Sundays on WBFO-FM 88.7. See a related story on the importance of colon cancer testing, Page 14.

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