Cancer in Europe: The situation for women
Could the number of people dying from cancer be lower in Europe?
GM: Yes, if all the best approaches were made available to each and every patient, cure rates would rise dramatically. Thousands of unnecessary deaths would be avoided.
What about the debate on paying for breast cancer screening only from a certain age...
GM: It is very unlikely to get breast cancer when you are under 40. Breast cancer is [usually] a disease of older women.
So it’s OK to start screening only from 40. But it shouldn’t stop at a certain age. Denying older women the screenings is really bad, as they’re much more likely to get the disease than women under 40.
Plus: The more mammograms you have the more you have a risk as the x-rays damage the cells. And don’t forget that mammography increases anxiety levels and costs.
So does breast cancer screening actually increase the risk of breast cancer?
GM: Yes, the x-rays damage the cells every time you have a screening, but the damage is usually repaired by the body.
If a woman has damage to one of the family breast cancer genes (BrCa1or 2) the damage is not repaired efficiently. This is well known which is why we advocate MRI that uses magnetic fields rather than x-rays to monitor young women with those dud genes. Again, unfortunately MRI is not available in each region of Europe.
Is there a proven way to prevent breast cancer?
GM: Yes, remove the breast. There is no other 100 percent prevention than that, no dietary prescription or anything like that. Other than a total mastectomy, there are hormone treatments proven to be successful for women with a high risk of breast cancer – that is those women with a family history, lumps in the breast, no children or those who haven't breastfed.
We haven’t found a virus which might cause breast cancer so we have no vaccine. In contrast cervical cancer is due to certain viruses which are caught by having unprotected sex with a man carrying the virus.
Fortunately we now have a vaccine which should protect most women from the virus, and therefore the cancer. No evidence has been produced yet to show that the vaccine is any good in women already infected by one of the viruses.
Overall, in your opinion has the situation for women improved?
GM: There is good news and bad news. The good news is that we have dramatically reduced the number of women dying from breast cancer. For others like cervical cancer we even know how to prevent it: safe sex and the new vaccine.
But the bad news is that the number of women smoking has grown and therefore the number getting and dying from lung cancer has also grown, so much so, that more women die from lung cancer than from breast cancer. The sad thing is that this is purely self-inflicted because more than 90 percent of lung cancer cases come from smoking.