cancer testing: a fiasco,a misunderstanding or a mystery?

This post has nothing to do with wine but is something I’ve been pondering …

On Wednesday we went as a family to the funeral of Annabel Cooke, a friend who passed away young after battling cancer.  She was an amazing wife and mother but now Richard and their three young children – Josh, Olivia and Ben- must face life without her.  She was also an adored daughter, daughter- in-law and sister.  She was an incredibly giving person and will be missed in many areas of the Marlborough community.  Tragically she is the third young mum to pass away from our St Mary’s primary school community in the last 3 – 4 years (in October of 2008 we lost Janet McLean to cystic fibrosis and before that Jo MacFarlane, also to cancer), all wonderful women who I often have moments of expecting to see walk cheerfully into the school grounds to collect their kids.   

During the time I spent with Annabel I was amazed by how she continued to put others before herself.  On the evening of her terminal diagnosis she was off to school to a parent helpers’ meeting for school camp. Even in her final days when visiting her in the hospice, dosed up with morphine and in a lot of pain she wanted to know what she could possibly do to help out with the upcoming school gala, she was interested in my family and how they were doing, she loved hugging my baby boy and trying to make him smile, she mentioned having Plunket stuff  to finish, she expressed concern about another cancer sufferer in Blenheim who she thought was doing it harder than her, she wanted to work on scrapbooks for her kids …and this wasn’t someone in denial – she was also busy planning her funeral.

I was stunned at how graciously she accepted her fate and how courageously she faced her suffering.   This was someone who made the decision very early on not to be angry nor to fall into justified self-pity.   As a mum I could only feel gutted at her predicament and couldn’t  imagine how I’d cope if I was facing having to leave my children.  It prompted  me to check my own smear test dates and see if I was due again.  But I knew testing hadn’t saved Annabel despite her being conscientious about it.  I also watched a piece on tv recently about Taihape mother Elizabeth Lennox who was diagnosed with terminal cervical cancer despite a series of normal smear test results.  I wondered what sort of fiasco was going on with smear testing – was there incompetence, was someone not doing their job, was there another Bottrill case brewing? 

All this made me pick up the recent Listener (Feb13-19 edition) because of a heading on the cover:” Cancer Test controversy – why you can’t rely on screening to save your life.”  The article was a bit of an eye opener for me as I had misunderstood cancer testing to be fairly full proof.  I was not aware that false results are quite common with cancer screening and that these are not really evidence of negligence as such but are simply a reflection of the limitations of cancer testing.   As the Listener article stated: “About 21 women are likely to  develop cervical cancer each year despite being screened.”  According to Breastscreen Aotearoa “if 1000 women aged 50 to 69 have a mammogram very two years for 20 years, seven will have their lives saved, nine will end up with breast cancer that wasn’t detected by screening and 13 will die despite being screened.”  According to the National Screening Unit, women aged 50 – 69 reduce their risk of dying from breast cancer from 1.42% to 1 % with regular mammograms.  All that boob squashing and anxiety for 0.42%.  And for you blokes, well prostate cancer testing  is probably the most unreliable of all – this time with too many false positives – a large European study is reported to have found that as many as half of all men with screen detected prostate cancer may be being treated unnecessarily.  And I gather that this treatment is no fun either!  It surprised me that testing was so inaccurate.  Don’t get me wrong, I still value cancer screening tests immensely because  there’s no doubt it does save lives – but it’s not full proof.  The New Zealand Cancer Society warn in the Listener article that while they support screening they don’t want it to lead to complacency – in other words, you can’t afford to ignore  symptoms and lifestyle changes just because your test results showed no cancer.  

And then there are the cases of aggressive cancer that strike during the interval between screenings that simply can’t be stopped with current treatment options.   This is the reality Annabel had to face and she was remarkable in the way she accepted this and just got on with making the best of her situation.  She had a very strong Christian faith and she really did trust that God had everything under control.  Even the minister, Rev Michael Treston, said he went to offer her hope but she already had bucket-loads and it did overflow – again she was one the giving.  At her funeral service Michael openly said he could not answer the question of why – an honest answer that I appreciated.  He said it was part of the mystery of God. 

I have another friend who has just had her first child , a little girl who ironically she has named Annabelle.  It’s a lovely name that means ‘beauty and grace’.    The miracle of a new life is just as mind-boggling as the way someone can just be gone from this Earth.   

And so this mysterious thing we call life goes on…

(gee that was getting a bit much… think I need a glass of wine 😉 )


2 Responses to “cancer testing: a fiasco,a misunderstanding or a mystery?”

  1. February 27, 2010 at 10:03 am

    Good poat, Jacinda,
    No seam-less explanations from me either. 🙂
    Hope you and Aaron and the kids are well,

  2. March 5, 2010 at 9:23 pm

    Hey Dale – nice to hear from you :-). We are all well, the calm before the storm really with vintage approaching in just a few weeks. Hope you’ve had a great summer, I see on fb that your little man is growing fast too.

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