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More on the Harms of the POEM Assumptions — the CA-125 Test

June 19, 2011

I received a heartfelt response to one of my posts about Dr. Oz. The response is a reply to that post and I re-post it here in its entirety. First, the thoughts of the writer, Mr. Graham; then, my response.

From Mr. Graham:

My wife died December 2, 2010 at our home from Ovarian Cancer. She was misdiagnosed from January 2008 until September 2008 by a pair of doctors resulting in the cancer being in Stage 3c. She was not given the CA125 test during that entire time period. She wanted me to do what I can to increase awareness and spread the word about the CA125 blood test. Trials from M. D. Anderson and England have shown that using the test with trend analysis is an effective screening tool. We see pink everywhere but no teal and Ovarian Cancer is the fourth leading cause of death among women? Some of the things my wife was told during the 2008 period were: “Go home and do sit-ups.”, “You have IBS.”, “You have vaginal dryness.”, and “You may have diverticulitis.”. I have found very few women that have ever heard of the CA125 blood test. The only ones that have heard of it either have ovarian cancer or a family member does. In the past any CA125 number greater than 35 was considered not good. The first CA125 that my wife had was 5,500. I have been told by multiple doctors that the current standard is that when a woman has symptoms of Ovarian Cancer they try to rule out everything else before investigating Ovarian Cancer. By that time it is too late. It is absolutely necessary to find Ovarian Cancer in Stage One when the cancer is still contained in the ovaries. At that time it is 95% curable. After that the best that there can be hope for is remission for a period of time. The current chemo is not effective against the stem cells.
I am very glad that Dr. Oz is helping spread the word about the CA125 blood test. Some doctors have told me that they believe it will become a standard test in a few years as it should be. It can save the lives of hundreds of thousands of women from this terrible disease.
If you are only concerned about cost, the CA125 test is very inexpensive. The cost for the chemo, which is not very effective, is extremely expensive.

My response:

Mr. Graham,

My deepest condolences on the death of your wife. Your reactions are completely understandable, but also demonstrate how the POEM assumptions as promoted by the Government Industrial Medical Coalition (GIMeC) have made your journey even more difficult.

The timing of your post is ironic as a large randomized clinical trial of CA-125 and vaginal ultrasound screening was published online by the Journal of the American Medical Association this week. This study enrolled 78,000 women and followed them for 13 years total. Half received yearly CA-125 and transvaginal ultrasound screening, the other half received no screening. There was no difference in ovarian cancer deaths or overall deaths between the two groups. The screening tests were useless. The doctors who believe it will become a standard screening test are wrong.

How do we make sense of these results in light of your wife’s story? The results mean that the cancer was aggressive and widespread when her symptoms began. GIMeC has convinced you and most of the American people that early detection prevents all deaths, which is much more often a fallacy than reality. Her stage was highly probably 3c in January of 2008, and a CA-125 test wouldn’t have changed her ultimate outcome.

The harm of this test used for cancer screening is much more than financial. Seeds of doubt probably entered her and your mind after you received the diagnosis. What if we had known about and insisted on the test? Couldn’t we have done more to prevent her from dying? Ovarian cancer commonly strikes women in their middle ages, which makes the painful loss of a spouse even worse.

GIMeC wants you to believe that you are in complete control of your health, which is mostly untrue with cancer. Yes, stage 1 cancers are more curable, but it’s not because they’re caught early, it’s because they are inherently less aggressive. GIMeC suggests that your doctors, and you and your wife to an extent, should have done more to her earlier. The truth is it’s absolutely nobody’s fault that she contracted a bad cancer then died from it.

I don’t know why God allows good people to die at an early age. It’s a painful mystery of life that has been questioned for all of human history and I don’t have the answer. However I do know that the conventional assumptions of the American healthcare industry have made a bad situation worse. It’s time our entire society humbly accepts that women will die of ovarian cancer, and there’s nothing we can do to prevent this in women who aren’t cured by standard treatment.

I pray that the pain of the grieving process for you isn’t excessively prolonged. I pray that you have supportive family and friends to help you cope with your severe loss. I pray that you come to an emotional place where you don’t blame your wife, yourself, or others for her death. I pray that when you die, you have a joyous reunion with your wife.

Thank you for sharing your story.

Richard Young, MD

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One Response to More on the Harms of the POEM Assumptions — the CA-125 Test

  1. Tracie Updike on June 20, 2011 at 8:24 am

    I am a family doctor and I spend so much of my time trying to explain to patients that some treatments are worse than death. My big problem is we can not cure every and we can not stop every ones pain.

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