Compassionate, informed advice about healthcare decision making

published by Hank Dunn - March 10th, 2022
Ending Cancer Screenings at MY Age

I have entered a medical-screening twilight zone. When I was in my 60s, I always got colon and prostate cancer screenings. Now, at 74, I am thinking about stopping the screenings.

Photo by Hush Naidoo Jade Photography on Unsplash

JAMA Internal Medicine recently published a research letter — “Comparison of US Cancer Center Recommendations for Prostate Cancer Screening With Evidence-Based Guidelines.” The guidelines recommend that all men 50–70 years old have an annual screening, regardless of their risk factors for prostate cancer. They suggest the patient and clinician share the decision to do this screening.

The clinician should also inform the patient of both the risks and benefits of the screening. There are downsides to prostate cancer screenings at any age — false positives, misdiagnoses, and overtreatment. Treatment can cause urinary, bowel, or sexual function problems — things I would rather avoid.

Why stop at 70? Turns out, the research shows that annual screenings of men with no other risk factors for prostate cancer do NOT reduce their chance of dying of all causes. In other words, both men who did and did not get screened lived about the same number of years.

My greatest fear is dementia

My greatest fear is that I spend my last years with Alzheimer’s, fully demented and a great burden to my family. Once I get that diagnosis, I would welcome an earlier death by cancer.

Years ago, I heard the story of a woman in a nursing home who no longer recognized her family because of dementia, and she had a mastectomy. They saved her life so she could get more demented.

I did not know this woman and her family well enough to hear about their decision-making process. Perhaps, the patient had stated before losing her mind that she wanted everything done to keep her alive. Maybe, her physicians told the family they had to do the surgery and gave them little choice.

I do not judge this family and their decisions. I take it as a warning for my family and me.

In my case, let the cancer grow

If I live to my 90s but am confined to a wheelchair in a memory-care unit, I do NOT want to be checked for cancer. We do not allow euthanasia in this country, but we do respect a patient’s right to refuse treatment. For me, in the presence of dementia, I would want cancer to run its course. Perhaps this could save my family years of heartaches.

__________________________________________

Chaplain Hank Dunn is the author of Hard Choices for Loving People: CPR, Feeding Tubes, Palliative Care, Comfort Measures and the Patient with a Serious Illness and Light in the Shadows. Together they have sold over 4 million copies. You can purchase his books at hankdunn.com or on Amazon.

Join Hank’s mailing list!

Loading
Quality of Life Publishing Logo

Quality of Life Publishing Co. is the proud publisher of Hank’s books, as well as other branded educational materials for health care & end-of-life care.

www.QOLpublishing.com

Copyright 2022, Hank Dunn. All rights reserved. Website design by Brian Joseph Studios

Volume Discounts for Branded Book Orders

Minimum quantity for branded books is 100. English and Spanish branded books are sold separately. Click here for more information or contact us with questions.

Black

  • 100 to 249 copies: $4.00 each
  • 250 to 499 copies: $2.84 each
  • 500 to 999 copies: $2.24 each
  • 1000 to 1499 copies: $1.69 each
  • 1500 to 1999 copies: $1.43 each
  • 2000 to 3999 copies: $1.30 each
  • 4000+ copies: $1.11 each

Color

  • 100 to 249 copies: $6.65 each
  • 250 to 499 copies: $3.95 each
  • 500 to 999 copies: $2.79 each
  • 1000 to 1499 copies: $1.96 each
  • 1500 to 1999 copies: $1.61 each
  • 2000 to 3999 copies: $1.44 each
  • 4000+ copies: $1.17 each

Volume Discounts for Unbranded Book Orders

Discounts apply to the total books ordered of all titles. Mix and match to get quantity discounts on unbranded books.

  • 1 to 9 copies: $7.35 each
  • 10 to 24 copies: $5.13 each
  • 25 to 49 copies: $4.24 each
  • 50 to 99 copies: $3.75 each
  • 100 to 249 copies: $2.87 each
  • 250 to 499 copies: $2.37 each
  • 500 to 999 copies: $1.98 each
  • 1000 to 1499 copies: $1.54 each
  • 1500 to 1999 copies: $1.32 each
  • 2000 to 3999 copies: $1.21 each
  • 4000+ copies: $1.05 each
There are no products