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Should I Be Tested for Cancer?

Maybe Not and Here’s Why

H. Gilbert Welch M.D., M.P.H. (Author)

Available worldwide
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Paperback, 234 pages
ISBN: 9780520248366
March 2006
$20.95, £15.95
Getting tested to detect cancer early is one of the best ways to stay healthy—or is it? In this lively, carefully researched book, a nationally recognized expert on early cancer detection challenges one of medicine's most widely accepted beliefs: that the best defense against cancer is to always try to catch it early. Read this book and you will think twice about common cancer screening tests such as total body scans, mammograms, and prostate-specific antigen (PSA) tests.

Combining patient stories and solid data on common cancers, Dr. H. Gilbert Welch makes the case that testing healthy people for cancer is really a double-edged sword: while these tests may help, they often have surprisingly little effect and are sometimes even harmful. Bringing together a body of little-known medical research in an engaging and accessible style, he discusses in detail the pitfalls of screening tests, showing how they can miss some cancers, how they can lead to invasive, unnecessary treatments, and how they can distract doctors from other important issues. Welch's conclusions are powerful, counterintuitive, and disturbing: the early detection of cancer does not always save lives, it can be hard to know who really has early cancer, and there are some cancers better left undiscovered.

Should I Be Tested for Cancer? is the only book to clearly and simply lay out the pros and cons of cancer testing for the general public. It is indispensable reading for the millions of Americans who repeatedly face screening tests and who want to make better-informed decisions about their own health care.
Acknowledgments
Introduction: The conventional wisdom about cancer testing and what this book is about

PART I. PROBLEMS YOU SHOULD KNOW ABOUT
1. It is unlikely that you will benefit
2. You may have a "cancer scare" and face an endless cycle of testing
3. You may receive unnecessary treatment
4. You may find a cancer you would rather not know about
5. Your pathologist may say it’s cancer, while others say it’s not
6. Your doctor may get distracted from other issues that are more important to you

PART II. BECOMING A BETTER-EDUCATED CONSUMER
7. Understand the culture of medicine (and why we are pushed to test)
8. Understand the statistics of cancer (and why five-year survival is the world’s most misleading number)
9. Understand the limits to research—even genetic research (and why it is hard to be sure there really are benefits to screening)
10. Develop a strategy that works for you

Appendix: Summary of cancers discussed in this book
Glossary
Notes
Index
H. Gilbert Welch, M.D., M.P.H., is Professor in the Departments of Medicine and Community and Family Medicine at Dartmouth Medical School and Codirector of the VA Outcomes Group in the Department of Veterans Affairs, White River Junction, Vermont.
“One of those gems to come out of the academic press. . . . If you’re worried about cancer, this lucidly argued book will be a godsend.”—Malcolm Gladwell The Week
“Intelligent and eminently readable . . . a timely reminder that screening is not all it’s all cracked up to be. This is a book that should be read by all healthcare providers and all symptom-free individuals who are being coerced into a screening test.”—Michael Baum New Scientist
“A brilliant account of the statistical and medical uncertainties surrounding cancer screening.”—Malcolm Gladwell New Yorker
“This book, which offers a sobering view of the status of cancer screening today, deserves to be widely used by patients and providers as they navigate an expanding and often bewildering array of screening options.”—Ernest T. Hawk and Jaye L. Viner New England Journal Of Medicine
“A welcome antidote to the hype and simplistic slogans that characterize the current widespread and indiscriminate promotion of cancer screening.”—Hanna E. Bloomfield, MD, MPh Jama
“This thought-provoking book offers a unique perspective on cancer screening.”—Barbara Bibel Library Journal
“Often we surrender our judgment to a doctor, trusting in his or her skills. Should I Be Tested for Cancer? argues to the contrary. It is not a book for sick people — Welch is emphatic that people who have clear symptoms should see a doctor — and it might be an especially difficult book for the hypochondriacs among us. But sometimes the most important lessons are the hardest to hear, even when they promise to make us all better informed consumers in the medical marketplace.”—Nick Owchar Los Angeles Times Book Review
“Welch, a specialist in cancer detection, challenges common knowledge about everyday screenings, such as mammograms and PSA tests . . . in this readable, thought-provoking book. . . .Accessibly written, Welch’s perspective provides needed balance to current emphasis on testing.”—Whitney Scott Booklist
"I have long been a fan of Dr. Welch's research and his considerable insight into the dilemma of disease screening. I'm profoundly grateful that he has now made this information available to everyone in an easy-to-read, practical book. Should I Be Tested for Cancer? is a must-read for every doctor and patient in this country."—Christiane Northrup, M.D., author of Women's Bodies, Women's Wisdom

"I did not think it possible to bring such a dry topic to life, but Dr. Welch has done it. He writes wonderfully well. For anyone interested in cancer screening or preventive medicine, this book is a page-turner. It will be a rare person—layperson or health professional—whose perspective is not changed by reading this provocative book."—Alfred Berg, M.D., M.P.H., Chair of the U.S. Preventive Services Task Force

"Dr. Welch has performed an invaluable public service. Whatever the successes of the nation's 'war on cancer,' too many people now believe it's always in their best interest to detect the disease early and rout it, regardless of the costs. This book will inject reason and good sense into an arena of medical decision making often dominated by hype and fear."—Susan Dentzer, Health Correspondent, The NewsHour with Jim Lehrer

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