医生那点事儿

Julia
Julia

发布于2018-12-28 11:34来源:原创 2 评论 3 点赞

 

Doc Talk: Fake News in Cancer

医生那些事儿:关于癌症的虚假消息

 

Fake news can lead to panic.

假消息可能导致恐慌。

 

In September 2018, Singapore formed a parliamentary select committee to make recommendations on tackling the issue of fake news and the potential chaos in society that intentional falsehoods, particularly falsehoods concerning politically sensitive issues, may trigger. Society at large has also seen the need for the people to be imbued with a stronger ability to pick out false information.

2018年9月,新加坡成立了一个议会特别委员会,就如何处理虚假消息的问题提出建议。蓄意的谎言,尤其是涉及政治敏感问题的谎言,可能会引发潜在的社会混乱。全社会也都看到,人们需要被赋予更强的辨别错误信息的能力。

 

Fake news exists aplenty, in the area of health and healthcare.

在医疗保健领域,虚假消息层出不穷。

 

This too, can lead to panic.

这也会导致恐慌。

 

And, such false information may not be always easy to pick out.

而且,这种虚假消息不可能总是被轻易识破。

 

Many false claims concerning health on the Internet are so egregious that no sensible individual will likely take them for real. But surely, the results of a scientifically conducted blood test from a reliable laboratory will not give “false” information?

互联网上许多关于健康的虚假声明令人震惊,因此任何有理智的人都不太可能把它们当真。但是,在可靠实验室完成的科学验血结果就一定不会提供“错误”的信息吗?

 

Think again.

再想想吧。

 

Mr. C, a gentleman in his late forties, was seized by a sense of dread when he first consulted me. A blood test performed as part of his regular corporate-sponsored health screening check showed a cancer marker - CA 19-9 - was elevated.

C先生是一位年近五十的绅士,当他第一次来找我咨询时,可以感到他非常害怕。作为公司赞助的定期健康筛查的一部分,血液检查显示他的癌症标志物CA 19-9升高了。

 

Mr. C has done his homework through an Internet search before our meeting. Elevated CA 19-9 is associated with the diagnosis of cancer of the pancreas, so he read. To make matters worse, his mother just passed away from cancer of the pancreas six months ago.

在我们见面之前,C先生已经通过网络搜索得出了自己的结论。他了解到,CA 19-9的升高与胰腺癌的诊断有关。更糟糕的是,他的母亲六个月前刚刚死于胰腺癌。

 

Panic set in.

恐慌开始了。

 

After sleepless nights and extensive evaluation with repeated blood tests, CT scans and evaluation of his stomach and colon with endoscopy, nothing remotely like a cancer was found.

经历过数个不眠之夜,通过反复的血液检查、CT扫描、胃镜和结肠镜检查等进行了全面评估,并没有发现任何癌症迹象。

 

Two years came and went. No cancer showed up. His cancer marker remained elevated.

两年过去了。癌症没有出现。但他的癌症指标仍然很高。

 

Cancer markers may be elevated in the blood for causes other than the actual presence of a cancer. On occasions, the exact trigger cannot even be nailed down.

 

除了癌症的实际存在之外,血液中的癌症标志物也可能由于其他原因而升高。有时甚至无法确定导致它升高的原因。

 

In all likelihood, this was a case of false alarm.

这可能只是虚惊一场。

 

Ms. T, a lady in her fifties, turned up in my clinic with an obvious 2.5cm lump in her left breast. The lump turned out to be cancerous.

T女士,一位五十多岁的女性,来到我的诊所。她的左乳房有一个2.5厘米的明显的肿块。这个肿块是恶性的。

 

Breast cancer often takes a few years to grow to the size of 2.5cm. The first and only mammogram she did for breast cancer screening was more than 5 years ago. She had ignored subsequent reminders from her doctor to repeat the examination every 2 years.

乳腺癌通常需要几年的时间才能长到2.5厘米大小。她为乳腺癌筛查做的第一次也是唯一一次乳房X光检查是在5年多以前。后来医生提醒她每两年复查一次,但她没有理会。

 

Having experienced some discomfort associated with the compression of her breasts by the mammogram machine during her first check, she substituted the mammogram with an annual blood check measuring a cancer marker - CA 15-3 - that she learned, through her own search, could detect breast cancer. Her CA 15-3 was normal till the day I diagnosed her with breast cancer.

在第一次检查时,x光机压迫到她的乳房,这让她感到有些不适,于是她用每年一次的血液检查——癌症标志物CA 15-3检查——来代替x光检查。她自己通过搜索得知,这种标志物可以检测出乳腺癌。在我诊断出她患有乳腺癌之前,她的CA 15-3一直都很正常。

 

Cancers do not always secrete the common cancer markers that laboratories measure.

癌症并不总是会分泌出实验室测量时常见的癌症标记物。

 

This was a clear case of false reassurance for the poor lady of being cancer-free.

对于这位可怜的女士来说,跟她说没得癌症显然是一个虚假的安慰。

 

Things get more confusing when what is scientifically sound gets mixed up with what is scientifically unsound.

当科学上合理的东西与科学上不合理的东西混在一起时,事情就会变得更加混乱。

 

Cancer markers in the blood have a role to play in medical practice. I use these markers often to track the progress of my cancer patients undergoing treatment, if by happenchance such markers are produced by the cancers, to see if their disease is responding. This would be sound scientifically.

血液中的癌症标志物在医学实践中可以发挥一些作用。我经常使用这些标记物来跟踪我的癌症患者接受治疗的进展情况。如果碰巧这些标记物是由癌症产生的,则看看他们的疾病是否对治疗有反应。从科学上讲,这是非常合理的。

 

But owing to the tendency for cancer markers in the blood to give false conclusions in people not previously diagnosed with cancer, the use of these blood tests for general cancer screening creates huge headaches. This would be unsound scientifically.

但是,由于血液中的癌症标记物常常在以前未被诊断为癌症的人中给出错误的结论,因此将这些血液检测用于一般的癌症筛查会带来巨大的麻烦。它在科学上是站不住脚的。

 

And this is the reason why the Ministry of Health through its public education efforts has been persuading Singaporeans in the right risk categories to consider screening mammogram for breast cancer and screening colonoscopy for colon cancer but has not, for once, advocated cancer marker blood tests for cancer screening.

正因为如此,卫生部一直通过公众教育,努力劝说那些可能有患病风险的新加坡人,考虑进行筛查乳腺癌的乳房x线检查和筛查结肠癌的结肠镜检查,但从未提倡将癌症标志物的血液检测用于癌症筛查,一次也没有。

 

 

The use of cancer marker blood tests to screen for cancer as part of a regular health check is popular among Singaporeans. Every week, scores of Singaporeans have these test performed. Indeed, there were cases of cancer fortuitously picked up by cancer marker blood tests.

作为定期健康检查的一部分,使用癌症标志物血液检测来筛查癌症在新加坡人中非常流行。每周都有许多新加坡人进行这样的检测。的确,有些癌症病例是偶然通过癌症标志物的血液检测发现的。

 

But before you sign up for yours, do take into consideration the possibility of being hit by the “fake news” that you have cancer.

但是在你参加检测之前,一定要考虑一下你被“患了癌症”这一“假消息”击中的可能性。

 

Think about the potential emotional chaos it may trigger.

想一想它可能引发的情感混乱吧。 

 

 

 

 

 

 

 

 

 


相关标签:

  • 医生
  • 标志物
  • 科学
  • 癌症
  • 假消息

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