Health

By LAUREN GROVER
Staff Writer

All things prevention, modern medicine's latest mantra, might find its match in Dr. James Goodwin, a longtime geriatric researcher who spoke to more than 100 elderly Tyler residents on Friday about the untold risks of cancer screening.

Goodwin, dir-ector of the Uni-versity of Texas Medical Branch's Sealy Center on Aging in Galve-ston, was the keynote speaker at the Fourth Annual Healthy Aging Lecture Series hosted by the University of Texas Health Science Center at Tyler on Friday.

Once people reach a certain age, cancer screening isn't the necessity it once was, Goodwin said.

For some, it can lead to unpleasant treatment on pre-cancerous cells that won't have developed into symptomatic cancer until after the person's death, he said.

Data shows that many cancers develop so slowly after age 70 that they rarely cause death; whereas, diabetes, heart disease and high cholesterol lead to geriatric deaths at much higher rates, he said.

This complicated reality will soon be on the lips of public health officials as over-screening takes its toll on the population, he predicted.

"Medicine, in each passing year, is more comfortable with the fact it must deal with complex issues," he said. "We can't make a screening rule for 50 year-olds and apply it to 80-year-olds - it's not ageism to treat these groups differently. They are."

Goodwin cited the results of over-screening of prostate cancer - that nearly twice as many men are diagnosed with prostate cancer now than in 1975, but death rates from prostate cancer haven't dropped or heightened.

"Many men say, thank God they found it, and what can you reply?" he said. "From a public health perspective, prostate screening does more harm than good."

This is the attitude Goo-dwin is challenging, he said. For men over 75, prostate screening is irrelevant, he said. Although the public remains largely ignorant of it, no cancer association recommends scree-ning at that age or above.

Prostate cancer develops at a snail's pace after 70 or 75, he said. If abnormal cells were detected in such a patient, the treatment he received wouldn't matter until long after he was dead.

The same goes for Pap smears, which aren't recommended for women over 65.

"The time it takes for abnormal cells (detected in Pap smears) to develop into cancer is around 20 to 25 years, and you might get all kinds of treatment but you'll need to live another 25 years for it to matter," he said.

Goodwin's answer is that judicious decisions must be made between a patient and his or her doctor, not a screen-all attitude.

Older folks should have a healthy desire for quality of life, he said.

"(You don't want) a woman spending the last six months of her life getting a mammogram, surgery, radiation, chemotherapy, before dying of something else," he said.

But new waves in medicine take time to find equilibrium, he said. His research is simply at the forefront of what's to come, he said.

"It tends to be overdone, then underdone, before finding where it is just right," he said. "We're just right with cervical cancer screening. We need to get there with others."

Elderly residents in attendance said Goodwin's lecture was informative and encouraging.

"It confirmed a suspicion I had that a number of these tests were ridiculous, at our age," said a 68-year-old Flint resident. "At a certain age, surgery and radiation and chemo is not quality of life, it's quantity."

Mary Jones, 71, of Tyler, said she understood Goodwin's point, but was relieved to hear him say tending to the patient's wishes is foremost for any geriatric doctor.

"I wanted a test that my doctor said I didn't need to get, and I got it anyway, because it made me feel better," Jones said. "I liked that (Goodwin) affirmed that - it's what makes you feel best."

UTHSCT president Dr. Kirk Calhoun reminded the audience that the judgment calls made between them and their physicians are the most reliable resource for individualized care.

"Our own doctors know our history, and there we can choose which paths to pursue and which we shouldn't pursue," he said.

The Annual Aging Lecture Series is sponsored by longtime UTHSCT supporters and Tyler residents Red and Kim Little, who gave a $100,000 donation in 2004 to begin the lecture series for geriatrics.

Red Little celebrated his 88th birthday with his wife at the lecture on Friday. Goodwin said Little was a wonderful example of how a positive attitude and fulfilling work lead to longevity.

"I'm certainly blessed," Little said. "I'm just a happy old man, and I appreciate every day as a bonus."

Dr. Peter Dirks of the University of Toronto identified possible cancer stem cells in brain tumors.
((AP File Photo))