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The second-most common cancer in women is breast cancer. According to the Centers for Disease Control, 41,000 women die each year from the disease.
Breast cancer has affected many women in every community in America. Some women have themselves been diagnosed; but even when a relative or friend gets the news, it still can be a very personal experience for everyone involved: spouses, partners, children, parents and friends.
Even for the health-care community, breast cancer can be a very sensitive topic. A recent article in the Journal of the American Medical Association encourages doctors and health-care authorities to rethink cancer screening guidelines, and the U.S. Preventive Services Task Force has actually changed mammography screening recommendations. You may have heard about these changes on television news or in The New York Times. The outcry from the media, legislators and doctors has been substantial.
It certainly is a good time to take a careful and reasonable look at breast cancer issues. In this column, I will outline the screening recommendation changes and their reasons. In following weeks, I will discuss approaches to breast cancer screening, prevention and treatment that make sense from a mainstream medical and naturopathic perspective.
No one is disputing whether mammography works for detecting early-stage breast cancer; it does. The concern is that all of the suspicious lumps found by mammogram can result in unnecessary biopsies and unnecessary worry; at some point the cost outweighs the benefit.
According to the best statistical evidence, for women 40 to 49 years of age it takes screening almost 2,000 women to identify one cancer that would be helped by treatment. For women 50 to 59 years old the number falls dramatically, to about 1,300 women screened to identify one cancer helped by treatment. For women 60 to 74 years old, the numbers get even lower.
The bottom line is that there are potential benefits and costs to any health-care choice. With the guidance of your physician, you get to choose the approach that makes sense to you; every woman has different risk factors and concerns.
In my next column, I will discuss prevention and other screening options.
Richard Malik is a naturopathic doctor with a practice in Lakeville offering comprehensive health care for the entire family.
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Telecom Reg’s Best Kept On the Books
When Connecticut land-use commissions update their regulations, it seems like a no-brainer to jettison old telecommunications regulations adopted decades ago during a short-lived period when municipalities had authority to regulate second generation (2G) transmissions prior to the Connecticut Siting Council (CSC) being ordered by a state court in 2000 to regulate all cell tower infrastructure as “functionally equivalent” services.
It is far better to update those regs instead, especially for macro-towers given new technologies like small cells. Even though only ‘advisory’ to the CSC, the preferences of towns by law must be taken into consideration in CSC decision making. Detailed telecom regs – not just a general wish list -- are evidence that a town has put considerable thought into where they prefer such infrastructure be sited without prohibiting service that many – though not all – citizens want and that first responders rely on for public safety.
Such regs come in handy when egregious tower sites are proposed in sensitive areas, typically on private land. The regs are a town’s first line of defense, especially when cross referenced to plans of conservation and development, P&Z regulations, and wetlands setbacks. They identify how/where the town plans to intersect with the CSC process. They are also a roadmap for service providers regarding preferred sites and sometimes less neighborhood contention. In fact, to have no telecom regs can weaken a town’s rights to protect environmental, scenic, and historic assets, and serve up whole neighborhoods to unnecessary overlapping coverage and corporate overreach. Such regs are unique to every town and should not follow anyone else’s boiler plate, especially industry’s.
Connecticut is the only state that has a centralized siting entity for cell towers. The good news is that applicants must prove need for new tower sites in an evidentiary proceeding and any decisions have the weight of the state behind them. The bad news is that the CSC used to be far less industry-friendly and rote in their reviews, which now resemble a check list. There is an operative assumption at CSC that if an applicant wants a tower, they must need it, otherwise why spend significant money to run the approval gauntlet? This reflects a subtle shift over the years at CSC from sincere willingness to protect the environment toward minimal tweaking of bad applications with minor changes. The bottom line is that towns really cannot rely on the CSC to do all the work for them.
What CSC issues telecom providers is a “certificate of environmental compatibility” after an evidentiary proceeding (not unlike a court case) with intervenors, parties, expert witnesses, and the service provider’s technical pro’s sworn in and subject to cross examination. Service providers get to do the same with any opposition from intervenor/party participants – like towns and citizens -- and their experts. It’s an impressive process whose ultimate goal is the fine balancing between allowing adequate/reliable public services and protecting state ecology with minimal damage to scenic, historic, and recreational values. They unfortunately often fall short of their mandate – like approving cell towers with diesel generators over town aquifers -- evidenced by CSC only rejecting about five cell towers in the past 15-20 years.
The CSC was founded in 1972 and clarified its mission in the 1980’s to prevent the state from being carved up willy-nilly by gas pipelines, high tension corridors, and broadcast towers. With the sudden proliferation of cell towers beginning in late 1990’s, it became the most sued agency in Connecticut by both an arrogant upstart industry if applications were denied and by towns/citizens when bad sites were forced on them. CSC gradually formed a defensive posture that drives their decisions toward industry with deeper pockets and attorneys on retainer.
For citizens, nothing can wreck one’s day like the CSC. It behooves towns to protect what little toolkit they have, and understand the legal parameters of the CSC’s playing field. The CSC is not a “normal” government agency where municipal/citizen redress is based on logic and local support. Their process is largely immune to everything but specific kinds of evidence – like town regs with setbacks/fall zones, radio frequency transmission signal strengths, sensitive areas identified, and detailed wildlife inventory, among others.
There is a current cell tower fight involving two intervening towns -- Washington and Warren; both with good cell tower regs – over a tower site within 1200’ of a Montessori School, near Steep Rock’s nature preserves with comprehensive geology/wildlife databases that include endangered, threatened and special concern flora and fauna, on established federal/state migratory bird flyways, within throwing distance to a historic site capable of being listed on the Underground Railroad, and with an access road on a blind curve entering a state highway that will permanently damage wetlands, vernal pools, and core forests. There are well credentialed environmental experts, including Dr. Michael Klemens, former chair of Salisbury’s P&Z, as well as the former director of migratory bird management at the US Fish and Wildlife Service, and an RF engineer testifying to alternative approaches, plus three attorneys representing intervenors. It is the most professional challenge I have seen at CSC since Falls Village successfully mounted one that protected Robbins Swamps several years ago.
The hearing is ongoing, with uncertain results. To see what it takes today to stop an inappropriate tower siting, see Docket #543 under “Pending Matters” at https://portal.ct.gov/csc before removing local cell tower regs – the lowest hanging fruit that any town can possess in case it’s needed.
B, Blake Levitt is the Communications Director at The Berkshire-Litchfield Environmental Council. She writes about how technology affects biology.