You may have seen print or television ads promoting the Galleri blood test for “early cancer detection.” Neither this test nor any others are covered by Medicare or commercial insurance, but you can have it if ordered by your doctor and you are willing to pay $949 out of pocket.

            Assuming you can afford it, is it worth it?

            It is considered self-evident that detecting cancer early is better than finding it late, and routine colonoscopy for the detection of early cancer or pre-cancerous polyps does prevent colon cancer deaths. Screening smokers for lung cancer with low-dose chest CT scans has also been shown to reduce the death rate from lung cancer. While somewhat controversial, there is evidence that routine mammograms reduce breast cancer deaths.

            This leaves many cancers for which there is no accepted screening tool. Also, not all eligible people are able or willing to have the tests mentioned. Enter the “liquid biopsy,” a single blood test that promises to detect many cancers.

            These tests work by detecting minute amounts of tumor DNA or abnormal proteins secreted by cancers.

            There are many problems with these tests.

            First, while they are pretty good (90%) at detecting advanced cancer, which has already spread, they are much less effective (15%) at detecting early localized cancers, the kind where early detection and surgery is expected to be life-saving.

            Secondly, they have a high number of “false positives:” an abnormal test but no detectable cancer. In two large studies, enrolling over 16,000 people, 600 people had positive tests. The large majority had no cancer and only 14 had early-stage solid tumors that were treated. Most of the positive tests required extensive imaging and invasive biopsies to be sure there was no cancer.

            To date, there has not been any evidence that screening with a blood test saves lives.

            Bottom line: have your colonoscopy. Have your Pap and mammogram. If you are middle-aged and have smoked, have a screening chest CT.

            I am sure that more precise and actionable tests are on the horizon. For the time being, do not spend your money on a blood test that is unlikely to impact your survival and that may lead to uncomfortable and possibly dangerous testing.

            Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.

What Does The Doctor Say?

By Dr. Edward Hoffer

            Bird Island sits roughly half a mile off the coast of Butler Point and Kittansett Golf Club. The island is at the mouth of Sippican Harbor on the approach to Marion. Many stories and local legends persist and are spoken of by locals. So, let’s get to the bottom of the surprising rich and eventful history of the minuscule, rocky islet.

            The island is aptly named after the roseate terns who nest there. Once hunted for their plumes, they are considered endangered with a large percentage of their population residing on Bird Island. The Mass Audubon states that the island is home to 60% of the state’s roseate terns, and cites worry over the island’s rapid erosion over the last 30 years.

            The rocky, treeless island was largely untouched during early colonial times. Some say it was a popular spot for pirates and corsairs to dock, though none of this is recorded in public record and the island itself does not host any markers of this. However, it is said thicker stone walls were used as pirates were seen in the area during construction.

            Being a danger to boats entering the harbor, a lighthouse was constructed in 1819. The Bird Island Lighthouse, or “Bird Island Light,” would allow ships to more easily avoid the dangerous outcropping. It was also constructed about 100 years before the Cape Cod Canal (opened 1914), meaning nearly all ships would be heading north straight toward it. Veteran of the War of 1812, William Moore, served as the Light’s first keeper.

            Many local legends about Moore are known by locals, largely about both his wife and infant son being buried on the island. A story alleges Moore’s infant son was sick, with no way of getting off the island for medical help. When help arrived, it was too late. As to his wife’s fate, possibly dying from TB or being murdered by William himself, it is still not fully confirmed and agreed upon. Stories of locals bringing tabacco and medical supplies to the island to help Moore’s wife’s condition also exist. Moore would bury his wife on the island in 1822 without a known ceremony. Sources differ on whether he continued to be keeper here or departed to another lighthouse following his wife’s death.

            The island and lighthouse would go through another 12 confirmed keepers, with Peter Murray (keeper 1891 – 1895) claiming the island was haunted or cursed. The lighthouse and attached domiciles would gradually decay, being buffeted by salty air or numerous powerful storms. The Coast Guard would deactivate the lighthouse in 1933. The final blow would be the 1938 New England Hurricane. The high tide was 14 feet above average, and the storm and would destroy all structures but the lighthouse tower itself. The Cleveland East Ledge Lighthouse, situated farther out in Buzzards Bay, began operation in 1943.

            The island would go through a few private owners until it was acquired through efforts of the Marion Conservation Commission in 1966 for $2,500. The town would raise money for repairs and conservations and even once relit the light to celebrate the nation’s 200th birthday in 1976. However, it wouldn’t be until Marion Harbormaster Charles “Charlie” J. Bradley formed the Bird Island Preservation Society in 1994 that things started to turn around. With the island and mossy tower being cleaned up, the lighthouse was officially relit and automated in July of 1997, following efforts by the Preservation Society and Select Board (then, Board of Selectmen).

            Today, the island is one of 143 locations in Plymouth County on the National Register of Historic Places.Visitation of the island is allowed September 1 through April 15,and it is closed throughout most of the summer due to bird breeding and nesting. However, it is recommended to ask the Harbormaster office before a visit to make sure it is safe for you and the birds.

History of Bird Island

By Sam Bishop