No Free Lunch

04/28/2009 at 5:08 AM Leave a comment

Yesterday I wrote about the problems with early cancer detection. And my perception that testing is not a benign thing. There are many problems with testing a large group of healthy people. First of all we should do no harm. That wise admonition comes to us from over 2000 years ago. 

It is not just a random admonition but a warning about hubris. That we know so much that we can and should do all we can, when in fact doing nothing is exactly what is called for. The fact that it was an important enough thing for Hippocrates to instill it into his followers and that it has survived to this day says something about the reality  of medicine apart from the economics.

Here is the question that to me is most relevant: How many healthy people are you willing to harm in order to find one cancer? For relatively rare cancers like Ovarian Cancer the number will have to be very high. 

And as is being discovered currently, early detection of some cancers does not seem to alter the  mortality of Prostate Cancer or perhaps even Breast Cancer. There are many very smart caring doctors out there looking at prevention/ detection and  as far as I have been able to tell, all the low hanging fruit has been identified.

My energy goes there: into patient life style, smoking, exercise, seat belts, mental health. All available, and with immediate enormous benefits and no side effects.

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Entry filed under: Doctor Musings, How things work.

Cancer Schmancer Should I start prescribing that?

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