In an Opinion column on CNN, Dr. H. Gilbert Welch, M.P.H., a professor of medicine at the Dartmouth Institute of Health Policy & Clinical Practice and the author of Overdiagnosed: Making People Sick in the Pursuit of Health" (Beacon Press 2011), raises questions about a new simple blood test that is
“able to detect minute quantities of cancer cells that might be circulating in your bloodstream.”
Below just a few lines from the column that I found particularly provocative. You can find the entire op-ed here.
(Thanks to Dr.Val and Gary Schwitzer for spotlighting this column.)
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“The conventional wisdom is people either have a disease or they do not. But, in fact, there are a lot of people somewhere in between. . .
“I don't know whether this test will help some patients. It might, but it will take years to figure that out…"
“Ironically, what this test might actually teach us is that it's not that unusual for healthy people to have an occasional cancer cell in their blood.”
The real question is “Does early detection improve quality of life and longevity?” It’s not an easy question. Look at prostate and breast cancer. I’m afraid that this will lead to early aggressive treatments that in themselves will cause more harm than a “wait & see” course of action. But of course they will be profitable.
Bruce–
Thank you.
I agree. And I think the qualify of life question is extremely important. Once a man is told he has prostate cancer, many will feel they have a sword hanging over their head. Even if they are experiencing no symptoms, and opt for “watchful waiting.” The anxiety alone willl mar their sense of well-being.
As for longevity … That
can be a mixed blessing.
As we live longer,more of us will live long enough to develop Alzheimer’s and other forms of senile dementia. As a baby-boomer, my greatest fear is that my body will outlive my mind.
Today many Americans do live into their 80s (and even longer) enjoying a high quality of life. My
husband’s Uncle John is 96, and was doing very well until recently, when he began to become confused . . .
(Meanwhile his wife, who is 95, reports that they just gave up driving. Wince. But that’s another story.)
Back ot the subject at hand: “early detection” doesn’t always mean cure. Often it just means that the patient spends mroe years thinking of himself as ‘sick’– and worried that he is going to die of cancer or another disease.
In truth, we all are dying –from the day we are born. But most of us are not sick, unless we let an aggressive medical industry test us and test us until they find something wrong. . . .
Dr. Elaine Schattner pointed out that Dr. Welch may have mised the point of this technology. It was developed primarily to help oncologists monitor tumors in patients who already are known to have disease. For example, doctors could check for new, resistance-conferring mutations in patients who are already on a cocktail of meds for lung cancer. The blood test could obiate the need for repeatedly doing CT scans and biopsies to measure disease, the extent of disease and new mutations in people undergoing cancer treatment.
The June issue of Oncology News International (June 2010, V 19, No 6) quotes a Duke University study of the use of high-tech cancer imaging, with one representative finding being that the average Medicare lung cancer patient receives 11 radiographs, 6 CT scans, a PET scan, and MRI, two echocardiograms, and an ultrasound, all within two years of diagnosis. A study co-author (Dr. Kevan Schulman) asks: “Are all these imaging studies essential? Are they all of value? Is the information really meaningful? What is changing as a result of all this imaging?”
So the investment by Johnson and Johnson, which was what the news was about, makes it more likely this will actually happen in non-research clinics. The technology has the potential to make cancer patients’ lives easier and less costly and for doctors to stop giving them meds to which they’ve acquired resistance.
http://www.scientificamerican.com/article.cfm?id=a-chip-against-cancer
I agree with Mr. brucefryer. My solution based on my humble opinion is that we should all start live a healthy lifestyle & be mindful of our health.