The Myth of Catching It in Time

Mass screening has been ‘sold’ to American consumers as the way to catch life threatening diseases in time. Mass screening has been sold as preventive care when in reality it is early detection. And, unlike prevention, mass screening has its benefits and its risks.

Gilbert Welch, MD, author of Should I Be Tested for Cancer, Maybe Not and Here’s Why, roiled the conventional medical community, the media, and the American public by presenting the fact that science fails to back up mass cancer screening. Dr. Welch takes on the PSA blood test to screen for prostate cancer, mammography for breast cancer, colonoscopy for colon cancer, among other screenings presenting in easy-to-understand language that for those with a family history or genetic predisposition and risky lifestyle habits screening may make sense. For others, not only are you risking the cost of screening but you risk the dangers of screening. These dangers include false positives, false negatives, and unnecessary intervention for abnormalities that may never develop into cancer.
Now, a published study termed to be “definitive” of more than 78000 women over 18 years finds that screening healthy women for ovarian cancer may have more risks than benefits. While ovarian cancer is one of the most deadly and the most feared malignancies, using ultrasound and the CA 125 blood test as screening tests did not result in women living longer. In fact, those screened died at the exact same rate as those not screened. The combination of these two tests often produced false positives, that is, alarm when none existed. At the study’s end, it was determined that 3300 women had unnecessary surgery and 166 developed complications from that surgery. Every surgery comes with risks as does the anesthesia used during the surgery. The study, paid for by the National Cancer Institute, was released at the annual meeting of the American Society of Clinical Oncology.
While the study ended with the traditional “we need more money for more studies”, it is clear that a different approach than mass screening is needed to affect how long women live who are at risk of ovarian cancer. Too often, doctors fail to acknowledge the power of lifestyle as a powerful tool to affect genetic predisposition. That is, science clearly confirms that genes are turned on and turned off by lifestyle factors. These include chemicals found in food packaging, water, pesticides, lawn sprays, personal care and home cleaning products, as well as a myriad of other sources, laughter, nutrients like antioxidants and phytochemicals or the lack of them in our diet, fats like the good fats found in cold water fish and vegetables like flax, exercise, and nearly every aspect of our daily lives. For example, Japanese research demonstrated 26 different genes that control blood sugar were inactivated by watching funny videos and comedy for two days vs. the control group who listened to dry boring lectures and were unable to control blood sugar.
New research indicates that over half of cancer are affected by our environment. That is a powerful incentive to take control of our daily lifestyle choices channeling them to inactivate genes that predispose us to diseases including cancer, diabetes, inflammatory diseases like Alzheimer’s and heart disease, just to name a few. Books like Jeffrey Bland, PhD’s Genetic Nutritioneering educate us and our practitioners that once we know our unique genetic map we can tailor our daily lifestyle habits and choices to affect those genes, inactivating those that predispose us, for example, to inflammation that may increase our risk of diseases like colitis and Alzheimer’s.
However, medical school education, clinical practice guidelines, drug company advertising influence, and doctors in clinical practice fail to emphasize, educate, and encourage consumers to use these tools to prevent diseases that may run in their families or diseases for which their lifestyle may put them at risk. Consider the recent front page headlines that we have a drug to prevent diabetes; and it is Avandia. Of course, we later learned the risks of Avandia outweighed the benefits. But, reading further we learned Avandia could help prevent diabetes up to 47% of the time. No reference was made to the lifestyle choices verified by Harvard School of Public Health research that confirmed up to 90% of all diabetes could be prevented or reversed by a series of lifestyle choices.
This is an area of potential American innovation for true health care reform. Let’s not let the voices of vested interests drown out the fact that much of our health is within our control. We can make a positive or negative difference each and every day. The choice is yours. Let’s make sure the incentives are there because as we all as know “it’s just too expensive to be sick”.