The Science of Prevention

A recent Wall Street Journal article told the story of a group of 600 volunteers at Emory University who underwent an exhaustive predictive health assessment in order to prescribe lifestyle changes. Emory plans to use the data to help identify areas for intervention, assigning half the participants to health coaches to determine their effectiveness.
While the article related that many of the tests utilized at Emory—carotid artery ultrasound, CRP measurement, and determination of oxidative status—are not standard predictive tests, conventional medicine may be undergoing a paradigm shift regarding preventive screening.
A one-size-fits-all approach to preventive care—e.g., colonoscopy screening every five years after age 50, annual mammogram screening after age 35, PSA screening each year after age 50—has recently been put to the scientific test and has been found lacking. PSA screening has been termed by Stanford clinicians to be “clinically useless.” Routine cancer screening for colon and breast cancer did not help individuals to live longer or better, according to Dartmouth’s Gilbert Welch, MD, in his book Should I Be Tested for Cancer? Maybe Not and Here’s Why.
The best chance of truly preventing disease, as revealed by years of scientific research, is to make lifestyle choices based on one’s own genetic profile. Over 90% of cancer is related to the lifestyle choices we make each day, according to research cited in Dr. Bruce Lipton’s book The Biology of Belief. Less than 10% of breast and prostate cancer is determined by genetics. And if we are genetically predisposed to breast or to prostate cancer, we can adopt lifestyle choices that can help prevent the expression of that genetic tendency. If one has a family history of prostate cancer, for example, one might consider the dietary program designed by Dean Ornish, M.D., which has been shown to arrest prostate cancer cell growth and lower PSA .
Looking at and listening to the patient using functional testing rather than the structural diagnostic approach often adopted by conventional medicine is key. Dr. Peter Libby of Brigham Womens’ Hospital in Boston spends time educating his patients that heart disease is not a structural plumbing problem as medicine and consumers have been conditioned to think.