July 30, 2013

THE COSMETIC SURGERY ENTITLEMENT:

Overtested Americans: When cancer isn't cancer at all (Jacque Wilson and Amanda Enayati, 7/30/13, CNN)

The patient slammed his fist on the table in Dr. Otis Brawley's office.

"Dammit, I'm American," Brawley remembers him saying. "You can't tell me I have prostate cancer and that we're just going to 'watch it.'"

Brawley is the chief medical officer for the American Cancer Society, a world-renowned cancer expert and practicing oncologist. If you're going to get someone's opinion on a cancer diagnosis or course of treatment, he's a good choice. And in this case, he was recommending no treatment.

It's a scenario that may happen more as science reveals cancer's secrets, the biggest one being that what we now call cancer maybe shouldn't be called cancer at all.

"The word 'cancer' often invokes the specter of an inexorably lethal process," a working group for the National Cancer Institute wrote in a recent recommendation. "However, cancers are heterogeneous and can follow multiple paths, not all of which progress to metastases and death."

Basically, cancer is scary, but some kinds may be more boogeyman-in-the-closet scary than serial killer scary. [...]

We all harbor abnormalities, says H. Gilbert Welch, Dartmouth professor of medicine and author of the book "Overdiagnosed: Making People Sick in the Pursuit of Health." And new technology is increasingly able to find these abnormalities. When we do, our inclination is to act, even when the remedy turns out to be far more harmful than the disease would have been, had it run its course.

There is a growing consensus, backed by mounting scientific evidence, that Americans tend to be overtested, overdiagnosed and overtreated across a variety of conditions. Some experts estimate that unnecessary interventions account for 10% to 30% of U.S. health care spending.

Posted by at July 30, 2013 7:36 PM
  

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