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How To Avoid Medical Overdiagnosis & Overtreatment – Part 2

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How To Avoid Medical Overdiagnosis & Overtreatment – Part 2

In part 1 of this blog series – The Shocking Dangers of Medical Overdiagnosis & Overtreatment – I shared with you the data supporting how more tests do not necessarily equate to better health. In fact, if you read the post, you’ll see that even medically recommended cancer screening tests, such as mammography, can result in false positive tests, misdiagnosis, or overdiagnosis, potentially leading to medically unnecessary surgical procedures and potentially dangerous treatments, such as chemotherapy and radiation.

The tendency for many health conscious, cancer-fearing patients is to request every test on the planet. How many of you have received the fear-mongering viral emails insisting that you march right up to your doctor and demand that she order a CA-125 test in order to prevent your late-stage ovarian cancer diagnosis? (Yup, it showed up in my inbox 14 times. And if you want to know what I think about CA-125 as a cancer screening test, read my book What’s Up Down There. I explain my thoughts there.)

In short, more tests means more diagnoses – which doesn’t necessarily translate into better health. In fact, it can translate into more side effects, more complications, and more risky treatments.

The Risk Of Unnecessary Medical Tests

From the time she was a young woman, Barbara just knew she was going to get cancer. Although she had no family history of cancer and no reason to believe it should afflict her, something in her gut told her it would happen – some day. She did what she could to avoid it. She went for yearly physicals, got her Pap smears every year, and ate an organic, mostly plant-based diet.  She even convinced her doctor to let her start getting mammograms five years younger than the recommended age.

When she turned forty-five, she saw an advertisement for a full-body scan that promised to detect cancer early. Her insurance wouldn’t cover it, but Barbara figured yearly body scans would be the best way to detect cancer early, so she chose to make the investment in her health. Sure enough, although she was asymptomatic, her first body scan revealed multiple tumors – one in her kidney, one on her ovary, and one in her liver.

Multiple tests and biopsies ensued. The liver and kidney tumors turned out to be benign, but a CA-125 blood test, performed to evaluate whether the ovarian tumor could be cancerous was found to be elevated.  Because this raised the suspicion that the ovarian tumor could be cancer, Barbara underwent surgery to remove her ovary. Fortunately, no cancer was found.

A week after the surgery, Barbara was in severe pain and went to the emergency room, a thorough work up revealed that during the surgery, Barbara’s ureter, the tube that connects the kidney and bladder, was accidentally severed. Another surgery was necessary to repair the damaged ureter, and Barbara had to wear a catheter for a month after the surgery.

Why? Because she was afraid, and her fear led her to undergo medically unnecessary tests that wound up putting her health at risk.

But What If Cancer Is Found?

Barbara’s case study highlights why unnecessary medical testing can be harmful to your health. But what if the scans had diagnosed a previously undiagnosed cancer? Wouldn’t that have been a good thing?

Not necessarily. You see, we all make cancer cells every day.  Our bodies are at risk all the time. Infectious agents cross into our bodies. Abnormal proteins get made. Strands of DNA get damaged. Stuff goes awry pretty much 24/7. But the good news is that the body is perfectly engineered to repair itself when the self-repair mechanisms are activated (Hint, Hint: They’re only active when your nervous system is relaxed.)

Left untreated, many diseases come and go, without ever producing symptoms or getting diagnosed. And that’s how it should be.  When we start overmedicalizing the body’s natural process, we may wind up putting the body at risk.

Sure, if you’re one of those asymptomatic people who gets diagnosed early with a cancer because of a screening test, you’re probably counting your lucky stars. And phew – hopefully your early diagnosis was a good thing. But when you look at the data, the reality is that your outcome might not be much different than if you waited until you had symptoms in order to pursue treatment…

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Lissa Rankin

Lissa Rankin, MD is a mind-body medicine physician, founder of the Whole Health Medicine Institute training program for physicians and other health care providers, and the New York Times bestselling author of Mind Over Medicine: Scientific Proof That You Can Heal Yourself.  She is on a grassroots mission to heal health care, while empowering you to heal yourself.  Lissa blogs at LissaRankin.com and also created two online communities - HealHealthCareNow.com and OwningPink.com. She is also the author of two other books, a professional artist, an amateur ski bum, and an avid hiker. Lissa lives in the San Francisco Bay area with her husband and daughter.

9 comments

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7:18AM PDT on Oct 21, 2012

After my 3rd child, I had a physical and pap test. The pap test came back positive. The doctor told me about all the things they could do to get rid of the offending tissue and I was terrified. I got pregnant again and moved to another city. I decided that after I'd had the baby, I would concentrate on the positive pap test results. Well, I had another physical and lo and behold, my pap smear came back negative. My new doctor told me about false positives and how often they are an issue, especially when tested too often. It's been 30 years now and my pap tests are still negative. My youngest daughter had a pap test last year and it came back positive. They made her go to a special clinic where they told her she had to have 3 consecutive negative pap tests before she could return to her family doctor. She had the first, including an coloscopy and it was negative. She just had her 2nd and they told her she was fine and could return to her family doctor. The doctor told her that he couldn't see anything abnormal about any of her tests. I guess it was just an overzealous lab technician. False positives are scary!!!

1:23AM PDT on Oct 21, 2012

Steve M. My sister had her first child in a British hospital - meant to be monitored by a midwife who didn't do any fetal monitoring of baby's heart. We still don't know why she didn't. As a result the baby got into difficulty and my sister and her husband had a baby that lived for approximately three days. This would not have been the case if the baby's heart had been monitored When she eventually realised the baby was in difficulty she notified another midwife who hit the emergency button but the damage had already been done. I would rather have a child be monitored than not because not to do so can have terrible consequences.

1:21PM PDT on Oct 18, 2012

I take the tests that my doctor tells me t take; no more and no less.

11:50AM PDT on Oct 18, 2012

I avoid testing whenever possible. But I donated blood in 2001, first time in my life. Just to get a letter letting me know that I am Hep C positive, so I should refrain from future blood donations. After researching the subject, and having all my other tests, including liver tests, excellent, I couldn't care less about the RNA's which amazingly, don't correlate with liver damage, but should be monitored when undergoing treatment - that's what doctors tell you. Something responsible for (an imaginary) disease, which doesn't correlate with anything, you don't even have symptoms, but you are declared chronically diseased!!! Hepatitis means inflammation of the liver...but I have no inflammation at all, my liver is in perfect health. Supposedly, I am now 28 years after the presumed infected blood infusion I received at the birth of my daughter. How slow is a so-called slow virus? Frankly, I couldn't care less. I didn't take any purported Hep C treatment and I will never take. I continue my healthy lifestyle, and my liver is very grateful for it. It is outrageous that real diseases are not treated properly, but inexistent diseases are invented for the purpose of profit.

11:32AM PDT on Oct 18, 2012

Another example is electronic fetal monitoring in childbirth. Constant electronic monitoring is now standard beyond a certain stage of labor, but there is NO evidence that this intervention has done anything to improve outcomes over the old method of intermittent checks with a stethoscope or fetoscope. What it does do is 1) pin the mother to the bed and keep her from walking around, 2) create anxiety for the mother and her attendants when the heartbeat seems to "stop" due to normal fetal movement, 3) disconnect doctors and nurses from their patients - they come in and look at the monitor or readout instead of looking at YOU, and 4) significantly increase the C-section rate due to "false positive" of fetal distress, and probably also by causing more fetal distress due to lack of maternal movement and due to increased anxiety and tension on the mom's part.

If you wonder why 1 out of 3 US births is now by C-section, this is one of the big reasons. It's an unnecessary intervention that makes things worse instead of better, and it should not be used, and yet it's standard medical practice in hospitals across the country today. The other main cause is early induction, which is also often the result of false positives of an "overdue baby" due to yet another massively overused intervention: prenatal ultrasound pictures, resulting in the doctors actually telling women their due date, often in contradiction to the woman's own calculations.

Less intervention is better. Receiving

5:27AM PDT on Oct 18, 2012

So true. Don't look for trouble. Let it try to find you if it can. Maybe G-d protects you more than you know.

12:29PM PDT on Oct 17, 2012

noted, thx

10:47AM PDT on Oct 17, 2012

thank u

10:28AM PDT on Oct 17, 2012

thanks.

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