5 ms·

Isn't there catch-it-early type diseases? Like breast cancer, testicular cancer, colon cancer, etc... that prove this wrong? The funny thing is, the older you

Isn't there catch-it-early type diseases? Like breast cancer, testicular cancer, colon cancer, etc... that prove this wrong? The funny thing is, the older you get, you are likely to have some sort of symptom. Such is life. For blood pressure, I would expand and add general bloodwork for health conscious individuals or people with a family history for certain issues -- diabetes, liver, androgen, heart health markers.. Here in Canada you just need to mention you are interested for health reasons and a doctor refers you -- not sure how costly it is in USA -- but apparently private clinics are a choice to build custom panels.

franga2000 5y ago
I've heard many experts talk about issues with "catching disease early", one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. I don't want to risk trying to explain it from memory since I have zero medical knowledge, but there's a YouTube video by "MedlifeCrisis" about this that also has sources cited in the description. The title is something like "the problem with screening".
- throwaway4aday 5y ago
  > one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. This is not a reason to not screen regularly. If treating very early is the problem then you should still aim to detect it early and then closely monitor it until you have enough information to decide whether to act or not. There are many people that will simply not go in for testing until there is a major problem if you advise against regular testing. A close family member of mine just passed away recently because he didn't go in for regular testing and they caught the cancer way too late.
robbiep 5y ago
For ‘catch it early’ you are talking screening. That’s why there’s cervical cancer screening (pap smear/the new cytology test), mammograms, faecal occult blood tests, in australia skin cancer screening, etc. And that’s why people should have a regular doctor and that’s why as you get older you see your doctor more frequently. But for young(ish) otherwise healthy people, the whole concept of something ther occurs annually doesnt make sense. In the other hand, since most screening and medical engagement is with females, you are left with lots of men who get into their 40s without ever having seen a doctor. So - if thats you - go and see one, build a relationship, and if everything is good ask when you need to come back for prostate screening, FOBT, cholesterol or anything else. All across the board is unnecessary. With regards to your last point, I’m all for devolving autonomy and power to the patient, but frankly across the board wide ranging blood testing (especially regularly) just doesn’t make sense for a significant percentage of people, unless there is a high pre test probability or a significant family history. All blood results are managed at the 95% CI so if you go in and have 20+ blood tests then more than likely at least one is going to be out of order. All you need to do is visit the askdocs subreddit to see the immense anxiety and flow down effects that has on a population who have absolutely no way of understanding a slightly out of bounds result. Those private clinics trying to spin up and do ‘wellness checks’ are frankly in my opinion, and until the evidence proves otherwise, a parasite on the worried well
- xeromal 5y ago
  Shouldn't you at least do regular blood panels to check for prediabetes and the like?
  - robbiep 5y ago
    If a person is otherwise healthy, no. Or at least, there is no medical indication to do so. But a person with pre diabetes is not generally otherwise healthy. T2DM is not a condition of a healthy person, it is a lifestyle disease caused by lack of exercise, poor diet and obesity. This person should see a doctor, but they’re not a healthy person. They should be aiming to exercise and reduce body mass.
    - xeromal 5y ago
      Of course, but there are plenty of people that won't realize that without seeing a doctor.

franga2000 5y ago

I've heard many experts talk about issues with "catching disease early", one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. I don't want to risk trying to explain it from memory since I have zero medical knowledge, but there's a YouTube video by "MedlifeCrisis" about this that also has sources cited in the description. The title is something like "the problem with screening".

throwaway4aday 5y ago
> one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful. This is not a reason to not screen regularly. If treating very early is the problem then you should still aim to detect it early and then closely monitor it until you have enough information to decide whether to act or not. There are many people that will simply not go in for testing until there is a major problem if you advise against regular testing. A close family member of mine just passed away recently because he didn't go in for regular testing and they caught the cancer way too late.

robbiep 5y ago

For ‘catch it early’ you are talking screening. That’s why there’s cervical cancer screening (pap smear/the new cytology test), mammograms, faecal occult blood tests, in australia skin cancer screening, etc. And that’s why people should have a regular doctor and that’s why as you get older you see your doctor more frequently. But for young(ish) otherwise healthy people, the whole concept of something ther occurs annually doesnt make sense. In the other hand, since most screening and medical engagement is with females, you are left with lots of men who get into their 40s without ever having seen a doctor. So - if thats you - go and see one, build a relationship, and if everything is good ask when you need to come back for prostate screening, FOBT, cholesterol or anything else. All across the board is unnecessary. With regards to your last point, I’m all for devolving autonomy and power to the patient, but frankly across the board wide ranging blood testing (especially regularly) just doesn’t make sense for a significant percentage of people, unless there is a high pre test probability or a significant family history. All blood results are managed at the 95% CI so if you go in and have 20+ blood tests then more than likely at least one is going to be out of order. All you need to do is visit the askdocs subreddit to see the immense anxiety and flow down effects that has on a population who have absolutely no way of understanding a slightly out of bounds result. Those private clinics trying to spin up and do ‘wellness checks’ are frankly in my opinion, and until the evidence proves otherwise, a parasite on the worried well

xeromal 5y ago
Shouldn't you at least do regular blood panels to check for prediabetes and the like?
- robbiep 5y ago
  If a person is otherwise healthy, no. Or at least, there is no medical indication to do so. But a person with pre diabetes is not generally otherwise healthy. T2DM is not a condition of a healthy person, it is a lifestyle disease caused by lack of exercise, poor diet and obesity. This person should see a doctor, but they’re not a healthy person. They should be aiming to exercise and reduce body mass.
  - xeromal 5y ago
    Of course, but there are plenty of people that won't realize that without seeing a doctor.