8 ms·

"Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found..." This

by nfw2 10mo ago

"Some cancer specialists counter these concerns, saying the surge in diagnoses is primarily a surge in detecting cancers that did not need to be found..." This seems excessively paternalistic. If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things, it leaves patients with no way to discover life-altering information about their own health.

kulahan 10mo ago
There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason. We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.
- poszlem 10mo ago
  That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight. I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website. If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse. Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
  - kulahan 10mo ago
    No, it’s nothing like that. I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions. In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out. Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot
    - poszlem 10mo ago
      That's amazing, and also totally misses the point, but I guess it let's you keep feeling smug, so that's a plus. If you’re aiming for the full "ackchyually guy" meme, mission accomplished. Meanwhile you’re not touching the core of my argument: we’ve already seen what happens when you lecture people to “trust the science” instead of actually engaging with them. They just go vote for someone who will talk to them, and that’s exactly how you end up with a Kennedy in charge.
      - kulahan 10mo ago
        This entire comment is you whining, but not clarifying whatever point you seem to think I've missed. I'm happy to engage with you, if you have something of substance to add?
      - missinglugnut 10mo ago
        Chill out...the most condescending comment here by far is yours, and the "well ackchually" that sent the thread of the rails is your comparison between cancer cells and needing insulin. If you don't want people to poke holes in an analogy like that don't make it.
  - stvltvs 10mo ago
    It's literally true that cancerous cells happen all the time in our bodies and no treatment is necessary because the immune system handles it. The ideal diagnostic test would only detect cancers that need intervention.
- alistairSH 10mo ago
  At a population level, that makes sense. But, as the article notes, we don't know if any particular cancer will kill an individual. It's a conundrum. But, "Meh, let's not test since it might not kill you." doesn't feel like the right answer.
  - lm28469 10mo ago
    It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go
    - darth_avocado 10mo ago
      Ehh. It’s only that expensive because we let be. You can get a basic cancer screen in India for 2500 rupees which is about $35.
      - lm28469 10mo ago
        Because everything is mostly following on local purchasing power. You can build a beautiful modern house in buttfuck nowhere Belarus for 20% of what you'd pay for the same exact house in Germany. The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.
        darth_avocado 10mo ago
        The point I was trying to make was that cancer screening is expensive only because we have a highly inefficient healthcare system. (India was an example and their healthcare system has its own flaws) Sure we can point to PPP, but the reason why screening is that cheaper elsewhere is not ONLY because of PPP. Since you mentioned Germany, public health insurance covers early detection cancer screen every 3 years (2 for skin cancer) once you’re 35. The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here. It shouldn’t be that expensive to screen and it shouldn’t be that expensive to treat. https://www.informedhealth.org/what-screening-tests-does-german-public-health-insurance-cover.html#:~:text=In%20Germany%2C%20public%20(statutory)%20health%20insurance%20covers,the%20doctor%20will%20explain%20everything%20in%20detail. https://www.informedhealth.org/what-screening-tests-does-ger...
- bill_joy_fanboy 10mo ago
  > You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason. The idea that a position of authority means ~anything~ anymore is completely ridiculous. What did the medical field do to earn such credibility with you? Any intelligent person should have developed a high degree of skepticism regarding the operations of the medical field as of 2025.
  - deleted 10mo ago
    [deleted]
  - cogman10 10mo ago
    > What did the medical field do to earn such credibility with you? For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date. Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.
  - advael 10mo ago
    There's a pretty stark difference between medical science, medical practitioners, and medical institutions. Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)
- jamesrom 10mo ago
  > We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own. Strawman. No one is suggesting adding extra stress to healthcare workers. It's also not you or your doctors call to make: let's gatekeep this patients cancer because our hospital can't deal with the workload. What a truly wicked idea. To help alleviate the extreme shortage of available healthcare workers we should instead allow those wanting to pay for these elective surgeries, to pay for them! Drive money into healthcare, scale up treatments, drive money into research. Let the system work. Don't just turn off the lights and shut the door.
  - kulahan 10mo ago
    It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying. Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important. Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.
    - Ajedi32 10mo ago
      I often wonder if people who make these kinds of statements simply don't know how market forces work, or if they know how market forces work but just choose to pretend they don't exist in certain contexts where that reality feels particularly unfair... Demand suppression doesn't work. "Having money doesn't make your illness more important" sounds like a noble sentiment, but by applying it in the real world you'd actually be reducing the total size of the pool of resources available to treat everyone. Talk about holier than thou...
      - kulahan 10mo ago
        Of course I know how market forces work. They are not the only forces we can manage. They are not the only levers we can pull. Economics are cool, but not almighty. There is no scenario in which a hospital gets extra profit, and turns around and simply reduces the cost for those in need. No - no additional resources are being removed. That's not how hospitals work. TaLk aBoUt hOlIeR ThAn tHoU....
- Veserv 10mo ago
  Your response is a non-sequitur. The original statement was about intentionally not detecting cancer. You are talking about whether the cancer is medically necessary to treat. You are just assuming that all cancer must be treated if detected, even if it is medically unnecessary, therefore we must not detect medically insignificant cancer which would be net harmful to treat. You can detect things and determine no action should be taken. I can understand if that might be the modern standard of care, but if so then that is the problem; not early detection of cancer, which could be medically insignificant, but which may also allow the early detection of medically significant cancer.
  - kulahan 10mo ago
    I'm pretty sure every medical show had an episode where the "money-grubbing hospital admin" character want to start selling full body medical scans, and the "very well-respected and honor-bound doctor" character points out how this is quite literally one of the most useless and corrupt ways for a hospital to make money. There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment. There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist. If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.
    - jauer 10mo ago
      at the same time you have endless stories of people losing family and friends to cancer because a doctor dismissed complaints as anxiety or needing to exercise more leading to cancer not being discovered until it was too late to treat. The answer can't be to put our collective heads in the sand.
    - xyzzy123 10mo ago
      You also have the issue of information creating liability. A thing that nobody knows about is nobody's problem, a thing that COULD be a problem but probably isn't in someone's professional judgement creates liability for the decision maker.
- cogman10 10mo ago
  What determines if a cancer should be treated is the type, size, growth, and age of a patient. Type and size and growth you can't find out without doing some sort of test/screening. I agree that oncologists are ultimately who should be making the call on what needs to be treated and how. But I think your characterization of how common non-dangerous tumors are is off.
- throwawaylaptop 10mo ago
  My father has a high rate PSA change a few years ago so I learned everything I could about prostate cancer for about 4 weeks. I then talked to several doctors I know (family practice and two internal medicine). It was embarrassing how little they knew. And even more shocking actually, is how wrong they were about things. Two of them told me the risk of infection from a prostate biopsy was basically zero. I asked for clarification with actual numbers, and even led them with "for what kind? Like 1 in 100 or 1 in 1000?" One said basically zero, the other said 1 in a million. Neither knew to mention the two common types, and to make sure we go with the one type that carries less risk of infection. Even then, the less risky one is about 1 in 1000. If you have bad insurance you might go with the older type which is about 1 in 100. And that's with them giving you antibiotics beforehand.... Basically they got everything I asked about wrong compared to specialists you can read online. Ps, my dad got an MRI with two 1cm growths. He changed his diet and added fasts, and did nothing else. His doctor basically writing him off in anger. 5 years later, PSA lower than before the incident. Paid for a scan last year, zero growth. Internet/YouTube experts/doctors really do beat most general doctors. The odds of you having someone in the top 10% of their field, let alone top 1-2% in your local town is pretty low. Even my bay area doctor friends work at pretty basic general bay area hospitals. Imagine who's left in Modesto, CA.
  - kulahan 10mo ago
    I'm glad your dad got better, it had nothing to do with his diet and fasting. It's no different than Steve Jobs stubbornly becoming a fruititarian to treat his cancer. If his immune system had fought it off, then fruit would be a cancer cure and all his doctors would be idiots. Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.
    - 10mo ago
- xupybd 10mo ago
  People have a right to make their own medical choices. Saying on people with the correct credentials should have input is offensive.
- deleted 10mo ago
  [deleted]
- nfw2 10mo ago
  > you're not in the medical field citation needed
bawolff 10mo ago
If the cancer is not clinically significant, then its not life-altering information. Essentially they are saying that many of these diagnoses are potentially false positives. To the point where detecting them might be more harmful then not. Keep in mind most cancer treatments are pretty harsh. They are better than cancer, but if you don't have clinically significant cancer then the treatments can be very not worth it.
- poszlem 10mo ago
  That could be true, but it isn't, since we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis.
  - bawolff 10mo ago
    You could say the same thing about diagnosing cancer via astrology. A test that with low specificity is simply not a useful test. > we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis. You didn't know prior to the test either.
  - bryanlarsen 10mo ago
    We don't know if a tumor is harmless, but we do know that treatment has significant harm. Radiation and chemotherapy are nasty. We also know that the stress of a positive diagnosis has significant harm. First do no harm.
- jamesrom 10mo ago
  Then here's an idea: instead of hiding that information, you can explain it to the patient. You have no authority to treat your patient like a child.
  - bryanlarsen 10mo ago
    We're not talking about hiding information, we're talking about not looking for it in the first place. Information that is costly to acquire but not actionable once acquired.
phkahler 10mo ago
>> If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things They said detecting. Diagnosing is "hey, somethings wrong or odd, what is going on." Detecting is looking for something you otherwise may not ever notice. Not a doctor, just offering my definitions of two different words being used here.
ASalazarMX 10mo ago
I agree. I wouldn't contest "cancers that did not need to be treated", but this would imply finding, following, and deciding if the tumor needs treatment. Not needing to be found sounds like cost saving, leave that to the accountants.
fellowniusmonk 10mo ago
I've seen every single professional field go through boom and bust cycles over the course of my life except one. It is my dearest dream to see a single bust in the MD profession.

by nfw2 10mo ago

kulahan 10mo ago

There is cancer in your body every single day. Your immune system handles it just fine. There is an explicit difference between cancer that needs treating and cancer that should be ignored because it's a waste of time and resources to treat. You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason. We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own.

poszlem 10mo ago
That's kind of like saying that there is diabetes in your body every single day, and your body handles it just fine by producing insulin. Obviously that statement is nonsensical and essentially devoid of any useful insight. I'm not even going to comment on this: "You're not a doctor, you're not qualified to tell the difference", because this is such a weird statement that I don't understand how anybody could utter it on this website. If that is your standard for critical thinking, you are paving the way for anti-science rhetoric to dominate public discourse. Treat people like stupid idiots if you want but then don't be surprised by the way they vote in elections as a result.
- kulahan 10mo ago
  No, it’s nothing like that. I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions. In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out. Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot
  - poszlem 10mo ago
    That's amazing, and also totally misses the point, but I guess it let's you keep feeling smug, so that's a plus. If you’re aiming for the full "ackchyually guy" meme, mission accomplished. Meanwhile you’re not touching the core of my argument: we’ve already seen what happens when you lecture people to “trust the science” instead of actually engaging with them. They just go vote for someone who will talk to them, and that’s exactly how you end up with a Kennedy in charge.
    - kulahan 10mo ago
      This entire comment is you whining, but not clarifying whatever point you seem to think I've missed. I'm happy to engage with you, if you have something of substance to add?
    - missinglugnut 10mo ago
      Chill out...the most condescending comment here by far is yours, and the "well ackchually" that sent the thread of the rails is your comparison between cancer cells and needing insulin. If you don't want people to poke holes in an analogy like that don't make it.
- stvltvs 10mo ago
  It's literally true that cancerous cells happen all the time in our bodies and no treatment is necessary because the immune system handles it. The ideal diagnostic test would only detect cancers that need intervention.
alistairSH 10mo ago
At a population level, that makes sense. But, as the article notes, we don't know if any particular cancer will kill an individual. It's a conundrum. But, "Meh, let's not test since it might not kill you." doesn't feel like the right answer.
- lm28469 10mo ago
  It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go
  - darth_avocado 10mo ago
    Ehh. It’s only that expensive because we let be. You can get a basic cancer screen in India for 2500 rupees which is about $35.
    - lm28469 10mo ago
      Because everything is mostly following on local purchasing power. You can build a beautiful modern house in buttfuck nowhere Belarus for 20% of what you'd pay for the same exact house in Germany. The screening isn't even the problem, finding you have _a_ cancer is one thing, pinpointing where it is, how to treat it, treating it and recovering from it cost orders of magnitude more than the initial diagnosis.
      - darth_avocado 10mo ago
        The point I was trying to make was that cancer screening is expensive only because we have a highly inefficient healthcare system. (India was an example and their healthcare system has its own flaws) Sure we can point to PPP, but the reason why screening is that cheaper elsewhere is not ONLY because of PPP. Since you mentioned Germany, public health insurance covers early detection cancer screen every 3 years (2 for skin cancer) once you’re 35. The concern about “raising insurance costs significantly for everyone” in US only exists because of the way healthcare is set up here. It shouldn’t be that expensive to screen and it shouldn’t be that expensive to treat. https://www.informedhealth.org/what-screening-tests-does-german-public-health-insurance-cover.html#:~:text=In%20Germany%2C%20public%20(statutory)%20health%20insurance%20covers,the%20doctor%20will%20explain%20everything%20in%20detail. https://www.informedhealth.org/what-screening-tests-does-ger...
bill_joy_fanboy 10mo ago
> You're not a doctor, you're not qualified to tell the difference, you're not trained on cancers, you're not even in the medical field. The monopoly is held for exactly this reason. The idea that a position of authority means ~anything~ anymore is completely ridiculous. What did the medical field do to earn such credibility with you? Any intelligent person should have developed a high degree of skepticism regarding the operations of the medical field as of 2025.
- deleted 10mo ago
  [deleted]
- cogman10 10mo ago
  > What did the medical field do to earn such credibility with you? For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date. Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.
- advael 10mo ago
  There's a pretty stark difference between medical science, medical practitioners, and medical institutions. Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)
jamesrom 10mo ago
> We already have an extreme shortage of available healthcare workers. We don't need to stress them further because 20% of the population suddenly decides they need 80 elective surgeries to remove things that would've gone away or stayed benign on their own. Strawman. No one is suggesting adding extra stress to healthcare workers. It's also not you or your doctors call to make: let's gatekeep this patients cancer because our hospital can't deal with the workload. What a truly wicked idea. To help alleviate the extreme shortage of available healthcare workers we should instead allow those wanting to pay for these elective surgeries, to pay for them! Drive money into healthcare, scale up treatments, drive money into research. Let the system work. Don't just turn off the lights and shut the door.
- kulahan 10mo ago
  It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying. Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important. Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.
  - Ajedi32 10mo ago
    I often wonder if people who make these kinds of statements simply don't know how market forces work, or if they know how market forces work but just choose to pretend they don't exist in certain contexts where that reality feels particularly unfair... Demand suppression doesn't work. "Having money doesn't make your illness more important" sounds like a noble sentiment, but by applying it in the real world you'd actually be reducing the total size of the pool of resources available to treat everyone. Talk about holier than thou...
    - kulahan 10mo ago
      Of course I know how market forces work. They are not the only forces we can manage. They are not the only levers we can pull. Economics are cool, but not almighty. There is no scenario in which a hospital gets extra profit, and turns around and simply reduces the cost for those in need. No - no additional resources are being removed. That's not how hospitals work. TaLk aBoUt hOlIeR ThAn tHoU....
Veserv 10mo ago
Your response is a non-sequitur. The original statement was about intentionally not detecting cancer. You are talking about whether the cancer is medically necessary to treat. You are just assuming that all cancer must be treated if detected, even if it is medically unnecessary, therefore we must not detect medically insignificant cancer which would be net harmful to treat. You can detect things and determine no action should be taken. I can understand if that might be the modern standard of care, but if so then that is the problem; not early detection of cancer, which could be medically insignificant, but which may also allow the early detection of medically significant cancer.
- kulahan 10mo ago
  I'm pretty sure every medical show had an episode where the "money-grubbing hospital admin" character want to start selling full body medical scans, and the "very well-respected and honor-bound doctor" character points out how this is quite literally one of the most useless and corrupt ways for a hospital to make money. There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment. There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist. If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.
  - jauer 10mo ago
    at the same time you have endless stories of people losing family and friends to cancer because a doctor dismissed complaints as anxiety or needing to exercise more leading to cancer not being discovered until it was too late to treat. The answer can't be to put our collective heads in the sand.
  - xyzzy123 10mo ago
    You also have the issue of information creating liability. A thing that nobody knows about is nobody's problem, a thing that COULD be a problem but probably isn't in someone's professional judgement creates liability for the decision maker.
cogman10 10mo ago
What determines if a cancer should be treated is the type, size, growth, and age of a patient. Type and size and growth you can't find out without doing some sort of test/screening. I agree that oncologists are ultimately who should be making the call on what needs to be treated and how. But I think your characterization of how common non-dangerous tumors are is off.
throwawaylaptop 10mo ago
My father has a high rate PSA change a few years ago so I learned everything I could about prostate cancer for about 4 weeks. I then talked to several doctors I know (family practice and two internal medicine). It was embarrassing how little they knew. And even more shocking actually, is how wrong they were about things. Two of them told me the risk of infection from a prostate biopsy was basically zero. I asked for clarification with actual numbers, and even led them with "for what kind? Like 1 in 100 or 1 in 1000?" One said basically zero, the other said 1 in a million. Neither knew to mention the two common types, and to make sure we go with the one type that carries less risk of infection. Even then, the less risky one is about 1 in 1000. If you have bad insurance you might go with the older type which is about 1 in 100. And that's with them giving you antibiotics beforehand.... Basically they got everything I asked about wrong compared to specialists you can read online. Ps, my dad got an MRI with two 1cm growths. He changed his diet and added fasts, and did nothing else. His doctor basically writing him off in anger. 5 years later, PSA lower than before the incident. Paid for a scan last year, zero growth. Internet/YouTube experts/doctors really do beat most general doctors. The odds of you having someone in the top 10% of their field, let alone top 1-2% in your local town is pretty low. Even my bay area doctor friends work at pretty basic general bay area hospitals. Imagine who's left in Modesto, CA.
- kulahan 10mo ago
  I'm glad your dad got better, it had nothing to do with his diet and fasting. It's no different than Steve Jobs stubbornly becoming a fruititarian to treat his cancer. If his immune system had fought it off, then fruit would be a cancer cure and all his doctors would be idiots. Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.
  - 10mo ago
xupybd 10mo ago
People have a right to make their own medical choices. Saying on people with the correct credentials should have input is offensive.
deleted 10mo ago
[deleted]
nfw2 10mo ago
> you're not in the medical field citation needed

bawolff 10mo ago

If the cancer is not clinically significant, then its not life-altering information. Essentially they are saying that many of these diagnoses are potentially false positives. To the point where detecting them might be more harmful then not. Keep in mind most cancer treatments are pretty harsh. They are better than cancer, but if you don't have clinically significant cancer then the treatments can be very not worth it.

poszlem 10mo ago
That could be true, but it isn't, since we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis.
- bawolff 10mo ago
  You could say the same thing about diagnosing cancer via astrology. A test that with low specificity is simply not a useful test. > we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis. You didn't know prior to the test either.
- bryanlarsen 10mo ago
  We don't know if a tumor is harmless, but we do know that treatment has significant harm. Radiation and chemotherapy are nasty. We also know that the stress of a positive diagnosis has significant harm. First do no harm.
jamesrom 10mo ago
Then here's an idea: instead of hiding that information, you can explain it to the patient. You have no authority to treat your patient like a child.
- bryanlarsen 10mo ago
  We're not talking about hiding information, we're talking about not looking for it in the first place. Information that is costly to acquire but not actionable once acquired.

phkahler 10mo ago

>> If medical professionals hold a legal monopoly on providing diagnostic care, then decide it's better to just not diagnose things They said detecting. Diagnosing is "hey, somethings wrong or odd, what is going on." Detecting is looking for something you otherwise may not ever notice. Not a doctor, just offering my definitions of two different words being used here.

ASalazarMX 10mo ago

I agree. I wouldn't contest "cancers that did not need to be treated", but this would imply finding, following, and deciding if the tumor needs treatment. Not needing to be found sounds like cost saving, leave that to the accountants.

fellowniusmonk 10mo ago

I've seen every single professional field go through boom and bust cycles over the course of my life except one. It is my dearest dream to see a single bust in the MD profession.