There’s a dirty little secret in medicine: As you grow older, you’ll more than likely will have cancer.
When men in their 30s who died of non-cancer related causes were autopsied, about 30 percent of them already had prostate cancer. And this percentage increased as the age of the men examined increased, studies show. Look hard enough and you will most certainly find something wrong.
In other words, cancer is part of nature.
Yes, cancer is a natural phenomena. Let me explain. Your body is constantly regenerating itself. Think about your layers of skin or your wounds healing. Cells come and go all the time. This process is not infallible — and nor do we want it to be. We make a minor slip up duplicating the DNA in our cells at about a rate of 1 in 100,000,000 and most of the time it doesn’t matter.
Anything that causes your cells to have to repair damage increase this slip-up rate. That’s why alcohol, tobacco, radiation all increase our risk of cancer. So, too, does chronic inflammation like chronic stress or obesity. You are literally forcing your body to replace and/or fix cells at a faster rate. And like us — when we’re stressed and rushing — we are more likely to make mistakes.
Here’s the good news: At least in medicine, I have to respectfully disagree with Kelly Clarkson — “what doesn’t kill you” doesn’t “make you stronger.” More to the point, “what doesn’t kill you” DOESN’T MATTER.
Doctors are very good at doing lots of tests and telling you what’s wrong. But, so what? The better question is, is that “something wrong” going to kill you? Does knowing that something is wrong going to change your life in any meaningful way? If the answer is “no,” then the test probably should not have been ordered in the first place.
This is not just a philosophical point. The very tests to diagnose a disease that doesn’t matter is expensive and potentially can cause you harm and cause you a great deal of anxiety.
For example, in prostate cancer, there is a blood test, the PSA, that can catch the disease early. Every year, over 240,000 people per year are diagnosed with prostate cancer. Lots of people have prostate cancer. About 3 percent of those people die from the disease.
Most people (97 percent) probably would have been fine not knowing. Treatment for prostate cancer that wouldn’t have killed you is no cake walk — it’s often life-changing: inability to have an erection and urinary incontinence are the two most common side effects of treatment.
As a result of overtreating patients, the U.S. Preventive Services Task Force (USPTF), a non-governmental panel of independent experts in prevention and evidence-based medicine, recommended that doctors stop using the PSA blood test to screen men with no symptoms of prostate cancer.
Critics argue that you would be letting people die because the disease wasn’t caught early enough. It’s a fine balance — are more people going to die because you didn’t catch the prostate cancer earlier, or are you basically causing more people harm who didn’t need treatment in the first place? The USPTF clearly thinks the latter.
Until we get a better prostate cancer test that tells you the cancer is going to kill you, I tend to fall into that camp as well.
And people will disagree with me. But the take home point here is that having a disease is not the same as having a disease that is likely to end your life. Know the difference and make an educated decision before you undergo testing.
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