Searching for ‘Sickness’
Is screening a dangerous marketing trick for your health?
 
There was an interesting article, some time ago, in The Atlantic, written by Oklahoma physician John Henning Schumann, which brings up the issue of over-screening—medical tests that simply are not necessary, or worse, detrimental. “General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although the number of new diagnoses was increased. Important harmful outcomes, such as the number of follow-up diagnostic procedures or short-term psychological effects, were often not studied or reported and many trials had methodological problems. With the large number of participants and deaths included, the long follow-up periods used, and considering that cardiovascular and cancer mortality were not reduced, general health checks are unlikely to be beneficial,” says the Cochrane Library.
 
I have been condemning routine screenings, especially cancer screenings, for decades. Many routine screening-detected ‘cancers’, in fact, are only incidentalomas which, if left alone or not detected in the first place, would have outlived the person. For example, the so-called ‘ductal carcinoma in situ’ in the breast is not a cancer at all. 
 
Cancer screening is not only useless but downright dangerous. The best studies (these are studies done over 10-year durations in Canada, the US and Europe) have found that you have to screen 2,100 women every year for 11 years to prevent one death. So, to answer the question, ‘Is it lifesaving?’ Yes. One in 2,100 women would benefit from being screened over an 11-year period. 
 
But, at the same time, of those 2,100 women, about 600 to 700 will have a false-positive. They will find something unusual or something abnormal and that will require biopsies, open surgeries, mastectomies and psychological trauma wrote Alan Cassels of University of Victoria (BC) who has authored several books on screening. The best one, according to me, was: Seeking Sickness: Medical Screening and the Misguided Hunt for Diseases. This book is an encyclopaedia of the scam of screening.
 
Screening in apparently healthy people is encouraged mainly to make lots of money from post-screening activities. It is just another marketing trick and a potentially dangerous one at that.
 
One can have a cancer in his/her body and live a perfectly long and healthy life. The cancer literature in medical science which is funded by the industry is mostly wrong. John Ioannidis at Stanford found that most of those studies cannot be replicated independently. Of the hundreds of studies by John Ioannidis, most did not stand up to scrutiny. This applies especially to cancers and statin drugs for prevention.
 
I would end this by quoting Dr Andrew Oxman of the Norwegian Knowledge Centre for the Health Services in Oslo, who told Reuters: “There are lots of examples where things start to be used and have entered the market based on surrogate outcomes and then actually proved harmful.” He mentioned the heart rhythm drugs encainide and flecainide which, for many years, were given to people with acute heart attacks. But trials showed they were actually bad for these patients. 
 
“These drugs were given by well-meaning clinicians, but they actually killed more people than the Vietnam War did,” Oxman said. I still remember the days when I was senior registrar in cardiology at The Middlesex Hospital, London, where the protocol in the CCU was to give all these drugs one after another even if a couple of innocent premature beats are seen on the monitor in this order—Lignocaine, procainamide, encainide, flecainide. Most of these drugs were later shown to be killers!
 
I was once hauled up before an enquiry committee for not following the protocol in a healthy MP admitted one evening directly from the House of Commons where he felt ‘suffocated’. He was, of course, absolutely normal, as proved by later tests. He was grateful to me but I had to face a trial for dereliction of my duty in preference to my patient’s safety!
 
“When it comes to screening, a doctor who says ‘Let’s err on the side of caution,’ may actually err on the side of reckless ignorance and grave harm.” – Otis Webb Brawley
 
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)
Like this story? Get our top stories by email.

User

COMMENTS

Sreekanth Yelicherla

4 years ago

Prof, it is high time that you should think about writing a book which creates awareness among the people. Please think about it. These online articles appear for a week or two and have limited target. But a book can be gifted to elders to read.

Joseph Korah

4 years ago

Thanks Dr. Hegde for spreading the awareness of unnecessary medical tests.

Pulse Beat

Pentavalent Vaccine

Dr Jacob Puliyal, a noted child specialist at St Stephen’s Hospital in Delhi, is a vaccine specialist. His estimate of the new pentavalent vaccine which piggybacks one on the triple vaccine is not only dangerous but could kill a significant number of children. This vaccine has already been withdrawn in many countries, although the company and their thought leaders are selling an idea that these are sudden cot deaths and not due to vaccines, a claim only they believe. I hope, and pray, that our government in its wisdom does not allow this useless and dangerous vaccine from coming into this country.
 

Beta-blockade Fraud

It was hypothesised some time ago that if we blocked, on a short-term basis, people undergoing risky surgery, mortality will fall. I had vehemently opposed it then. Since 2009, the European Society of Cardiology (ESC) guidelines have recommended the initiation of beta-blockade for patients with ischemic heart disease, or positive pre-operative stress test results, who are going in for high-risk surgery. This involves giving a short course of oral beta-blockers shortly before surgery until a few days or weeks after surgery to prevent heart attacks. 
 
The principal support for the recommendation came from two of the DECREASE (Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography) family of trials, which were discredited in 2011 because of misconduct. Our 2013 meta-analysis of the remaining 11 credible randomised controlled trials indicates that initiation of beta-blockade increases mortality by 27%. No prizes for guessing who was pushing such ideas that kill more: drug companies.
 

Animal Farm

“At a remote research centre on the Nebraska plains, scientists are using surgery and breeding techniques to re-engineer the farm animal to fit the needs of the 21st-century meat industry. The potential benefits are huge: animals that produce more offspring, yield more meat and cost less to raise. There are, however, some complications.
 
Pigs are having many more piglets—up to 14, instead of the usual eight. But hundreds of those newborns, too frail or crowded to move, are being crushed each year when their mothers roll over. Cows, which normally bear one calf at a time, have been re-tooled to have twins and triplets which often emerge weakened or deformed, dying in such numbers that even meat producers have been repulsed. All for making more money. Products of such engineering could have long-term deleterious effects on meat-eaters. Who bothers? As for animal lovers, they say we love our money much more than your love for animals.
 
“They pay tons of attention to increasing animal production, and just a pebble-sized concern to animal welfare,” said James Keen, a scientist and veterinarian who worked at the centre for 24 years, quoted in New York Times. “And it probably looks fine to them because they’re not thinking about it, and they’re not being held accountable. But most Americans and even livestock producers would be hard pressed to support some of the things that the centre has done.”
 

International Yoga Day

The 21st day of June is declared as the International Yoga Day by the World Health Organization and the UN. A great tribute to India through the efforts of our dynamic prime minister! People all over the globe, who know the benefits of Yoga, are gearing up to celebrate. I have an invite from Portugal that has a large organisation of Yoga practitioners which has been very active popularising Yoga there. You know about the benefits of Yoga. Do practise it. If not, start today. 
Like this story? Get our top stories by email.

User

Nature as a Cure for Our Ills
A good 95% of the people, can make do with change of mode of living, tranquillity of mind and some holistic healing techniques
 
Man has a radically different physiology compared to a machine. Nature is the healer for the human machine, which is built from a single cell, the zygote, the union of mother’s ovum and father’s sperm, into a 120-trillion-cell organism. This organism, additionally has 10 times more germ cells inside. It runs on sun’s energy, food and oxygen. It is dynamic and, like everything else in the animate world, it has a built-in healer called the immune system. Outside intervention for minor illness syndromes seems not only unscientific but also dangerous. 
 
That said, I must hasten to add that, in the unlikely event of the immune system failing, the person develops symptoms asking for some assistance from outside. Only then must outside help be used to relieve distress. It will again be foolish to claim that outside intervention will keep humans alive on this planet for a long time. The truth is that outside interventions by the medical fraternity can only “cure rarely, comfort mostly, but console always.” Nothing more and nothing less.
 
Today’s hi-tech medical world would want us to believe that they are here to prevent diseases in the ‘early’ stages, to save us from danger and premature death. This is a false claim and the sensible thing to do would be to see doctors only when one has some symptoms. Nature’s mechanisms are more than adept at dealing with most illnesses. 
 
If you have ever observed animals like cats or dogs, you will notice that when a dog has a stomach-ache it knows precisely where the remedy is in nature and looks for grass or leaves to eat. It is you and I who go to a hospital or a doctor when we have minor problems. In return, we get a drug (proven to be alien to the human system by sophisticated studies) or an exploratory laparotomy. There is no end to the cycle of drugs and testing as there is an ill following every pill. We get caught in this vicious cycle. I am reminded of what late Chakravarthi Rajagopalachari wrote to his friend Jawaharlal Nehru, the then PM who was the last Englishman to rule India. Nehru wanted to be one up on Nasser who built the huge Aswan Dam on the Nile, and so was planning the Bakra Nangal dam. “Dear Jawahar, Please respect and treat Nature as your mother, she will then feed you for all time to come, but if you mistreat her as your mistress she will kick you in the teeth!” 
 
If we keep to a healthy lifestyle, with respect to food, work, sleep, thought and action, we would remain healthy till we die. However, the food we eat, the water we drink and even the air we breathe are all severely polluted and our immune system has every cause to be overwhelmed by the stresses imposed on it. To live a long and healthy life, one must follow a rigorous way of life with pranayama and yoga to assist the immune system. This addition will help reduce our distress, to a great extent. 
 
In the first Western textbook of medicine, published in 1773 in Vienna, the Mecca of medicine, the author, Charles Scharschmidst wrote about the present-day killer diseases like heart attacks, hypertension and diabetes. He said that these were, “Diseases with intense agitation of the mind and spastic constriction of the vascular bed.” 
 
The best treatment plan he wrote was: “Change of mode of living, tranquillity of mind, and intervention rarely ever, if ever.” I fully endorse that even today, with factual and scientific backing.
 
Accidents are the only exception where Western hi-tech medical and surgical help for quick fix relief could be lifesaving. Most of the other times, a good 95% of the ill segment of society, can make do with change of mode of living, tranquillity of mind and some holistic healing techniques. God save mankind in the New Year 2015.
 
“In all things of nature there is something of the marvellous.” —  Aristotle
 
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS.)
Like this story? Get our top stories by email.

User

COMMENTS

Ramesh Poapt

4 years ago

tooo goood,dr! pl give us more such articles. thanx....

Jagannath Chatterjee

4 years ago

The immune system keeps us healthy. When a child is born we bombard its immune system with a mind boggling range of vaccines and booster doses. We are creating disease for life. Who benefits from disease?

Narendra Nath Hazra

4 years ago

Medication, can it really help a human being to live long, as per me no when he is o die he will die , only for satisfaction we go for medication to help some professionals to survive. Result is dangerous, most of the cases man dies but after his death his family dies out of starvation or malnutrition.
It is fact of life that change of life style/ food habits and regular expertise like Yoga ill be more beneficial than any other method.

vishal

4 years ago

A unborn child or a just born child often hears the word paracetamol as if this wonder drug has given by God to cure fever. Modern day Doctors, I am sure learn more about drugs than about body immune resistance. The word antibiotic is known to everybody in the world even if one is a illiterate. What we need to have a healthy life, some times I wonder it is related to our past karmas.

We are listening!

Solve the equation and enter in the Captcha field.
  Loading...
Close

To continue


Please
Sign Up or Sign In
with

Email
Close

To continue


Please
Sign Up or Sign In
with

Email

BUY NOW

online financial advisory
Pathbreakers
Pathbreakers 1 & Pathbreakers 2 contain deep insights, unknown facts and captivating events in the life of 51 top achievers, in their own words.
online financia advisory
The Scam
24 Year Of The Scam: The Perennial Bestseller, reads like a Thriller!
Moneylife Online Magazine
Fiercely independent and pro-consumer information on personal finance
financial magazines online
Stockletters in 3 Flavours
Outstanding research that beats mutual funds year after year
financial magazines in india
MAS: Complete Online Financial Advisory
(Includes Moneylife Online Magazine)