How To Avoid Medical Overdiagnosis and Overtreatment
In part 1 of this blog series, The Shocking Dangers of Medical Overdiagnosis and 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…
Cancer Screening – Should We or Shouldn’t We?
So what about cancer screening? In many ways, advances in cancer screening are a blessing. Cancers like cervical cancer are almost completely preventable now, since pre-cancerous lesions of the cervix can be detected with Pap smears, but there’s also a price to pay. In order to prevent one cervical cancer death, 1,140 women have to be regularly screened over 10 years. And among those 1,140, many are going to wind up with abnormal Pap smears that lead to medical procedures like LEEP procedure, which not only increases medical cost and causes pain, but which can actually lead to issues like infertility, miscarriage, and difficulty diagnosing future cervical cancers or uterine cancers. (If you’re curious about what makes a good cancer screening test, this is a GREAT review article about it).
If you look at cancer screening protocols, there’s a big trend towards less testing – fewer Pap smears starting later in life, fewer mammograms starting later in life, and recently, some advisory groups now recommend against the use of the PSA test to screen for prostate cancer because the benefits, if any, are small and the harms can be enormous.
The solution to the anxiety and uncertainty health fears engender is not more tests or more treatments.
Then what is the solution? It’s a simple three-step process.
How To Decide About Medical Testing
Step 1: Get educated.
I’m not saying you shouldn’t get medical tests. But I am saying you shouldn’t just blindly take the lab slip from your doctor’s hands without even knowing what’s being tested.
Getting your cholesterol checked? Why? If the test is abnormal, what will your doctor recommend? How will that treatment affect your long term health? Are there any risks to that treatment? Is that a treatment plan you’re willing to agree to?
Getting a mammogram? How good is the test? How likely is it that an abnormal mammogram will actually be a breast cancer? How likely is it that you’ll need a surgery in order to find out whether the abnormality is the real deal or not? How likely is it that the mammogram, if it finds an asymptomatic cancer, will actually increase your life expectancy and/or quality of life?
Getting STD tests? How accurate are they? What’s the chance that you’ll be falsely labeled as carrying an STD? What’s the chance that you’ll have an STD and the test will miss it?
If you don’t know the answers to these kinds of questions regarding tests you’re being asked to take, you shouldn’t be taking the test.
Your body is your business. Get informed. Ask questions. Talk to your doctor. Get educated about the risks and benefits of any test you agree to take. How good is the test? What’s the false positive and false negative rate? What treatment might be required if the test comes back abnormal? How much anxiety is the test going to create? If the test is abnormal, will it change the treatment plan?
Empower yourself with knowledge.
Step 2: Listen to your intuition.
I call that wise, sage, loving, knowing part of you your “Inner Pilot Light.” Your Inner Pilot Light often uses the body as a vehicle to communicate with you. Are you in touch with your body’s wisdom? Are you listening to your symptoms and physical gut reactions and gaining awareness about what they’re trying to teach you?
When your doctor recommends a test, what does your body say? What does your inner wisdom whisper? Are you spending enough time being quiet to even hear those whispers? Are you dialoguing with your body compass? Can you interpret what your body and your Inner Pilot Light are communicating to you? If not, sign up for daily messages from your Inner Pilot Light to help you get in touch with the inner doctor that resides within us all.
Step 3: Trust that whatever is in the highest good for all beings will manifest.
Live a healthy lifestyle. Do what you can to minimize your risk of disease. Then… and I know this is the hard part… let go and trust.
“Ee gad!” you say. But what if it’s in the highest good for me to die of breast cancer with two young kids? What if it’s in the highest good for me to drop dead of a heart attack at 50? What if it’s in the highest good for my baby to miscarry?
Surely, we can’t trust and surrender to that, right?
Yes. That’s what I’m saying.
Do what you can. Be conscious about what food you put in your body. Exercise in a way that makes your heart sing. Ditch your bad habits (or not.) Get regular check ups and talk to your doctor about disease prevention. Sleep well.
And don’t forget to get radical about alleviating loneliness, avoiding pessimism, managing depression and anxiety, and living the kind of wholly healthy, fearless life that makes the body ripe for miracles.
Make reasonable effort to minimize your risk, then trust that whatever is in the highest good for all beings will manifest.
Trust that even if you get sick, it’s because your soul has something to learn – or perhaps even that your soul has completed what it’s here on this earth to learn – and your illness just might be the vehicle your soul needs in order to fully express itself.
I’ll be talking more about how to reduce anxiety and fear around illness and death in the next part of this blog series, so make sure you’re subscribed to my blog.
How Do You Make Decisions About Medical Tests And Treatment?
Share your thoughts and tell us your stories.