Just because there is a treatment out there, doesn’t mean that that treatment is good for everyone. Prostate cancer, for example affects about 80% of males who reach the age of 80. Should this 80% be treated for this cancer? For the most part, absolutely not! Many more men die with prostate cancer rather than from it Most prostate cancer in older men should probably be left alone, as the treatment for this cancer is risky.

Yes, some treatments are worse than the disease. In other words, for some the treatment may more likely cause death or disability than the disease itself. Another recent example comes from a study of persons 66 years and older who were diagnosed with kidney cancer. Now, kidney cancer is nothing to ignore and can be treated with surgery, chemo and radiation. Yet for those over 66, at least according to this study treated patients were much more likely to die than those whose kidney cancer was simply watched.

Why? Well older people don’t tolerate surgery, chemo or radiation as well as their younger counterparts. Older people have a shorter life expectancy, so should be careful about treating something which probably would not have shortened their time on earth more than the treatment.

I want to be very clear however, that many, many treatments are in fact good for you. Controlling elevated, blood pressure, lipids and sugar (as in diabetics) will increase your quality and length of life. Treating many cancers will do so as well. It’s just that as more research unfolds about the risks and benefits of many treatments, there may be certain patients who are likely to benefit and others who won’t. In other words, one size doesn’t fit all!

Not only treatments but diagnostic tests need to be carefully chosen. No test is perfect and there will always be patients with positive results who really don’t have the disease and those with negative results who really do have the disease. Carefully choosing which patients should get these tests is important, as no one wants to miss a diagnosis or diagnose someone with a bad disease he or she really doesn’t have.

There are many examples of tests which are widely used, but should really be ordered less often. PSA tests, despite all the fanfare have yet to be shown to reduce mortality. Many patients are diagnosed with small cancers which really wouldn’t have caused a problem if these cancers had been missed. After being diagnosed, these patients might undergo¬† unnecessary surgery or radiation. CT scans of the chest looking for coronary artery calcification might find calcified arteries, but it is not the presence of plaque that it so much of a problem as whether the plaque is stable or not. And guess what, these scans result in quite a bit of radiation and aren’t cheap.

Ask your doctor about any proposed test or treatment. Is the treatment worse than the disease? If  so than think twice before starting down that road.

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