What would you do if you knew…

This past weekend, I had the opportunity to attend a lecture presented by Mayo Clinic Physicians about the use of new technologies in the medical field, specifically ultrasounds in the emergency room, to better diagnose patients and save more lives.  For some reason, this presentation brought to mind a study I recently read, Scientists Find Spinal Clue to Detecting Dementia, which detailed new medical technologies that can potentially detect Dementia, and eventually Alzheimer’s, ten years before it sets in.  The scientists conducting the study examined the spinal fluid of patients who had mild thought and memory issues, and a decreased amount of a specific protein, beta-amyloid, in their cerebro-spinal fluid.  These study participants’ memory and thought processes were tracked for ten years, and the end result for nearly all of them was a prognosis of Dementia/Alzheimer’s in the near future.

While reading this article, it reminded me of a study done a few years ago about new medical technology that can detect the genes which can potentially result in Breast Cancer.  Women who tested positive for these genes, who had no history of breast cancer in their family, and no other indicators of possibly developing the disease other than this particular gene, went to extreme measures, a total mastectomywith reconstructive surgery, to give themselves the peace of mind that they will not develop breast cancer.  It was also noted that women with all the indicators: family history, one or many of the identified Breast Cancer genes, etc., never developed breast cancer, while those without any indicators did.

So this begs the question, are we better off not knowing if we are “predisposed” for certain medical conditions? Are these medical technologies for identifying certain illnesses reliable? Are the results, positive or negative, useful in creating a better quality of life?  Does the knowledge of knowing you test “positive” for, in the case of these articles, a certain gene or protein deficiency cause you to live in fear of the disease? What measures will we take to prevent these diseases if we test positive? 

Medical technology is not a bad thing, it just needs to be used in beneficial, lifesaving ways, and I’m not sure if testing someone for Dementia/Alzheimer’s, Breast Cancer genes, or other life-threatening diseases is really a good use of technology.  These tests are informative, but are they necessarily beneficial or lifesaving?

Personally, I am not in favor of these medical technologies that will indicate if you are susceptible (or not) for a certain medical condition.  If women who test positive for a Breast cancer gene are getting mastectomies, then what extremes will potential Dementia/Alzheimer’s patients go to to prevent this condition?  Suicide?  This has yet to be determined.  I feel like if I tested positive for a condition that I would live in fear of developing it, and that is certainly no way to live a happy, healthy life.  These medical technologies are not 100% accurate, and as a result, they may give you false information—either a false sense of security, or false alarm for something you will not develop.

As far as preventing certain diseases, regardless of personal medical history, I believe in preventative care.  It has worked for decades, and continues to work now, in the midst of medical technological advances.  Obviously, certain people are more likely to get certain diseases than others, and there is simply no way to avoid some medical conditions.  For someone like me with fair skin, I am already at a greater risk for skin cancer and melanoma than others, and living in Arizona only increases my chances of getting it.  I don’t live in fear of skin cancer, I just use ridiculous amounts of sun protection to hopefully prevent it.  Medical technology has advanced in a way that there are now apps for your smartphone and tablet.  These apps can help you track medications, exercise, diabetes, heart disease, and even “diagnose” your condition–WedMD in an attempt to reduce doctor visits.  I like the fact that they can help track certain things like medications, and especially diabetic’s blood sugar and diet, but I’m not sure if they are really all that beneficial in the medicine and diagnosis aspect, and many doctors aren’t either.  The WebMD app is a useful tool if you simply want to know about certain medical issues, but as far as actually diagnosing yourself, I have found that WedMD has caused me more harm than good.  It tends to take simple things like a cold and blow them completely out of proportion to the point of some incurable disease.  So, are these medical apps really a good thing? For tracking diabetic blood sugar and diet, I would say yes, but as far as self-diagnoses, I would say no. So, go to the doctor for regular exams, use sunscreen, eat right, and exercise regularly.  This will be your best bet in warding off these dreaded diagnoses. 

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10 responses to “What would you do if you knew…

  1. This is a very interesting topic, and given that I am not particularly acquainted with the medical field, one I have never given much thought.

    I tend to agree with your analysis. Why should someone goes through such radical changes simply because they might be sick in the future? It may even be possible that the stress and other emotional factors involved with these treatments lead to other problems, thus creating a sort of self-fulfilling prophecy.

    We talked about practicing deconstruction while analyzing assumptions. I would argue that a major assumption of society is that medical advancements are always beneficial. Could it be that some of these technologies simply make our lives worse?

  2. I am extremely fascinated by this article and am personally very perplexed by this question. At first, I was very excited about the idea that we could use technology to determine potential genetic abnormalities, however after reading your stance, I do wonder if it’s a good idea. It would be more useful if some sort of prevention was available, but both cancer and Alzheimer’s are thus far unable to be cured or prevented. So what would be the point in knowing and living in fear (like you said)?

  3. I do not have much knowledge in the field of medical technology, but this does raise an interesting question. For me, I think that using the technology to see if people have the specific gene abnormality would only be beneficial if they are also finding ways to after you figure it out then you can have a chance of overcoming it. For example, if they are testing people to see if they have a gene that is linked to Alzheimer’s then there should be a “medical plan” to try and reverse your chances; such as doing daily mind/logic games.

    As for the medical apps, I believe that these can be beneficial as long as people use them correctly. Part of our problem with medical care in the United States is people going to a doctor or getting other medical care for simple illnesses that do not require medical attention. For example, the common cold you just need to drink liquids, get some sleep, and don’t run to your doctor because that is exactly what he is going to tell you. But of course it could also be dangerous for a hypochondriac to be searching up everything they feel is wrong with them and rushing off to the doctor after searching “itchy nose” and then WedMD saying they have brain cancer. So overall, I just think that the mentioned technology (and really all technology) just needs to be used responsibly.

  4. In terms of familiarity with the medical field, I’m kind of in the same boat as most of the people here having little to no in depth knowledge of it. However I thought this article did a good job of being relatable even with the focus on the medical field. It wasn’t an overbearing presence that would go over the heads of some readers. With that said, I also want to acknowledge that I agree pretty whole-heartedly with the article as well.

    Living life in fear takes away part of the quality and the excitement of the human experience. Part of the excitement of life for me at least is not knowing what is going to happen next, good or bad. While taking caution is a wise thing to do, it should be done in moderation. Everything should have a balance to it, and living life either completely without care or with too much is dangerous. The presence of new technologies can be a wonderful way to help us prolong our health and longevity on this planet, but letting is rule our lives is beyond what it is meant for. Take everything with a grain of salt and live life for yourself.

  5. I believe the advance of medical technology is a good thing. The population of women that got surgery after finding they were predisposed to breast cancer did what they thought was best and may or may not have felt better post-operation. Personally, if I knew I was predisposed to some disease, I would prefer to see if it would actually happen before subjecting myself to invasive (and possibly more dangerous) surgery.
    I think there will always be people that react negatively to the advancement of science, whether it be those who want to stunt it, or those that overreact to new information that they don’t fully understand. Very few things (especially in medicine) are black and white. A predisposition to cancer doesn’t mean you will get it, as mentioned in the article.
    In short, I am fully in support of this new technology. Imagine where it could lead us – detection of disease before it occurs is the first step to curing it.

  6. Not sure if anyone here has watched Scrubs, but one of the sons of a patient in the show goes through this exact dilemma. His mother was dying of a genetic disease, and he had a 50% chance of having it — and so the doctor (JD) offered to run some tests to see if he had the gene that caused it. The son refused the procedure, saying that once you learn it… “there’s no unlearning it”.

    I’m inclined to agree. I think it’s definitely impressive that medical technology can predict things like this, and I think it’s an option that should be open to those who do want to know. But, it seems like it can result in some drastic life changes for something that may be as little as a 1% chance of happening.

    In addition, I agree with you, Kelli — more preventative care education can be cheaper and less life altering. I’ve read (not sure how accurate it is) that prostate cancer can be just as common as breast cancer, yet I don’t know a single preventative test (if there is one) for prostate cancer, but preventative tests for breast cancer are plastered anywhere that breast cancer education is. Now, I don’t mean to discount breast cancer at all, but it would be nice to see prostate cancers (and most cancers anyway) receive more funding or awareness.

  7. Your blog post relates to a couple of medical sociology classes I’ve taken, both of which have discussed the biomedical model that the U.S. has traditionally loved. One aspect of this model holds that illness has a specific cause in a specific area of the body that, especially with the help of new technology, is detectable and hopefully preventable through such medical measures as mastectomies in the case of breast cancer that you discussed.

    As a result, medicine ends up looking at the body as a machine that needs fixing with other machines, and the effects of our physical and social environments on both creating and preventing illness are downplayed. Physicians fail to adequately incorporate preventive care into their routines (after all, it isn’t profitable for them), and patients aim for medicine and surgical operations before changes in diet, stress levels, and other aspects of lifestyle that clearly also affect the development of illness. Thus, women might jump to mastectomies in the face of possible breast cancer in the future, rather than looking critically at the aspects of their lifestyles, like diet and exercise, that they can easily change without spending thousands of dollars, and thus decrease their chances of developing breast cancer. The choice comes down to whether they would rather live with a little uncertainty, or without breasts, and both are perfectly understandable.

    If a person is genetically predisposed to a disease, lifestyle changes can only do so much. However, considering the unreliability of this still-new technology in pinpointing risk, I think physicians would do well to encourage lifestyle changes and alternative medicines before the more drastic, medical changes that may or may not solve the predisposition. Unfortunately, this would essentially require our society to drop the traditional biomedical model in favor of a more holistic, but less profitable for physicians, approach.

  8. In my opinion, it would be better all around to have the tests on file but leave it up to the judgement of the patient if they want to know or not. This would preserve the patients’ freedoms to choose while keeping a solid record for future physicians to be able to determine when these genetic diseases are beginning to manifest, allowing for a quick diagnosis without having to wait until the symptoms have magnified enough to identify the illness as genetic rather than pathogen-derived. Thus the patient who chose not to know would be told at the point of diagnosis, just as anyone who didn’t know in the first place.

    One major stipulation on the keeping of such records would be that they are not to be distributed publicly. This includes but is not limited to employers, relatives, government offices, universities/other educational institutes, etc. Such information could be detrimental to a person’s life and well-being if placed in the hands of anyone other than the personal physician. After all, the last thing mankind needs is yet another form of discrimination to hold back its advancement.

  9. Well this is an interesting post – kudos for that -, however I am drawn to a couple points in this post that I feel deserve some attention. I feel that this post makes some assumptions that are not properly justified, or at least not to the extent that they perhaps should.
    One of these assumptions that I perceive to be present, is that of the general public (in this case the general public being those who are privy to the information this blog makes a reference to, yet have no extensive knowledge in the medical field) being one who takes any set of new information that it is introduced to for granted, to the extent of not questioning the validity of said information. While I can understand how the actions of the women who went to great lengths to have peace of mind after finding the results of the Breast Cancer study, or the individuals that blew out of proportion the information presented in the mentioned Medical Apps, can create the notion that the general reaction by the general public to similar circumstances would be the same, I do not believe it is justifiable enough to only consider those scenarios, and assume that the case would be the same the majority of the time.
    That being said, I would also like to dispel another assumption that I believe stems off of the previous one, and that is, the assumption that these medical studies and medical apps were conceived to be “good”. I do not believe that these are necessarily meant to be “good”, but rather informative and contributory to the progression of the Medical field.
    Having all of the aforementioned in mind, I do not believe that these studies and or apps are “good” for us, now that also does not mean that they are “bad” for us, it just means that they serve a purpose more specific than that of being “good” or “bad”. Medical studies are just that, “studies”, which means they are meant to investigate and collect data, not necessarily to reach a definitive result and/or conclusion; they can lead to that, yes, but there are other intermediate steps in between which must also be accounted for. So I do not believe that the general bias against these (at least from what I can perceive) is properly warranted.
    Same thing with the Medical Apps. These are meant to be informative (regardless of how the information may be presented), not “good” or “bad”. It is up to those receiving the information to decide how to interpret what they read. There may be those who jump to immediate conclusions that may not necessarily be true, and those that take the information for what it is and go out of their way to make sure the information is justifiable. I personally like to believe that the general public is composed of the latter, but then again, that may also just be wishful thinking from my part.
    So that is what I think, at least from what I have read in this blog post. There may more information out there that relates to this, of which I am not aware of, but I believe my opinion is solid enough.

  10. After reading your article I would have to say that I very much agree with your statement. Especially when its in question if this technology is pus into good use of letting people get worried and scared of when they are told that they match up with such diagnosis that they begin treatment. That’s the question that bugs me is “What if they are mislead or even wrong”. Then they would have done the surgery and spent money for nothing. Hopefully individual’s take deep and further research consideration before “jumping” onto that surgery table.

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