The conventional medical wisdom is that the best way to avoid dying from cancer is to make sure you regularly subject yourself to screening tests. Medical authorities tell us that the best protection is early detection, and that when found early, many cancers can be successfully treated. This appears to be a sound strategy that should work. The problem is that it doesn’t; research does not support the use of screenings as a means for reducing deaths from cancer. This does not mean that screening does not help anyone; it means that screening does not help most people, and in fact it is unlikely to save your life.
I’ve written extensively about the risks associated with mammography and PSA testing, which include missing aggressive cancers that develop between screenings; false positives resulting in extreme distress and even more tests and procedures; and identification of “pseudo-cancers” which you’d probably be better off not knowing about and which usually result in over-treatment that can be harmful.
But screening tests are still aggressively promoted. In my opinion, there are two reasons why. First, screening generates a lot of money and creates a market for medical services. Doctors, hospitals, and other medical facilities bill insurance companies and Medicare for expensive screening tests and the tests produce customers for procedures and treatment, often offered by those same doctors and facilities (and also billed to third-party payers).
The other reason that screening continues to be a standard practice in spite of its lack of efficacy is the emotional outcry any time there is a discussion about limiting or eliminating ineffective tests. Public health officials, legislators, and the general population become almost hysterical, often accusing the government and insurance companies of trying to increase profits and ration care at the expense of public health.
I receive emails from people about this issue frequently. Some of these emails are outwardly hostile; people accuse me of being irresponsible for suggesting that cancer screening for the general public may not be a good idea. But most correspondence is from people who are frightened and concerned. They say things like “If these tests do not work, what am I supposed to do to protect myself? How will I know if I have cancer?” These people are genuinely upset because their belief system about how to protect themselves has been shaken.
I am often asked to recommend an alternative screening test that is reliable. Life would be so much simpler if I could, but there is no such test. Instead, I recommend the only option that really does work to reduce the risk of developing or dying from cancer – dietary excellence™ (a Wellness Forum-style diet). Adopting this diet does not eliminate all risk; it just eliminates the controllable risk. A good comparison is the practice of buckling children into the back seat with seat belts before backing out of the driveway. Doing so does not guarantee that children will not die in a car accident, but it does reduce the risk so significantly that there are few parents or caregivers who do not take the time to make sure that children are secure in the car.
A common frustration shared by people promoting a plant-based diet is that some people are resistant to the idea. I’ve found that this resistance is significantly lowered when people are provided with published evidence showing the futility of their current plan for health care, and also provided with evidence showing the potential for a well-structured plant-based diet to prevent, stop, and even reverse disease. The challenge in communicating this information is that people must be helped to move beyond the emotional state in which they find themselves when confronted with information that threatens their sense of well-being, which is often the case when the discussion about diagnostic testing begins.
The choice to eat plants instead of visiting doctors for tests and treatment represents a major shift for many people, and should be a well thought-out decision. The reason to do this is not because I say so. I remind people daily that the reason many people have been over-treated or mistreated by the medical profession is that they have formed the habit of doing what they are told. I am clear that just following my directions instead of someone else’s is not what I mean when I advise people to take control of their health. This is why we provide referenced information for people to read; we want them to make informed decisions and to take ownership of their choices.
Two great books that are helpful resources for learning more about this issue are Should I Get Tested for Cancer? Maybe Not and Here’s Why and Over-Diagnosed. Both are by Gilbert Welch, M.D. and discuss the myth of early detection and the risks associated with testing. They are well-referenced and easy to read.
The medical system is not going to reform itself, and the government is not likely to be a positive influence either. Consumers are going to force reform by collectively increasing the demand for strategies and services that work (like diet) and drying up demand for strategies and services that do not work (diagnostic testing and bypass surgery, for example). I am optimistic that this shift is taking place now and gaining momentum. Interest in health grows daily; dissatisfaction with medical care is at an all-time high; information can be disseminated rapidly, and the science is on our side.