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medpundit |
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Saturday, December 21, 2002Ultra-fast CT scans: The CT scans are advertised as a means to find tumors and heart disease that you might not be aware of. The problem is, they have more of a tendency to find uncertainties than disease. Cardiac CT’s measure the calcium content in the coronary arteries, but we don’t know how much calcium indicates a problem, and calcium is found in the arteries of most people over the age of 25. The finding of calcium usually leads to more testing - often a cardiac catheterization. Cardiac catheterizations are both invasive and expensive, and not to be undergone lightly. CT scans to screen for lung cancer are of dubious worth. Ditto abdominal scans. Both may lead to unnecessary biopsies, which in the case of the chest and abdominal cavities involve invasive, expensive, and risky procedures. PSA: This is the blood test that can detect early prostate cancer. It isn’t very good as screening tests go. The PSA can be increased when the prostate is benignly enlarged, or when it has cancer. Furthermore, many prostate cancers are very slow growers. Men can live with them for years and end up dying of something else. Having a postive PSA can lead to prostate biopsy. If cancer is confirmed, there’s then the very difficult decision of what to do about it - complete removal of the prostate, with its attendant complications of impotence and incontinence, or watchful waiting and observation? Female Hormone Panels: These are blood tests that can tell whether a woman is in menopause or not. Little harm is likely to come from doing them, but the question is why do them? Women who have all of their reproductive parts will know they’re in menopause when they stop having periods. Women with hysterectomies may have trouble knowing when menopause is upon them, unless they have symptoms such as hot flashes or vaginal dryness. But, in the absence of symptoms, there’s little reason to intervene. Hormone replacement therapy has turned out to be devoid of the health benefits we used to claim for it, and is now only recommended for symptomatic treatment of menopause. Testing for hormone levels isn’t likely to provide any useful information that can’t be had by simply asking about symptoms. posted by Sydney on 12/21/2002 09:15:00 AM 0 comments 0 Comments: |
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