What’s Worse, Health Care or Cancer?

The health care crisis in this country is a monster, like one of those mythical giant squids that could grab a sailing vessel, wrap its tentacles around it, and pull it to the bottom of the sea. President Obama’s message is that the U.S. economy is that ship. Without reform, health care costs will sink us in the near future. Yet it’s no surprise that Congress can’t find a solution or that the public is deeply worried about the cost of reform. Each arm of this monster thinks it has a right to hold on.  Doctors don’t want lower salaries. Pharmaceutical companies don’t want a flood of generic drugs from across the border.  Lawyers and insurance companies fight for their share of premiums and court settlements. Patients don’t want reduced care.

In a televised town meeting aimed at selling his program, Obama rightly pointed out that Americans pay more for health care than anyone else in the world but don’t necessarily get more. One example is the estimated $700 billion dollars in unnecessary tests that doctors routinely run each year. As soon as he made the point, however, a doctor in the audience raised a familiar specter. If your wife or daughter had cancer, he said, would you tell them they can’t get the best care possible, no matter what the cost? It’s a fearful question, and frankly, the ace in the hole that mainstream medicine has been pulling for decades.

So which is worse, cancer or the huge cost of health care?

If we can set our fears aside, certain facts need to be faced.  A recent European study on prostate cancer poked a hole in the need for early detection, a need that’s drummed into us constantly for every type of cancer and which costs billions every year in expensive tests.  The new study “indicated that saving one man’s life from the disease would require screening about 1,400 men. But among those 1,400, 48 others would undergo treatments like surgery or radiation procedures that would not improve their health because the cancer was not life-threatening to begin with or because it was too far along,” to quote The New York Times.  The same story covered an early-detection campaign known as “Check Your Neck” aimed at thyroid cancer. Yet this rare cancer kills only 1,400 people a year, and there’s no evidence that regular checkups for it save lives.  The same holds true for ovarian, lung, and skin cancer. Considering all the factors, including side effects and risks of treatment, one expert in early detection gloomily declared,  “There are five things that can happen as a result of screening tests, and four of them are bad.”

The one good outcome, finding a fatal cancer that responds well to treatment, is what Americans pay billions and billions of dollars in the hope of achieving.

So, will doctors back off on the standard PSA tests to detect prostate cancer, much less the protocols of radiation and surgery to treat it? Not unless a new system of health care emerges that reduces fear as well as costs. Thirty years ago I first entered alternative medicine with an emphasis on wellness, believing that it represented a new system. I still believe it does. Cancer, and the anxiety it induces, is a red herring.  The mean adjusted age of death from all types of cancer — meaning how long the average patient survives before succumbing to the disease — has barely changed since the 1930’s for both  men and women  With all the early detection and advanced treatments, a cancer patient today is by no means guaranteed to live longer than a cancer patient in our grandparents’ generation. That’s another fact we need to face.

The final fact is that American health care needs prevention more than anything else.  The majority of medical costs go to treating three conditions: obesity, diabetes, and heart disease. As this society grows fatter, older, and less likely to exercise regularly, all three will rise, and yet sensible prevention would go a long way to halt or reverse that trend. A major type of diabetes, Type 2, is directly linked to obesity, so even though type 1 is incurable, maintenance and prevention would effectively fight the scourge of diabetes, not to mention the myriad secondary problems it causes.

The thing about a giant squid is that you can’t peel it off one tentacle at a time. You need to find a way to pull off every arm at once. In our current crisis, doctors and Congress cannot do the job. Vested interests will be fighting over health care for years to come. The public is right to worry that Obama’s promised reforms cannot be paid for without extra taxes, and even then the overall costs may not go down. But it’s the public that is best equipped to kill the monster, not by focusing on the war on cancer, gene therapy, heart bypass surgery, and the next miracle drug — these all cost a king’s ransom and are controlled by powerful interest groups — but by finally waking up and taking charge of our own health. The cry for preventive medicine and inexpensive natural treatments isn’t new or glamorous, yet we need to heed it now more than ever.

Published in the San Francisco Chronicle