No contest. Preventive medicine is very close to being an oxymoron. Public health is one. Doctors are trained to detect disease and recommend options for treatment. We hardly know the cause for anything and have no scientifically valid evidence to back the "lifestyle" factors that are so often recommended---diet, exercise, etc. We have grandmothers to dispense that sort of advice.
It's funny the last 40 years or more "Preventive Medicine" (scans, tests, drugs-before-disease) has been sold as this big savior for health problems, when mostly it was just clever marketing.
"Today new names were added— including some cardiologists,"
oh dear; cardiology; oh dear; oh goodness;
they are so hopelessly lost in madness; stumbling around in their own version of the Truman Show; believing fats are bad; glucose is good; possessing no understanding at all of insulin's central role in the oppressive burdens of obesity, metabolic syndrome, T2 diabetes; all springing from endlessly high insulin levels;
bringing in a certified cardiologist seems like hiring two blind men; with white walking sticks; to do some task where good vision is central to what you want done;
it firstly verified what he said was true; then I said "but ALL-CAUSE MORTALITY is unchanged
it replied
"Your understanding is not just correct — it's the central, most damaging point in this whole debate, and it's better documented than the four claims we just went through."
(Sadly I can't emphasise text with appropriate bold and italic segments in Substack!!)
All-cause mortality is unchanged in most of all these type of studies because God decided our death date at our birth. Our number of days are pre-decided. It’s a mystery, but true.
From the Holy Bible:
Psalm 139:16 (NIV):
"Your eyes saw my unformed body; all the days ordained for me were written in your book before one of them came to be."
"Colon cancer screening - flex sig has the strongest data. Annual fecal DNA just makes a company money— lacks data on even cause specific death. Starting at 45 not 50 is made up. Might as well start at 35 or 20"
I am sure you are spot-on in your analysis; what would be great for the plodders; the great unwashed who follow your writings; is even one or two pointers to published data that we can glance at; I had understood that for colorectal cancer, that the ALL-CAUSE MORTALITY was not altered by screening; always grateful to hear from you;
The flex sig data is solid. Look up Prof. Wendy Adkins flex sig study in UK. And if you like colonoscopy read the NORDCC study. The emperor has no clothes. .
There has never been a colonoscopy study done in the United States with either all-cause mortality or colon cancer Mortality as the end point. The gastroenterologists don’t want to allow that study to be done because they know daddy will take the T bird away. The endpoint they use is “advanced neoplasia”— that’s a benign polyp bigger than a centimeter.
thanks for explaining that all so clearly Michael; much appreciated. You clearly are totally on to this, and have deep understanding; many thanks for this.
One of the things that bothered me about medicine back in the early 1980s was that so much of it seemed to be dogma driven. (Treating somebody with heart failure with a beta blocker was malpractice... failing to treat somebody with heart failure with a beta blocker was malpractice...)
I told myself that it was because our technology (MRI, CT, etc.) wasn't advanced enough so that we had to rely on "expert opinion"... but the basic statistical methods DID exist and could help identify meaningful treatments and screenings.
The "My Uncle Sam Likes Eggs" chapter in Marty Makary's book Blind Spots opened my eyes to the cholesterol and red meat lie that we have been led to by the expert opinion of Ancel Keyes in the 1960s.
And yet today... we are still ruled by dogma, and much or most of the time, the dogma is driven by those with a financial interest. I agree with Ernest below.
"Preventive medicine is very close to being an oxymoron."
you are right to criticize the USPSTF but you do so for the wrong reasons. Most of the panel are beholden to payors and are thus hopelessly conflicted. The USPSTF has twice recommended against pancreatic cancer screening despite the fact that early detection saves lives.
Spot on. USPSTF tries but they lack the courage. It’s the problem with preventive medicine in general. They’re shrinking violets. They’re afraid to assert themselves. They know the same facts Vinay does but are afraid to act.
Dr Prasad: How would I contact you regarding providing a second opinion for my cancer treatment? I know you mentioned doing these type consults, but don’t know to what extent. Is there a way I can private message you? I don’t use any social. I do use email and WhatsApp. Thank you.
No contest. Preventive medicine is very close to being an oxymoron. Public health is one. Doctors are trained to detect disease and recommend options for treatment. We hardly know the cause for anything and have no scientifically valid evidence to back the "lifestyle" factors that are so often recommended---diet, exercise, etc. We have grandmothers to dispense that sort of advice.
It's funny the last 40 years or more "Preventive Medicine" (scans, tests, drugs-before-disease) has been sold as this big savior for health problems, when mostly it was just clever marketing.
"Today new names were added— including some cardiologists,"
oh dear; cardiology; oh dear; oh goodness;
they are so hopelessly lost in madness; stumbling around in their own version of the Truman Show; believing fats are bad; glucose is good; possessing no understanding at all of insulin's central role in the oppressive burdens of obesity, metabolic syndrome, T2 diabetes; all springing from endlessly high insulin levels;
bringing in a certified cardiologist seems like hiring two blind men; with white walking sticks; to do some task where good vision is central to what you want done;
I pasted in Vinay's comments to AI:
it firstly verified what he said was true; then I said "but ALL-CAUSE MORTALITY is unchanged
it replied
"Your understanding is not just correct — it's the central, most damaging point in this whole debate, and it's better documented than the four claims we just went through."
(Sadly I can't emphasise text with appropriate bold and italic segments in Substack!!)
All-cause mortality is unchanged in most of all these type of studies because God decided our death date at our birth. Our number of days are pre-decided. It’s a mystery, but true.
From the Holy Bible:
Psalm 139:16 (NIV):
"Your eyes saw my unformed body; all the days ordained for me were written in your book before one of them came to be."
"Colon cancer screening - flex sig has the strongest data. Annual fecal DNA just makes a company money— lacks data on even cause specific death. Starting at 45 not 50 is made up. Might as well start at 35 or 20"
I am sure you are spot-on in your analysis; what would be great for the plodders; the great unwashed who follow your writings; is even one or two pointers to published data that we can glance at; I had understood that for colorectal cancer, that the ALL-CAUSE MORTALITY was not altered by screening; always grateful to hear from you;
The flex sig data is solid. Look up Prof. Wendy Adkins flex sig study in UK. And if you like colonoscopy read the NORDCC study. The emperor has no clothes. .
thanks Michael
" The emperor has no clothes. ."
what is the point you are making, please?
There has never been a colonoscopy study done in the United States with either all-cause mortality or colon cancer Mortality as the end point. The gastroenterologists don’t want to allow that study to be done because they know daddy will take the T bird away. The endpoint they use is “advanced neoplasia”— that’s a benign polyp bigger than a centimeter.
thanks for explaining that all so clearly Michael; much appreciated. You clearly are totally on to this, and have deep understanding; many thanks for this.
One of the things that bothered me about medicine back in the early 1980s was that so much of it seemed to be dogma driven. (Treating somebody with heart failure with a beta blocker was malpractice... failing to treat somebody with heart failure with a beta blocker was malpractice...)
I told myself that it was because our technology (MRI, CT, etc.) wasn't advanced enough so that we had to rely on "expert opinion"... but the basic statistical methods DID exist and could help identify meaningful treatments and screenings.
The "My Uncle Sam Likes Eggs" chapter in Marty Makary's book Blind Spots opened my eyes to the cholesterol and red meat lie that we have been led to by the expert opinion of Ancel Keyes in the 1960s.
And yet today... we are still ruled by dogma, and much or most of the time, the dogma is driven by those with a financial interest. I agree with Ernest below.
"Preventive medicine is very close to being an oxymoron."
you are right to criticize the USPSTF but you do so for the wrong reasons. Most of the panel are beholden to payors and are thus hopelessly conflicted. The USPSTF has twice recommended against pancreatic cancer screening despite the fact that early detection saves lives.
Spot on. USPSTF tries but they lack the courage. It’s the problem with preventive medicine in general. They’re shrinking violets. They’re afraid to assert themselves. They know the same facts Vinay does but are afraid to act.
Dr Prasad: How would I contact you regarding providing a second opinion for my cancer treatment? I know you mentioned doing these type consults, but don’t know to what extent. Is there a way I can private message you? I don’t use any social. I do use email and WhatsApp. Thank you.