Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

The Secret To Long Life: Do Nothing?

edwalkerEd Walker is 102 years old. I met him by chance on a steep hill in Lunenburg, Nova Scotia – not long after my husband blurted, “I hope you’ve got good brakes on that scooter!” Ed pulled up next to us (to demonstrate his brakes) and jubilantly announced his age, along with his suspected reason for it: “I have prostate cancer but chose to leave it alone.”

I chuckled to myself, thinking that he was probably right about his longevity-hospital avoidance connection.

Of course, the diagnosis and treatment of prostate cancer is being hotly debated these days. While no one likes the idea of leaving cancer untreated, slow-growing prostate cancer may be less of a threat to men at a certain age than the treatment required to cure it. And that’s a difficult truth to accept – especially for Americans.

My fellow blog contributors have noted the disconnect between scientific evidence and clinical practice in regards to prostate cancer. According to a recent study in the New England Journal of Medicine, PSA (a screening test for prostate cancer) testing has not made a difference in overall longevity. Urologists still favor testing (the American Urological Association guidelines recommend initiating PSA testing for all men starting at age 40) while family medicine physicians don’t usually recommend it. Is there a conflict of interest driving this difference in recommendation? Perhaps – though I suspect it has more to do with a surgical mentality (to cut is to cure!) than a conscious decision to protect one’s income. If you think there’s a shortage of urologic procedures to go around, then I’d recommend you simply consider the increasing age of the US population. It’s not as if the prostate gland is the only thing that needs work “down there.”

Perhaps Americans can take some cues from their elderly neighbors to the north – and try to accept that doing something is not always better than “doing nothing.” In the case of some prostate cancers, it’s cheaper, safer, and a lot less painful.

Just ask Ed Walker.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »