Comment by outworlder | Hacker News Reader

Comment by outworlder | Hacker News Reader

I shudder to think what could have happened, had she delayed the exam. From what I understand, she was not in a risk group and didn't yet require periodic exams. Not many people will jump through the hoops unless they have been told by a doctor that it is something they need to do.

And that's not even counting the heavy procrastinators, such as myself, that will postpone exams even when the doctor asks for them. Which reminds me...

In any case, I find the bureoucracy a pain. For most exams, you have to schedule an appointment in advance. Depending on what prompted you to seek medical help in the first place, you might even be feeling better already. Too many times I have been told that there was nothing wrong - no kidding, I was feeling better already.

Don't even get me started on how hard it is to find good doctors...

I believe we are reaching a point where we have the technology to cure most maladies, but which doesn't do us any good because it is not applied consistently enough, even disregarding economic factors.

I guess that's why the Star Trek's sick bay appeals to so many people. It is not hard to envy a future where one just has to walk-in with an obscure disease, get state-of-the-art scans, done by one of the very best doctors, who will not stop until he finds what's wrong. And not go broke afterwards.

Yeah, give me that over a transporter any day.

Were she to delay the exam, her life would have gone on pretty normal for a while, Eventually the lump, the cancer, would have grown, all the while trying to sneak into the rest of the body. Perhaps she would have eventually made it into a GP, and not a place that specialized diagnosing breast cancer. Lumps are normal, she's young, it's probably not anything to worry about, come back if it grows.

It's cancer, of course it grows, she goes back in a couple of months, eventually it's large enough to warrant removal regardless of what it is, they'll do the biopsy after they remove it.

Biopsy comes back, now she know it's cancer, but hopefully it's not too far along. They get her a PET scan, hopefully it's not in the blood.

The PET scan comes back, it confirms multiple tumors in the body. Metastatic, they call it. Atleast that explains the back-pain. Her options are limited now, there are treatments that can slow the growth, but not much hope in the way of getting rid of the cancer.

Chemo is much less useful at this stage, Chemo is a much more distant worry now, loosing your hair a much more distant worry, which makes it feel, a bit less real. The treatment is still very minor. She still feels pretty healthy all things considering, and this is just what the doctors are telling her. It's not real, but again, the cancer doesn't much care.

I don’t think they ignore lumps on the basis that you are young because cancers in younger people grow significantly faster.

You wrongly assume that all doctors think the same way.

Part of the problem is not just the cost of things like full body scans but the interpretation of the results. From what I understand, these scans tend to turn up all sorts of things that may or may not be anything serious; but all of which, once found, requires follow up.

This is exacerbated by malpractice lawsuits "But there was a spot on the scan 12 months ago, why didn't you do anything!". It wouldn't surprise me if doctors would be willing to use such technology even if it became cost feasible.

>From what I understand, these scans tend to turn up all sorts of things that may or may not be anything serious; but all of which, once found, requires follow up.

It's really worse than that. Most of the tests they end up doing with they spot some kind of abnormality have some risk associated - x-rays increase your risk of cancer, for example, and anything that penetrates the skin carries some statistical risk of infection.

Where I live there are companies offering these full-body scan deals, where for an exorbitant amount of money they run your entire body through an MRI machine and then have someone look at the results. What they're finding is the risks associated with the follow-on tests (xrays, biopsies, etc) outweigh the risk that you'll miss something curable. In other words, statistically you're actually shortening your life by having one of these scans.

> the risks associated with the follow-on tests (xrays, biopsies, etc) outweigh the risk that you'll miss something curable

And that doesn't even cover the psychological effects that can come from false-positives.

>I shudder to think what could have happened, had she delayed the exam.

There's a good chance nothing would have happened. Screening programs massively overdiagnose non-malignant breast cancer as malignant: http://www.bmj.com/content/339/bmj.b2587.abstract

That article claims a 35% overdiagnosis rate. While high, I wouldn't call that a good chance and wouldn't bet my life on it.

A 35% overdiagnosis rate means that for every 3 correct cancer diagnoses made, about one error occurs. That means if the diagnosis is cancer, about 75% of the time it actually is cancer. If the rate of false negatives is small enough, I think I would bet my life on that.

Edit: Sorry, I just noticed that what I wrote seems to imply I disagree with you when, in fact, I agree with you.

Bowel screening problems throw up issues with mortality too. I was at a recent review of screening at a group of UK hospitals and it was found that the average age of death is the same for those with bowel cancer that were detected by screening, detected by accident, detected after an emergency or detected at autopsy.

>I believe we are reaching a point where we have the technology to cure most maladies,

Not to cherry pick or anything, but most cancers still have a fairly high death rate. And chronic leukemias, for instance, are incurable.

So is existing, to be fair.

Considering the way I drive my bike, a transporter would properly be more likely to save my life.

On the other hand, can't we have both. I mean, my phone is almost a tricorder...

...and could be today except CBS pulled the tricorder app.

http://www.geek.com/articles/mobile/cbs-demands-removal-of-m...

>From what I understand, she was not in a risk group and didn't yet require periodic exams

Everyone is supposed to do self-exams. There is no consensus on preventative mammograms, some doctors still say to get them, but at different ages. Others say not to do it at all as the risks outweigh the benefits, and mammograms are most useful to diagnose lumps found through normal exams.

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