I do not think that we get to the point that you would have to take pills as a preventative for each possible cancer, there probably are some commonalities. Moreover, when such pills may be available, so would be genetic testing/metabolic profiling to allow a individualized selection for the cancer that are most likely in a given individual.

Many people already take daily vitamins and other supplements, I see little difference with this. For that matter how many people are taking their daily aspirin? What about vitamin D? I see absolutely no psychological issues with this. Taking a baby aspirin does not remind me that I am getting a heart attack, quite the opposite actually.

M

Great comments people, and helps me rethink my upcoming conversation. I am bringing this back to the top since I have two days before the meeting. Anyone else that what to jump in please do so.

For many years here in the UK it has been the norm to prescribe a small daily dose of asprin to help protect against heart attacks in what is perceived as high risk patients.Last week the media was full of doctors reporting on the possible dangers of taking daily asprin.Its so frustrating ..good for you one day,dangerous or worse still useless the next.Are theses studies flawed, published too soon,or just wishful thinking.

Brian

Liz's comments ring a bell with today's Washington Post report on the New England Journal of Medicine study questioning the worth of 2 drugs recommended by lots of doctors for preventing heart problems (Vytorin & Zetia)by exactly Heart drugs questioned
You have to wonder whether or not Woody Allen was prescient in his movie Sleeper dialogue:
[quote]Dr. Melik: This morning for breakfast he requested something called "wheat germ, organic honey and tiger's milk."
Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.
Dr. Melik: You mean there was no deep fat? No steak or cream pies or... hot fudge?
Dr. Aragon: Those were thought to be unhealthy... precisely the opposite of what we now know to be true.
Dr. Melik: Incredible. [/quote]

At the risk of sounding holistic, I believe the modern medical system in the US needs a change of thinking from a crisis-oriented care system to a more proactive approach. To me this means going beyond standard disease care and developing a program for helping people stick with recommended changes long enough to see a benefit, not just pushing the latest drug du Jour for the perks coming from the drug companies.

It seems that it is no longer about patient care, but what can be done for the bottom line and what procedure will befit those goals regardless of what the patient may actually need.

One has to wonder what could be accomplished by taking half of a drug company's budget for doctor perks, advertising and Washington lobbyist and re-focused that on patient care and more research.

Charm - with you again. I just finished reading that article about Vytorin & Zetia.

Not exactly comparable to above but another example of blame the patient is peptic ulcer disease. Remember when patients were told they needed to relax? They were causing their ulcers due to high stress, aggressive personality, etc. Turns out it's caused by a bacterium, treated with antibiotics. Lottie

Medical knowledge is increasing and is getting more refined. The fact that treatment modalities are altered to include such findings can only be positive. I am pretty sure that a MD with an ulcer got exactly the same advice as the rest of us. It simply was what was understood at that time. Then again, lifestyle has an effect on disease development and progression, if an MD cannot tell a patient that they are overweight (when they are massively obese) then this is plain insane (same goes for smoking).
There is a difference when you take a drug for an existing conditions which you must treat right now or when you are trying to prevent something long term. In the latter case the dosages are generally much smaller and drugs must be taken for a very long time (while having no symptoms of any kind) before one can even evaluate the benefit vs long term risks, in addition a large number of subjects are needed.

I would want to know what is available and have the option of making a choice, while knowing that there are no totally harmless drugs and this includes many vitamins and supplements.

M

I agree with Kevin. A pro active approach to treating patients would be a refreshing change. Im not talking about taking meds for years to possibly ward off a serious disease. Most people wouldnt do it. If there was a shot or series of shots to protect from serious diseases then it would be more successful than a daily pill.

If a patient sees a doctor trying to avoid a more serious problem later, then the doctor should help them. This only would work if the doctor had already established a relationship with the patient. There are too many hypocondriacs and drug users out there. For instance, if I go to the doc for a upper respitory infection, I already know I will become sick from the antibiotics. My doc should treat me for both issues.

There are so many flaws with our health care system and medications. All too often a PCP becomes a puppet of whatever the drug reps who visit them are pushing. In other countries there are different regulations and standards drugs must pass before hitting the shelves. From what I understand, other countries are much quicker at getting products out to the public.

The Guardisil shot should be better explained to the public. It was offered to my daughter by our PCP when I asked about her shot records. I was already planning on having her get the shots, I wanted to see if my PCP would offer it. My PCP did offer it and explained it very well. However, there was not even one brochure in his waiting room about it. This should be available to boys too.

Markus, Your point is of course valid. Medical knowledge changes. However, I believe that there is a bias, which includes the advice given to MDs by MDs, to look for non-medical explanations when a medical cause is unknown.

In the above comment, I'm referring to bias with regard to personality causes, that often persist even after they've been discounted (autism & detached mother).

I would consider obesity and many other lifestyle issues as a medical issue. lottie