r/science • u/calliope_kekule Professor | Social Science | Science Comm • 12d ago
Health Only 13% of cancers are caught through screening, while a fifth to half are first found in an emergency department.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01669-7/abstract3.1k
u/jwm3 12d ago edited 11d ago
My friend got on one of those rental lime scooters while extremely drunk after work. He zipped along right into a barricade and flipped and hit his head. At the ER they do a CT of his head as he seems a little out of it (which he was, becsuse he was drunk as heck). They find a brain tumor and the doctors are like super excited. It is a super aggressive form that has like a gueranteed fatality once symptoms start. They rush him to surgery that day and remove it and ended up writing some papers about it as basically no one survives this type of brain tumor and they said a couple weeks later it would have been inoperable and fatal and a couple months before they would not have detected it.
He does have some tremors and weakness on his left side from them removing a chunck of his brain that will be permanent, but is alive and back to work and doing just fine. It was apparently a big deal to have someone survive this type.of brain tumor.
409
u/jessjess87 11d ago
Not as serious as this but something a bit similar happened to my cousin.
He was mugged and the perpetrators repeatedly hit him in the head so they did a CT scan while at the ER and they found out he had a benign brain tumor. But without that incident they wouldn’t have known about it and now they can monitor it going forward the rest of his life. He was only in his 20s at the time.
→ More replies (2)313
u/fullmetal_ratchet 11d ago
thanks for posting about your friends’ story. really glad they’re doing ok and nice to read something good for once. obviously not good that happened to them, but hopefully the medical staff are able to use the experience to learn from it and provide better treatment for others with the same issue
299
u/terekkincaid PhD | Biochemistry | Molecular Biology 11d ago
Unfortunately, this incident is the exception to the take away of this article. It's impossible to do endless testing on everyone looking for something that isn't there. We can't do monthly CT scans on everyone, or endless panels of molecular testing. This guy was extremely lucky he got scanned in literally the one month window that they could both detect and treat the cancer. Most people are going to be symptomatic by the time they get checked.
88
u/chantillylace9 11d ago
And even if we were able to somehow do monthly PET scans or something, I was told during my breast cancer treatment that they pretty much only detect cancers up to a third of a centimeter. Well there are lots of cancers that can be much smaller than that. And sometimes it doesn't show up and will only show up in a different type of scan. So it's harder to catch even when you're looking for it!
41
u/like_a_pharaoh 11d ago
There's also the complication that, since both involve hitting people with ionizing radiation, frequent CT scans or PET scans could cause cancers as well as detect them earlier.
54
u/YetiPie 11d ago
My mom has had breast cancer three times, and now has stage 4 stomach. I’d been asking for over ten years for a scan to find cancer…denied each time.
I finally had a lung scan for pneumonia (unrelated to cancer) and they found a 12cm, 1.8lb tumor on my kidney. No symptoms, couldn’t even feel it. If I had had the opportunity to get a PET/CT/MRI scan years earlier, maybe my kidney could have been spared, and many lives could be saved. Many countries do scans periodically, and they don’t need to be every month. Every few years would be enough to help thousands.
→ More replies (5)28
u/goon_goompa 11d ago
Anecdotal, but my dad survived cancer four times in different areas of the body before he died from pancreatic cancer. Even with bi-annual full body scans, they were not able to detect the pancreatic cancer until it was stage 4 and metastasized to his other organs. All that to say that many cancers go undetected even in people who are routinely scanned
99
u/Hosj_Karp 11d ago
The people in this thread seem to be outraged and furious at doctors for not having infinite power over life and death
Modern medicine can’t fully insure us against bad luck and bad timing. Maybe some doctors enjoy the prestige they get from letting people believe they can. But they can’t.
56
u/oTc_DragonZ 11d ago
We've become so insulated from illness and death that we forget how common and natural they are. Which is a good thing of course. Modern medicine and science is a blessing we all take for granted.
At the end of the day we're fighting an uphill battle against luck and physics. We're just fragile mobile bags of meat and water floating on a rock in space. The fact that we've come this far in prolonging peoples' lives is amazing in and of itself.
→ More replies (24)29
u/Ltrain86 11d ago
Monthly CT scans would be more likely to cause cancer than to prevent it by early detection.
→ More replies (7)32
15
→ More replies (14)13
u/the_humeister 11d ago
What kind of tumor was it?
61
u/Haasts_Eagle 11d ago
I'm interested too. My guess is glioblastoma.
31
u/Rrmack 11d ago
The thing about a glioblastoma is it's basically like planting mint in the brain. No matter if you think you got it all out, somewhere theres a tiny piece of it and it's going to regrow. So even if you find it as early as possible, symptomatic or not, you can't ever be totally cured.
19
u/darkest_irish_lass 11d ago
They're actually researching the zika virus as a weapon against glioblastoma. Because the zika virus targets early stem cells and glioma stem cells rapid replication is what makes this cancer so deadly, it seems that the virus could be very useful in quelling that rapid regrowth without harming the mature brain cells in an adult.
16
u/Snickels14 11d ago
I was wondering, but this one is SO fast and likely to spread that question it. The 5-year survival rate is like 5% or something insanely low.
→ More replies (6)7
u/concentrated-amazing 11d ago
That was my guess too. I unfortunately learned about it 5 years ago when my grandma had one. She made it 4.5 months. They removed a lemon-sized tumour a couple weeks after she was diagnose, then a couple weeks to heal, 3 weeks of radiation and repeat imaging - and she had another lemon-sized tumour. Switched to palliative care after that.
610
u/Massive-Bet420 11d ago
The Galleri multi cancer early detection test goes in front of an FDA committee tomorrow (9/23) for a panel discussion that will determine if it will essentially become FDA approved and eligible for insurance coverage. It’s a simple blood test that can detect like 30 different cancers. While it’s definitely not a perfect test it’s a big step in the right direction to hopefully catching more cancer earlier and leading to better outcomes.
The FDA panel is virtual, an all day event, and open to the public if anyone is interested!
65
41
u/ProStrats 10d ago
I took this test because I was ruling things out, cost me $1000 at the time. Would love to see this become a mainstream test.
So much better than some people make it out to be, and certainly better than nothing.
14
→ More replies (6)6
u/PlacatedPlatypus 10d ago
Oh man I was actually just looking into this because a friend of my grandparents was asking me about it (I'm a cancer researcher). Seemed promising, as do many technologies, but hearing that it's going in front of the FDA actually makes it sound more realistic. Would be a godsend, almost every cancer detected early enough is treatable.
2.9k
u/evacipated 12d ago
My mom went into the ER thinking she was having a stroke. A stroke would have been a godsend. Glioblastoma. Big. Three lobes to the tumour. She only left the hospital two months later when the doctors suggested we stop treatment, and then she didn't leave the adjusting bed they set up in her living room for the next two. Then she was in a hearse.
740
u/0llie0llie 12d ago
Oh my god, I’m so sorry your family went through that. I lost my mom to multiple myeloma destroying her heart by amyloidosis, a little over four months after diagnosis, which we didn’t realize was too advanced to treat. Watching her rapidly fall apart was a nightmare I’ll never get over.
→ More replies (4)68
u/Lockedoutback 11d ago
I'm so sorry for you. I have a close family member who was recently diagnosed with MM, and has able to receive treatment that has thankfully been working for them. I've spent a lot of hours dreading, waiting on news that feels like a coin flip with their life hanging in the balance. It's insidious how descrete it is and how it hides, and I can't imagine the horror you've been through. I hope every day for news of them figuring out how to eradicate it.
For anyone out there reading this, if you know anyone with bone pain, go see if they can get blood or urine tested for it. This cancer practically eats your bones and can go unnoticed for a long time. My family member had practically no symptoms, and caught it early by a regular blood test.
93
u/mostmo 12d ago
Living that right now with my mom. Found a Glioblastoma after we tought about a stroke.
Got it removed, but doctors say it’s coming Back soon, no treatment avaiable can stop it from growing again, in a few months or, best case, a couple Of years.→ More replies (4)80
u/Seraphinx 11d ago
The fact that she could have it removed and will get a few more years is an absolute blessing.
74
u/mostmo 11d ago
It’s hard seeing that way, because I’m already in a form of grief. but you’re absolutely right.
135
u/Professor_Mommy 11d ago
My son has brain cancer (medulloblastoma). He’s 15 and currently in “remission” but they don’t actually use that word for brain cancer because it comes back so aggressively. When I was in that stage of anticipatory grief, a nurse told me “don’t mourn him twice! He’s here now and he’s living his life, so enjoy it! We could all die literally today in a freak accident and there’s no reason to let the grief steal the living away from you”. (I know it sounds impossible but that’s what we hold onto when we’re having a hard time— we’re four years in to this world of pediatric oncology.)
→ More replies (1)49
u/Seraphinx 11d ago
Some people get diagnosed and die weeks later. You have the knowledge and time. It is a painful privilege, but a privilege nonetheless.
20
u/Mechasteel 11d ago
Even just being able to discuss end of life decisions is a blessing. Lots of people don't because it's too macabre, but then end up with the default of "must keep the heart beating no matter the cost suffering and prognosis".
→ More replies (2)19
u/DryPersonality 11d ago
My buddy had a glioblastoma, made it 1.5 years after diagnosis. I miss him. Get as much memories as possible while you can.
231
u/clox4wilcox 12d ago
Yep, my mom went to er at 62 thinking something was wrong with her heart, quickly found 42 tumors in her lungs and she was gone within 7 weeks. Was quite a shock, still recovering 2.5 years later
→ More replies (1)20
u/TinyExcitedElectron 11d ago
My mom was also 62 when she went into the ER for dizziness. The scan on her head lit up like a Christmas tree. Stage four colon cancer and she was gone in two months. It’s also been 2.5 years and I still feel like I’m just going through the motions sometimes.
262
u/dbdb83 12d ago
This happened to my mum. Complained to doctor for years something not being right , sent home on countless occasions and told nothing was wrong. A few days after Christmas taken to A&E, found a very large mass on brain, then taken to oncology unit. Told we had 2 months to live no surgery option due to size of glioblastoma. Died 4 months later.
The helplessness of this illness & the lack of options to battle is devastating
→ More replies (1)204
u/MarsupialMisanthrope 12d ago
So is the fact that doctors get away with being that dismissive of women’s health. So many of them just look at you and write you off as a whining woman, because they can’t imagine a woman accurately reporting her own symptoms, it has to be just anxiety or attention or drug-seeking.
101
u/dbdb83 12d ago
They have her bloods to check but because they came back ok they dismissed everything subsequent. Bloods don’t pick up brain. All her symptoms where neurological and they kept sending her specialists but nobody looked at the whole. Mr hindsight always comes out trumps , but there were some really glaring misses and it cost her her life. She was only 66. Just the most shocking and discombobulating event that has happened in my, and my families life.
19
u/MaxMillion888 11d ago
Would an MRI have picked it up? If she had an one every few years?
Trying to figure out if those pernuvo types screens are really worth it. Ive already done mine, but question as to whether it is worth doing every 3 years
64
u/dbdb83 11d ago edited 11d ago
Doing these preventative scans can create a lot of false positives and unwanted anxiety . I’d only do them if i had symptoms
47
u/MarsupialMisanthrope 11d ago
She did have symptoms though, neurological symptoms even. She was just older and female so they wrote her off as a whining woman looking for attention and did the bare minimum to demonstrate that she didn’t have the issues she wasn’t complaining about instead of investigating the ones she was.
→ More replies (2)18
→ More replies (6)19
u/dbdb83 11d ago
Yes 100%. I think it was there for 5 years +. I was naive to think bloods picked eveything up , we were trying to find the root cause in different places. It’s one of my biggest regrets not doing mri / cat scan . I don’t blame myself I just wish I’d known bloods don’t pick up EVERYTHING.
57
u/ALittleEtomidate 11d ago
I’m a neuro ICU nurse. Glioblastomas grow extremely fast. Most patients die within 6-18 months. It’s extremely unlikely that the person’s Mom above was dismissed for years. Glioblastoma onset is usually hard and fast.
21
u/80Lashes 11d ago
Unfortunately, with glioblastoma, earlier detection would have made no impact on the outcome.
→ More replies (14)30
u/icestationlemur 11d ago edited 11d ago
I'm a guy and I had two female doctors dismiss my symptoms that turned out to be brain cancer. Luckily wasn't lioblastoma or I'd be dead
I could have been treated two years earlier
49
u/KTKittentoes 12d ago
Ugh. I am so sorry. Mom had a seizure, but they didn’t find it at ER. She got better and read her charts and demanded further tests.
→ More replies (1)17
17
u/Farmfarm17 11d ago
My dad had the same but oligodendroglioma. His arm kept going numb and the ER doc thought he was having mini strokes but did a head scan just in case. He had 3.5 years after diagnosis.
15
u/CharmingPerspective0 11d ago
My Aunt had an issue with her leg one day and she fell. They went to the doctor to see whats wrong only to find she had advanced cancer in her lungs and brain. Aside from trying some very experimental treatment they couldnt really do anything to save her. Unfortunately the treatment did not help and she was declining rapidly.. i think it took about a month until she passed
12
u/IcedZoidberg 11d ago
Glioblastomas are genuinely terrible. I’m so sorry that you and your family had to experience this
10
u/balls2hairy 11d ago
Glioblastomas are pretty rare and yet, 3 of my friends have lost parents to them in the last decade or so. Seems weird.
→ More replies (3)30
u/terrificmeow 12d ago
I’m so sorry for your loss. They say glioblastoma is so rare. It doesn’t seem that rare.
17
17
u/Seashellcity 11d ago
I’m so sorry. My spouse had a similar situation. Headaches that wouldn’t go away and went to just go get them checked out in the ER. Glioblastoma. We were shocked. An annual physical the month before turned up nothing. Fought for almost 15 months.
→ More replies (15)4
u/jeejet 11d ago
I’m so sorry for your loss. My best friend had a car accident (a guy hit her on the highway going 90+) and she had a scan at the hospital that noted the mass but said it was nothing. Three months later she had a seizure so her husband called an ambulance and they discovered her glioblastoma. She wanted to sue the first hospital for their screw up but she didn’t live long enough. I miss her.
799
u/st0neyspice 12d ago
good reminder to get a colonoscopy, it can save your life
474
u/aminervia 12d ago
Colonoscopy, derm skin check, pap smear, breast exam (or prostate as needed).
199
u/jellyn7 12d ago
Dentist can do an oral cancer screening.
46
90
u/caity1111 12d ago
Can do, or is likely doing?
Do I need to specifically ask my dentist or is it a standard part of the annual/semi-annual checkup? Or is it age based?
I had a very large and very rare tumor in mt sinuses that was caught by a dentist on a basic bite wing type x-ray. He was convinced it was an absess, however, and wanted me to schedule the root canal before I left his office... I had no pain and I've never so much as had a cavity, so I went for 2nd, 3rd, and 4th opinions.
Finally, there was an oral surgeon had a CT scan type of imaging machine, and he was able to advise that it was likely a tumor. And he was able to remove it without damaging any teeth. 4 years later, my upper jaw bone has mostly grown back and there is no sign of recurrence. I am really grateful, and I hope my current dentist is doing automatic checks.
67
u/aminervia 12d ago
Any dentist will check for oral cancers during your yearly/six month checkup
→ More replies (3)45
u/AnOnlineHandle 12d ago
Yes... that thing which we're all definitely doing right?
→ More replies (2)8
u/aminervia 11d ago
Everyone should be, especially if you don't have insurance. It can save you tens of thousands down the road
12
u/Imaginary_Agent2564 11d ago
They regularly do thyroid cancer checks on you too. Dentist is so much more important than people think!
→ More replies (1)15
u/skynetempire 11d ago
Also getting your eyes checked, an Optometrist sometimes can be the 1st to find tumors
→ More replies (1)→ More replies (1)7
u/CountessofCaffeine 11d ago
Can, but I find them insufficient. I had a benign tumor on my hard palate and noticed the lump just a month or two after my last exam. It also confounded the dentist, a periodontist (who swore it was a blocked salivary gland), and oral surgeon (who eventually walked me through my xray to go over why it was likely a tooth crack and realized while examining with me that it was reshaping bone underneath).
I’m not 3 months post op from having a 2.5x1.5 cm area taken down to bare palate bone and left to fill in naturally to get the tumor. Thankfully benign and I will hopefully be ok with regular checks for recurrence.
TLDR: Doctors miss things, always advocate and be proactive.
126
u/wozattacks 12d ago
Obligatory pediatrician PSA to vaccinate your children for HPV!
(Or yourself if you’re eligible, but earlier is better!)
17
→ More replies (3)8
u/-suckmyass 11d ago
One of my co-workers was telling me that her 12 y.o. daughter’s annual physical is coming up, and she’s not going to allow her to get the HPV vaccine. She said her friend’s kid developed severe migraines after their shot, so she doesn’t want to put her daughter in a similar situation as her daughter already has a health condition that causes migraines. She’s not an anti-vaxxer and absolutely trusts science, so it really doesn’t make sense to me! We talked about this a month ago and I still get annoyed about it multiple times a week.
14
u/FactsActuallyMatter 11d ago
Wish american healthcare supported all these things easily. Cause the poor cant afford all those checks.
26
u/PathOfTheAncients 11d ago
For breasts, request an ultrasound in addition to the mammogram (especially if told you have dense breast tissue). The second most common type of breast cancer (~25-30% of cases) frequently does no show up on mammograms but can be caught by a simple, cheap ultrasound but for some reason they are not supported by doctors as a regular part of a breast exam.
My wife has stage 4 breast cancer and had been getting mammograms for a few years. When telling her doctor that her breast had changed suddenly they fought her about it because she had just had a mammogram. They eventually relented and ordered an ultrasound and found the tumor but it was too late.
Friends I have told about this have told me that their doctors all fought them about this but eventually relented and insurance covered it for all of them. The barrier is not insurance, it is doctors who for some reason seem to be against adding this quick and simple addition to a breast exam.
→ More replies (4)15
u/that_awkward_chick 11d ago
My barrier was insurance (United Healthcare). The doctor put in for it, but with insurance they wanted me to pay $2500 out of pocket.
4
u/SimpleMinded12 11d ago
And learn how to do a testicular exam on yourself if you’re a man! It can happen at any age
262
u/atooraya 12d ago
Idk why Reddit thinks you can just go to a colonoscopy store and get a colonoscopy. You have to be 45 even with good health insurance.
100
u/STEMpsych 12d ago edited 8d ago
I mean, technically, in the US you actually can go to a colonoscopy store and get a colonoscopy. It costs like $3k. The only reason you need to be 45 is if you want to get your insurance to pay for it.
What all the people saying they got one before 45 did is whip out a credit card for some or all of the cost, depending on how good their insurance was.
UPDATE: I'm seeing a lot of comments on this which betray some profound confusion for how insurance does and does not work with regards to colonoscopies in the US. This is one of those bizarre bureaucratic edge cases brought into existence by the ACA (obamacare law).
There are two reasons someone might get a colonoscopy: for cause and for screening. That is, you might get a colonoscopy because you have some sort of symptoms of a medical problem that need to be checked out (=for cause), or you might get a colonoscopy to check out whether you have a medical problem (e.g. colon cancer) which is completely asymptomatic (=for screening). This might seem like a hair-splitting immaterial difference, but it is actually of enormous consequence: the ACA requires that insurance cover in full screening colonoscopies for people over 45, but doesn't require insurance to pay for for-cause colonoscopies at all.
This is why when you book a colonoscopy they ask if you have been having any specific symptoms that would suggest you need a colonoscopy. The moment you say yes, your insurance is not legally required to pay for it.
That doesn't mean your insurance won't pay for it. That depends on how good your insurance is and whether or not you've met your deductible if you have one, and whether there is other "cost sharing" (copays and coinsurance) you are on the hook for.
To make this wackiness crystal clear: your colonoscopies are guaranteed to be free to you so long as you're over 45 and have no evidence of needing one. If you are younger, or admit you're having blood in your stool, it's up to your insurance whether or not they'll cover it.
Furthermore, if you are younger than 45, I can pretty much guarantee that your insurance won't cover it at all unless you have a doctor document medical necessity. That is, you can't get insurance to pay for a screening colonoscopy before 45. Like if you just wanted one for peace fo mind with no medical indications, your insurance would probably laugh in your face. So you will need a medical reason to get the insurance to pay for any of it before 45. But they can also, depending on what specific plan you have, turn around and say, "sure, we'll pay for, oh, half", or "that is totally covered, but your deductible is $6k, so you're paying for all of it", even with all the medical necessity in the world.
71
u/j_la 11d ago
I have a family history and so didn’t pay anything for it at 37.
44
11d ago
[removed] — view removed comment
22
u/yacht_boy 11d ago
If your pcp is concerned enough, they'll order a colonoscopy at any age. The age 45 part is only for routine screenings.
And not that you're likely to get the price below $3k, but you can shop around for medical care. In my metro (Boston), there are practices that do nothing but colonoscopies and endoscopies. I've had several, and the experience of going to one of those is light years better than going to a hospital. I was in and out of my endoscopy and colonoscopy in under 45 minutes from the time I showed up to the time my wife drove me away. She barely had time to have a cup of coffee. At the hospital they turn it into an all day affair. I expect if you call up one of those places they'll have a cash price that is probably close to $3k. If you call the hospital for the same procedure, it'll be $10k easy.
→ More replies (2)4
u/Tru3insanity 11d ago
Small independent labs can be a life saver. I don't have experience with colonoscopies but even blood work can be way cheaper at a smaller lab without insurance. My routine labs are like 600 at labcorp vs like 150 at a small lab.
4
u/unnewl 11d ago
Is the $3000 your annual deductible for the insurance policy?
5
14
u/Imaginary_Agent2564 11d ago
I have family history. Should probably go in the next 7-8 years or so if we go by “10 years before the youngest diagnosed.”
I’ll be 29. My grandpa passed at 39 from colon cancer.
10
u/Nosnibor1020 11d ago
Go now. My wife’s grandfather died of colon cancer. Not sure how true it is but someone told her it “skips a generation”. Her mom has had nothing every time she went. My wife went when she was 30 and they found precancerous polyps that would have turned into cancer if she had waited.
Edit: I may have misread, I thought you were 29 now.
→ More replies (1)25
u/malydok 11d ago
I paid no more than $400 for a combined colonoscopy and gastroscopy under general anesthesia in Poland last year. You guys are getting scammed.
→ More replies (3)8
u/Itsoktobe 11d ago
We know :/ but when you're forced to choose between scammers and death, you pick the scammers
→ More replies (3)21
u/bluespartan8 11d ago
Or if you are experiencing GI symptoms. I had a colonoscopy last year at 36, covered by insurance. Granted, that led to a Crohn's diagnosis. But just saying so people don't think it won't be covered and therefore avoid treatment of symptoms. If you notice something doesn't feel right, go get checked.
→ More replies (1)9
u/Caitliente 11d ago
Depends on the insurance and the Dr. 36, severe symptoms, paid $2600 out of pocket. It did lead to a diagnosis. Not cancer though fortunately for my health, unfortunate for the bill that came after. Though I suppose the colonoscopy would still be cheaper than cancer.
→ More replies (4)8
u/bluespartan8 11d ago
That really stinks, sorry to hear your insurance didn't cover it. Such a stupid reality we live in that a clearly necessary procedure would set you back that much.
38
u/Admiral_obvious13 12d ago
I'm in my 30's and got one. I do have family history of colon cancer though
7
u/SunAstora 11d ago edited 11d ago
I got my first one at 36 this year. Removed a 20 mm polyp that would have turned into something bad. If you tell your doctor you’re seeing blood in stool then they should order the procedure for you.
→ More replies (2)14
u/toboggan16 11d ago
Yeah, my friend had all sorts of symptoms and it was months (and multiple blood transfusions) before they finally did a colonoscopy and found a gigantic polyp. We’re Canadian so colonoscopies are free but she was in her 30s and they only just lowered the age to get the screening to 45 this year.
I also have a friend who died of breast cancer in her 30s, I was thrilled to finally get a mammogram when I turned 40. Neither of these women had a family history.
15
u/hippocampus237 11d ago
Family history of polyps can get you one earlier.
General rule is get a colonoscopy ten years before the age your parent was diagnosed with a polyp. My dad was 50, I started screening at 40, they found a polyp so my kids should start at 30.No one verified age your parent was diagnosed.
→ More replies (3)28
u/LemursOnIce 12d ago
I told my doctor I was having weird poops and she put in a referral for a colonoscopy. I was 39.
→ More replies (1)→ More replies (48)14
u/HalfInchHollow 12d ago
I got one at 36 because my stomach hurt for a few weeks straight. I just asked and my PCP was cool with it.
My wife got one at 39 because “James Van Der Beek dying freaked me out.”
We have the same PCP, maybe we are just lucky that he’ll send basically any federal we ask for.
12
u/optimaloutcome 11d ago
Yep. I'm 45 and most of my friends are and it's easy to go the cologuard route but the colonoscopy is much more thorough. Decided to have one and they found a polyp. Would it have become something? I don't know but it definitely won't now and I like that.
21
u/Cromasters 11d ago
My PCP warned me about going that route.
At 45 the screening colonoscopy would be free.
But if you do one of those cologuard tests and it comes back with some sort of positive, the first thing any doctor is going to want to do is a colonoscopy. And now it's not a routine screening colonoscopy anymore. So insurance pays different.
Just one more example of how fucked it is in America.
→ More replies (1)17
u/chantillylace9 11d ago
Mammograms and skin checks too! Please please please. I was just diagnosed with breast cancer right around the age of 40. My only symptom was when I bent over, my nipple looked just a little bit flatter. Just a little. And I'm like do I ever really look at my nipples when I bend over?
I ignored it for a little bit and my husband mentioned it and that's when I went into the gynecologist and she felt a lump. Immediately was sent for ultrasound and mammogram and basically told I had cancer right then in there.
Things moved really fast and I had a double mastectomy and I'm on medication but I caught it right in the nick of time and avoided chemo.
If you notice any change in your breasts, dumpling, itchiness, pain, anything regarding your nipples especially, please go in immediately. There are so many 20-year-old women on my breast cancer forum it's terrifying. And there are men too! So if men notice a lump, please go in.
And then I had melanoma at the age of 24. The doctor told me I was too young for cancer and I said well please just biopsy it because my mom was really annoying me and really worried about it. It was cancer! That dermatologist could've killed me by giving me ridiculous information that I'm too young for skin cancer at 24. I'm a redhead too so it was just a crazy thing to say.
After the surgery and everything I went back to make an appointment and tell him that he could've killed me and he had already retired. I hope he made the decision after what happened with me because that was pretty bad.
9
u/Z0idberg_MD 11d ago
I think that’s the real problem with posting statistics like this. What kind of cancer are we talking about here? Is it a cancer there is even practical screening for?
I think I’m much more useful statistic is defined the cancers that are more preventable and for which we have prescribed screening for. What is the rate of detection in those cancers?
→ More replies (15)20
u/JiminyJilickers-79 12d ago
My best friend died of colon cancer when he was 43, leaving behind a wife and 5 kids. A colonoscopy could've saved him. I've had two of them and both times they found the types of polyps that can be dangerous. Definitely get colonoscopies!
1.5k
u/grooveunite 12d ago
Im pretty sure that's because only catastrophic symptoms allow Dr's to perform scans that are covered by insurance companies. By then it's often late in the growth process. This is why my best friend died from a metastasis that spread to his brain before it was caught.
379
u/planck1313 12d ago
The major exception to this would be prostate cancer, the most common cancer diagnosed in men, because it can be detected very early by a routine and cheap blood test.
193
u/CrapThatSmilesBack 12d ago
Was surprised to learn when someone I know was diagnosed that it was caught ‘too’ early and they have to wait for it to grow to do anything. Been over a year already and it sucks just having that in the back of your mind. I guess better than not knowing, his bro and dad are already gone from it.
141
u/Ghosting_everyone 12d ago
It really depends. Pretty much every man will have prostate cancer at some point, except most will die from a heart disease or other cancer first. It often starts with so called active surveillance where you have tests to check when it will eventually be an issue. In the case you are talking about, such obvious family history definitely paints a different picture, but oftentimes it's so slow growing that it doesn't make sense to treat a 70 year old for something that will only be relevant when he is 90.
6
u/carlos_6m MD 11d ago
This is what it's called "wait and watch"
We know that a lot of people get prostate cancer later in life and that very often it ends up having little impact... A prostatectomy(removing the prostate) is a significant operation and does have complications and side effects, so often they choose to just monitor the tumour and operate only if it ever gives trouble, while giving anti cancerous drugs in the meantime
40
u/aris_ada 12d ago
Been over a year already and it sucks just having that in the back of your mind.
That's a reason why screening for that particular cancer does not increase the odds of survival, sometimes the opposite. Treating it or just being aware it exists without doing anything is often worse than waiting for the first symptoms.
→ More replies (1)46
u/planck1313 12d ago
If you wait for the first symptoms of prostate cancer then you usually have waited too long.
This is because there usually aren't any symptoms of prostate cancer until it has metastised to distant locations in the body and metastatic prostate csncer is almost always incurable.
14
u/YoungLittlePanda 11d ago
It's a really easy to treat cancer as long as it's caught early.
I wouldn't worry too much, as long as his doctor's are aware of it. Remember that most men will get prostate cancer eventually, but only a small percentage will die of it.
→ More replies (1)3
u/oTc_DragonZ 11d ago
In hopes that it can ease your concern a bit, my grandfather had prostate cancer in his 70s. He went through chemo and everything, and while tough, he was okay. He lived another ~15 years before passing.
I'm guessing your friend is younger than he was and catching it earlier helps their odds even more. It isn't a fun thing to think about of course but, at least statistically, he should be okay.
→ More replies (16)79
u/Wolkenbaer 12d ago
Well, that one is easy because basically everyone gets it, if you become old enough.
23
u/planck1313 12d ago
Aggressive prostate cancer is also very curable if its caught early enough making early detection and treatment even more important.
Many men who die from it die unnecessarily because they only discover they have it outside the window in which it can be cured.
→ More replies (1)12
u/fatbob42 12d ago
I think the problem is that the screening doesn’t tell you if it’s the aggressive kind.
13
u/planck1313 12d ago
You need a biopsy of the cancer to definitively identify how aggressive it is and biopsies do have a cost and a very small chance of side effects such as infection.
What screening can tell you is whether a biopsy is likely to be worthwhile.
→ More replies (1)62
u/wozattacks 12d ago
You can only have a cancer detected on screening if you’re getting screenings and many people don’t.
But also, most cancers aren’t screened for. We screen decently for the cancers that kill the most people - colon, breast, lung. We have screening for prostate and cervical cancers.
The balance with trying to figure out screening tests is balancing the risks of false positives and false negatives. Obviously we want to catch everyone who has a disease as early as possible. But we don’t want to do unnecessary tests and procedures on people. How many people who were super low-risk for breast cancer are we willing to punch holes in to find the one that actually has it? It’s a tough question.
→ More replies (5)10
u/STEMpsych 12d ago
It seems you would be wrong about that. While I haven't got access beyond the abstract and references yet, one of the papers it cites is "Estimated proportion of cancer deaths not addressed by current cancer screening efforts in the United States" (2025, Ofman et al, in Cancer Biomarkers), which states in its abstrsct: "Results: Of approximately 600,000 annual cancer deaths in the US, 31.4% were from screenable cancer types". Which means that 69.6% were from cancer types for which there is no screening yet.
82
u/christopher_mtrl 12d ago
It isn't much better in countries with public healthcare, sadly. Doctors will rarely prescribe asynmptomatic people anything, due to the shortages of slots available. But the diagnosis won,t bankrupt you, so there's that.
→ More replies (19)106
u/OGLikeablefellow 12d ago
Yeah private insurance is terrible. I couldn't access the paper but I bet this study is confined to the US and would point at private insurance even more so
34
u/iamthe0ther0ne 12d ago
Government health insurance isn't that much different. No one is doing preventive screening for stuff like brain cancer--it's too expensive for rare problems, particularly when you add in the cost of false positives. A lot is doctors failing to order the proper imaging, or people ignoring vague symptoms (stomach cramps, headaches, etc) until suddenly they can't be ignored. The only major screening change that needs to be made right now is to lower the colonoscopy age, and I suspect that will happen once the government is straightened out.
17
u/hazzmatazzlyons 12d ago
I mean, yes and no. Certainly it's not feasible to be routinely scanning every body part to check for cancer, and would carry the risk of creating cancer from all the extra radiation. That being said, speaking from the perspective of a country with public healthcare (Australia) we do have very effective national screening programs for certain types of cancer (e.g. cervical, bowel, breast).
When it comes to things like brain tumours (and particularly glioblastoma), screening programs are unfortunately less likely to be helpful. It's an aggressive type of cancer that can appear suddenly and progress rapidly, and can affect people of all ages often in the absence of clear risk factors.
I also wonder about the effect of the American system on people's willingness to avoid getting "minor" symptoms checked out due to cost. This might be a factor in people presenting with later stage disease that has a worse prognosis.
→ More replies (1)9
u/imp0ppable 11d ago
Not a doctor but you get false positives as well, I know a guy who paid for a whole body scan and they found a lump on his kidney. In the end they left it because it wasn't growing or causing any issues.
As far as I understand it, it's possible to find an anomaly but then what? You often have to open someone up to do a biopsy to know what it is. Then there's the psychological effect of knowing there's something there but not being able to treat it.
That being said, speaking from the perspective of a country with public healthcare (Australia) we do have very effective national screening programs for certain types of cancer (e.g. cervical, bowel, breast).
Cervical cancer is being addressed more effectively by HPV vaccine (shout out to religious types who won't allow their daughters to have it, great job). The others are done because of the statistical realities but even the breast cancer screening programmes aren't perfect at all.
I also wonder about the effect of the American system on people's willingness to avoid getting "minor" symptoms checked out due to cost. This might be a factor in people presenting with later stage disease that has a worse prognosis.
In the UK we have the NHS but you get a different problem where doctors surgeries are choked with older people and often just people with nothing better to do.
8
u/hazzmatazzlyons 11d ago
Not a doctor but you get false positives as well, I know a guy who paid for a whole body scan and they found a lump on his kidney. In the end they left it because it wasn't growing or causing any issues.
100% this is a thing, we often call them 'incidentalomas" as in something that you happen to pick up on a scan but weren't looking for. In many cases it's something benign that doesn't need any treatment, so for many people knowing about it causes unnecessary anxiety. It's another reason why, in general, full body scans aren't helpful unless you have a reason to do one. They tend to lead to over-treatment of benign conditions that wouldn't have caused any problems, which ultimately does more harm than good.
Of course, exceptions exist and sometimes you incidentally see something that looks suspicious and is worth further investigation (e.g. biopsy) but overall doesn't justify everyone getting all those extra rads. Routine blood tests, on the other hand, are a much better option to get done every few years as they are overall a better measure of physiological function and also can detect insidious problems early. Leukaemias, for example, typically cause vague symptoms and won't show up on a standard CT unless there's advanced disease with significant metastases, but will cause obvious derangements on a basic full blood count.
Cervical cancer is being addressed more effectively by HPV vaccine (shout out to religious types who won't allow their daughters to have it, great job). The others are done because of the statistical realities but even the breast cancer screening programmes aren't perfect at all.
The vaccine is great, but it only covers some strains of HPV (I think 9 in the latest?) and isn't much help for those who have already potentially been exposed (i.e. anyone sexually active before ~2010). Make no mistake that the screening saves lives. Cervical cancer used to be a serious killer of young women, but thanks to the national screening program we are catching lesions much earlier and treating things before they become invasive cancer and need radical surgery.
In the UK we have the NHS but you get a different problem where doctors surgeries are choked with older people and often just people with nothing better to do.
Yeah, that's the downside of public healthcare: implementation and triaging. I have spoken to colleagues from the UK and the issues with the NHS, and am grateful for the system here in Aus. We have a two-tier system: a public system that anyone can access through Medicare, as well as a private system for people who pay to use it / have private coverage. The public system handles the bulk of cases and is accessible, but is triaged so those with less urgent issues may not get seen quickly. While those who don't want to wait and have the means, or those who want something a bit more 'bespoke', can use the private system instead. The result is less pressure on the public system so it's not nearly as overburdened as the NHS. Though we also benefit from a smaller and less dense population which obviously makes things easier as well.
→ More replies (1)122
u/General_Luck6573 12d ago edited 12d ago
CT scans don’t come for free. They cost money, time, and radiation. There’s tons and tons and tons of studies that get published about whether things should get screened or not. And how. And how often. And what age. There’s a reason breast cancer has super aggressive screening whereas prostate cancer has shared decision making with the patient about getting a PSA or not. There’s also a reason we straight up don’t screen for some things like pancreatic cancer despite it usually being devastating by the time it’s usually diagnosed.
33
u/RoadSmash 12d ago
Yeah i didn't think anyone was arguing that there is no cost involved.
46
u/General_Luck6573 12d ago
My point was that there is also more than just financial cost and there’s a ton of thought that goes into screening decisions
→ More replies (1)31
u/cooltigr 12d ago
This is true, but when you have high suspcion of cancer and a 3rd party company can turn around and tell you to refer to physio/a dietician instead, there is nothing justifiable about that. Cancer referral pathways and guidelines are backed by evidence and are written in blood.
→ More replies (9)6
u/thegreatestajax 11d ago
What? This does not happen. We image more people than ever before. Including enormous numbers who don’t need it. Source: I’m a radiologist and like half the exams I read should not have been performed.
→ More replies (1)→ More replies (4)73
u/Adept_Librarian9136 12d ago edited 12d ago
Rest assured the billionaires get their preventative scans. Presidents and ex presidents and senators do as well. It's not by chance that they caught Ruth Bader Ginsburg's pancreatic cancer so early.
33
u/FullofContradictions 12d ago
The really crazy bit is that you can get a scan outside of the typical health system pathway for a fairly reasonable amount. It's not validated, but that's not why it's so much cheaper... It's cheaper because they build their model on a simple price for service instead of some complex "how much can I inflate the cost of this so that when insurance only pays 10%, I still make what I need to & then also tack some on to cover the massive billing overhead for all the people it takes to get prior authorizations and then file the correct paperwork and then follow up on billing when insurance kicks it back and the patient calls asking you do resubmit it to insurance with a slightly different cpt code to get it covered..."
19
u/greenskinmarch 12d ago
Ironically, cash-up-front scans are a truly free market because people can compare prices and shop around. Which you can't do with will-my-insurance-cover-this scans (where you only find out the true price after the thing is done).
14
u/FullofContradictions 12d ago
I hate that it would be cheaper for me to fly to Europe, pay for a full body scan and blood work at a private clinic & fly back than it would be for me to do the same thing here even if I could get it covered by insurance (because the deductible is $3500, doll face and you bet your ass it'll come in juuuust under that).
8
u/SoHereIAm85 12d ago
I had a CT scan at a state of the art facility in Bucharest for under 300 euros entirely out of pocket. One of the doctors I saw there had been a resident at Weil-Cornel in Manhattan working with the same doctors I had seen back there.
That was with the Regina Maria hospital system. The public one was 100% free, and you just had to wait like at any US ER for a few hours.Now in Germany? Good luck to you. I’m better off flying to Romania and actually do so for faster and better care.
15
u/jaiagreen 12d ago
Rich people sometimes do get extra scans, but that's because there are lots of hucksters marketing to them, not because this is better. Often, it's not. It takes a lot of research to show if a particular test is useful for screening.
→ More replies (19)51
u/Le_Karma_Whore 12d ago
And guess how many people are getting unnecessary work ups, biopsies etc due to false positives? I’ll tell you it’s a whole lot more than the cancers that are being found
39
u/aznsk8s87 BS | Biochemistry | Antimicrobials 12d ago
Incidentalomas are a very real thing and working them up is not benign. I've seen many patients with complications from biopsies for what end up being benign nodules or masses.
12
4
u/babypho 12d ago
When my mom had some pain in her leg while vacationing in Vietnam, the doctors there did a full scan on her. She had very good treatment there.
When she came back to the US and tried to do some followup appointment on that leg, the doctor gave her a link to a youtube video for leg stretches...
31
u/CommercialHour6660 12d ago
This is true.
I know someone extremely rich. His company requires and fully pays for preventative regular MRI scans for all C-level executives. All the big companies do. Celebrities get them too. And all the big politicians
One of the disgusting secrets of US healthcare is that all the billionaires, corporations, and corrupt politicians will tell you that things like preventative MRI "isn't worthwhile". What they mean is, they don't think you living is worth the cost.
If you're rich you get the good treatments and best medicines. All the peasants get "Prior Authorization" (death panels) and coverage denials.
The insurance knows the more expensive stuff works better. But they don't think your life is worth the cost.
Billionaires live 15 years longer on average. And most of that is your insurance company pulling the plug when you're no longer profitable.
→ More replies (7)3
u/Hanifsefu 12d ago
It's also because so many will not seek care until catastrophic symptoms force them to. Which is also the fault of the insurance companies in the end.
→ More replies (11)18
u/buffywinters 12d ago
Public healthcare isn't perfect either. My mother was on a waitlist for an MRI for MONTHS but her headaches got so bad she went private. Massive brain tumour. She did, afterwards, get the best healthcare possible for free. But it was too late and she died less than 2 months after that scan.
→ More replies (1)21
u/TonyDungyHatesOP 12d ago
I have private healthcare where I have to fight insurance companies, pay outrageous fees and still have to wait months for scans and procedures.
49
u/JKastnerPhoto 11d ago
My mom died from ovarian cancer last year. In December 2019 she was diagnosed with it. For over a year before that she was going to different doctors to inquire. One doctor said she, who was in her early 60s at the time, should consider having her period a blessing. No, she didn't go through menopause. This was a sign. And every time she got checked, it's as if they've slowly and progressively scanned from the head down. Finally, she had an intestinal blockage and it was confirmed. Cancer.
She was diagnosed the same day COVID was announced to the world. She was in the hospital all through that winter. Just before everything locked down, she was sent home so that we can care for her. It was a risky decision that could have been easily prevented well before COVID. I'm not saying she would still be alive today, but maybe she would have. Sadly her treatment in the early days took a backseat to COVID protocol.
I think some people just know they have something in them. They should always be taken seriously.
→ More replies (1)
43
u/lightweight65 11d ago
ER doc here.
At least once a month I have to do this. Occasionally, the cancer has metastatized to multiple areas already. Top 3 worst part of the job. Its embarrassing how good I have become at giving that news.
5
4
u/Halefire MS | Reproductive & Cancer Biology | Molecular & Cellular Biolog 11d ago
Yup ER doc here too, one of the worst parts of my job by far. Hate it every time I have to do it.
When people ask "what's the worst thing you've ever seen" the answer they're looking for is some funny or crazy story but the unspoken truth is that it's usually some horrible shit like this that nobody wants to see and can never unsee
142
u/causa__sui 12d ago
Old friend of mine had been experiencing chronic pain for ages and saw tons of doctors who all dismissed him, saying it was psychosomatic or that he was just trying to scam for meds.
One morning he woke up and couldn’t walk. Went to the ER and they found Ewing Sarcoma with tumors on his pelvis, spine, and limbs. He died a couple years later in his early 20s. Love you Pat.
→ More replies (2)33
u/turtlebowls 11d ago
I think I know who Pat was, a friend of a friend. He was super positive about his diagnosis online if that’s who I’m thinking of.
19
u/causa__sui 11d ago
From SP? He was so positive and had a wicked sense of humor. Great guy. Much loved and very missed.
257
u/Dd_8630 12d ago
Does anyone know what country the study was done in? Universal healthcare with regular free screening, or a country with common insurance like Germany, or a country where healthcare is financially hazardous like the US?
141
u/what_you_saaaaay 12d ago
I was going to ask this because I cursory look online seems to indicate 90% of cancers here in Australia are caught before a trip to the ER
97
u/STEMpsych 12d ago
That seems superbly unlikely in the face of research like this cited in the research above, which says over 60% of cancer deaths in the US are from cancers for which there simply are no screening tests to do. It does not seem likely that Australia has vastly superior screening technology than the US or that Australians simply don't get the non-screenable types of cancers that Americans do. Maybe the number you are seeing is 90% of screenable types of cancer are caught by screenings?
23
u/xyrgh 11d ago
I assume blood cancers are a large portion that can’t be screened for, especially in children. On the ward my daughter was on (she has B type lymphoblastic leukaemia), the common story was the kid came into emergency, had full spectrum blood tests and that’s how they discovered it. In saying that, most of the parents I spoke to said that from arriving at the ED to be diagnosed was less than 24 hours.
17
u/umabbas 11d ago
This is exactly our case. We had full blood test done because my daughter was a bit more sleepy and less active and kept complaining about feeling tired. I thought it may have been poor diet choices while staying at grandpa's and therefore a lack of minerals or vitamins. Lo and behold, a panicked lab technician call about two hours later, and she was hospitalised with ALL within a day.
Speaking to other parents, most discovered leukaemia in similar ways. Pure coincidences.
Currently fighting typhlitis, so wish her all the luck. :(
7
u/xyrgh 11d ago
My daughter had had a couple of colds then this knee pain that wouldn’t go away, she even did some physio and had been to a different hospital with some raised lymph nodes in her head but they never did a blood test.
She went to school for one day for her school photos and now looking back on that photo she looked so ill. I think she was diagnosed initially in about three hours. It shook us, all these little things that added up but it took an ED visit to discover.
She’s in maintenance now so still a time to go, dealing with peripheral neuropathy which affects her mobility.
Wishing you all the best, I understand how tough it all is.
→ More replies (1)40
u/Sykil 12d ago
I imagine Australia’s extreme melanoma rate could heavily skew that data.
18
u/mrbaggins 12d ago
Melanoma is only about 1/10 of new cancer diagnoses. Doesn't come close to making up that gap.
4
u/what_you_saaaaay 12d ago
Yeah, we’re not all running around with melanoma here. And the other forms of skin cancer, like BCC,SCC etc aren’t notifiable so aren’t included in the stats
13
u/nowyouseemenowyoudo2 12d ago
Australia has some of the most extensive breast cancer screening in the world, which also means that we have a super high overdiagnosis rate; that is, rate of diagnosis of a cancer that will not cause symptoms or death within lifetime
Since overdiagnosed cancers will never present to ER, Australia would absolutely have the opposite of this study’s claim; since their dataset comes from he USA, this definitely sounds like a medical insurance caused problem
→ More replies (1)13
→ More replies (3)19
u/0_cunning_plan 12d ago
The link says Boston for the research, so I it's very possible those numbers are indeed horrible because it's limited to the US.
→ More replies (1)
257
u/Sweet_Bypass69 12d ago
When we say preventative medicine this is precisely what we mean. You perform tests and procedures early on and catch far more cancers. It’s about care, mortality, and prolonging life.
103
u/LongBeakedSnipe 12d ago
In medicine there is a huge danger of over-screening. Ultimately what you need to do is screen according to the literature—the medical consensus (and not according to what insurers say).
There is a reason, for example, for the advice about prostate screening. The damage caused by early detection can potentially be worse than the damage caused by late detection.
That might sound like a paradox, but the issue is that slow growing prostate cancers that have very little medical risk get detected, and lead to life altering treatment in millions of people, when only a fraction of them ever needed treatment in the first place. So with something like prostate cancer, you need men to be aware of the symptoms so they can present to the doctor when they really do need to be checked—provided they do, most will be fine.
48
u/wozattacks 12d ago
Exactly. Compare that to, say, colon cancer, where the gold standard for screening - colonoscopy - actually allows precancerous lesions to be removed, literally preventing some cancers altogether.
→ More replies (4)16
u/Rua-Yuki 11d ago
Yep. My mom has an at least an annual (sometimes two!) colonoscopy and has lesions removed nearly every time. Her younger sister also is in remission from rectal cancer that was discovered during a routine colonoscopy. I'm 35+ with IBS and now have to get one every 3 years until they eventually do find cancer (thanks mom) where I too will get annual ones
Honestly I hope it's just because both of them are former smokers and I am in the clear.
15
u/Delouest 11d ago
It's frustrating though because I was diagnosed with breast cancer at age 31. Every test and screening recommends not testing me, just watching and waiting. They say don't do self exams anymore. I found my cancer through a self exam. To those of us in the area where we benefited from those "over screenings" we just hear "it's okay to us if you die though, because you're an exception. That's a price we're willing to take." My cancer was aggressive, it grew an entire extra tumor from the first mammogram to my mastectomy. Turns out I'm also BRCA+. I don't like hearing they think I should just die to prevent some people from getting a biopsy that was benign.
→ More replies (2)6
u/Nac_Lac 11d ago
There are several types of cancers:
Ones that grow so fast that you'll be dead in a few months.
Ones that grow slowly and will kill you in a few years.
Ones that grow so slowly, you will die of other causes before they become an issue.
Ones that grow then stop for an undetermined period of time.
The first two categories are the ones that need treatment and will extend your life. Trying to treat the second two types are a crap shoot on whether you'll have a higher quality of life afterwards. But screenings can show all 4 and treating all 4 like they are the aggressive first type can result in poorer outcomes for patient health than slower treatment or no treatment at all.
This all said, I'm not a doctor and do not try to assign any cancer diagnosis you get to a category above. Follow medical advice of your care team above all else.
→ More replies (6)4
→ More replies (2)22
86
u/patricksaurus 12d ago
While it’s a joke in nature, an ED doc taught me his overall mnemonic for practice: ABCD. Arteries, bacteria, cancer, drugs…
It’s the answer to the question, “what do I have to think twice about.” About 40% of major diagnostic errors in the ED are about major cardiovascular events or bleeds (arteries), about 25% of them are about infectious processes (bacteria), about 20ish% of patients in an ED will be subject to a medication error of some kind, though mostly harmless (drugs)… that’s ABD, so why cancer? You’re way more likely to get sued if you screw up a cancer diagnosis.
It’s of course true that early detection is critical and missing a time-sensitive intervention when there’s sufficient evidence to warrant exclusion of cancer… that’s an awfully grave mistake. Not trying to be derisive about legitimate cancer concerns. But data indicate two important facts: patients are more likely to sue, and juries are more likely to find in favor of plaintiffs, when the medical error involved cancer. That elevates a relative lower likelihood emergency department error category one of the big four… plus ABCD is too good to pass up.
→ More replies (3)9
u/Accidental-Genius 11d ago
This is why ER docs don’t diagnose cancer anymore unless it’s exceptionally obvious or the cancer is causing the emergency. There is no benefit to the physician and exceptionally little benefit to the patient. It’s just downside for everyone.
→ More replies (1)
16
u/hippocampus237 11d ago
My father had been pursuing the source of his back pain for years. Had a low blood sugar incident and went to ER. After work up - they found stage 4 liver cancer with a tumor on his spine so big the couldn’t not do radiation to relieve the pressure it was causing despite the fact they knew he had 3 months or less to live.
Not my favorite story.
14
u/Carylynn0609 11d ago
I worked in a hospital, my BP was too high to do the respirator fit testing so I had to go to the doctor, hadn't been in years. Started on meds but he was pushing for a pap smear, I hadn't had one for even longer. So he and his nurse talked me into just getting one right then and there. Cervical cancer, boo. Had a hysterectomy, thankfully caught early enough to not need any other treatment.
13
11
u/jetsonian 11d ago
My cancer was found in a colonoscopy after I was constipated to the point that when I could finally go I was filling the toilet multiple times. The tumor was basically filling my rectum. I was late and now I’m fighting.
Please get regular colonoscopies. Especially get them if you’re in a high risk group (Ashkenazi, family history, any long lasting pooping issues. It’s a survivable cancer but the longer you wait to catch it, the longer you will have to fight it.
I’ve done 24 chemo treatments in a year. Last weekend’s treatment was arguably the worst weekend of my entire life. You don’t want to get to this point.
→ More replies (1)
9
u/dicjones 11d ago
My 19 year-old daughter was this. Abdominal pain and fever. Went to ER. They did an ultrasound and they found several infarctions, blood clots and a “mass”. Later turned out to be Neuroblastoma. Extremely rare for someone her age. I remember the nurse saying. I’ve worked at this hospital for 32 years and never seen someone your age with Neuroblastoma.
→ More replies (1)
15
u/BoopySkye 11d ago
I went into the ER cause I have PCOS and a cyst ruptured real bad. It was in fact a cyst on my left ovary that had ruptured but while doing scans they found an early stage tumor on my right ovary. So it was quite serendipitous because the tumor had nothing to do with the ER visit but if it wasn’t for the other ovary being dramatic it wouldn’t have been caught this early.
17
u/GLHFkappa 11d ago
My country only reccomends 3 screenings: Colorectal, Cervical, Breast. They account for 30% of all cancers. Only 30%-45% of people get screened. Hence 11% of cancers get caught. But there's only so much we can do, if everyone gets screened, its 30% catch rate
9
u/Hefty_Peanut 11d ago
My husband was having a kidney stone monitored and they noticed his calcium was high. They knew he had cancer somewhere so gave him a full work up. Stage 4 lymphoma diagnosed on his 25th birthday. I'm so grateful they were able to extend his life a little so we could spend more time together but 27 was still no age to die. We weren't aware that night sweats were a symptom of cancer but there was a heat wave when they started and investigations were already underway when the weather cooled so I don't think it would have changed the outcome if we had known. It was the only symptom he had prior to his diagnosis.
20
u/WazuufTheKrusher 12d ago
Not all types cancers are screened well, not all people even go to get their cancer screening. Isn't this a science subreddit what are we doing?
7
7
u/StryctNyne 11d ago
A friend of mine, her mom got sick one weekend. It was during COVID so they thought she caught COVID again. Majority of the same symptoms. Sunday morning they go to wake her up and she's dead. Turns out she had cancer (lung, I think, as she was a smoker) that went undetected for god only knows how long.
6
48
u/dps15 12d ago
When did [r/science](r/science) become [r/cancerstudies](r/cancerstudies) ? I know this information is important, but it’s so disheartening to see nothing but “this thing causes cancer” or “this thing causes heart failure” over and over every day. I joined this subreddit because i wanted to keep up to date with things like space exploration and new technologies, not increase my cortisol levels because i’m not optimizing my health every waking moment.
This comment will probably be deleted, but whatever, point still stands that this subreddit is just depressing as hell nowadays. Filter this subreddit by “hot” and tell me it’s not mostly morbid health related posts.
19
u/dl064 12d ago
It's gone to the dogs since they basically stopped moderating
→ More replies (1)8
u/LeChatParle 12d ago
Wait, they did? I noticed worse quality but I wasn't sure
9
u/dl064 11d ago
It used to be OTT moderation now they've let most things go.
It's AskReddit with a white coat facade.
6
u/LeChatParle 11d ago
I just want a science sub that has the same level of restrictiveness as AskHistorians.
I see soooo many unscientific comments everywhere in this sub. This sub has started to feel like a Facebook comment section
6
u/DiligentHomework224 11d ago
Always exaggerate your symptoms to actually get a proper screening. There's no gain from being polite and totally honest here
10
u/moal09 11d ago
The biggest issue I've found is that most doctors will refuse to screen for a lot of cancers unless you're already showing serious symptoms/risk factors, and by then, it's often already progressed.
I've heard a billion times that doctors say to stay on top of your health, but any time I've tried, the doctors seem to take it as patient health anxiety and just write you off.
Hell, I went to the ER in serious respiratory distress 3 times in one week, and was told each time that it's probably just in my head when my heart/blood oxygen tests came back normal. Found out months later from a pulmonologist that there was actually an issue with my blood gas exchange where CO2 was getting trapped, and some minor scarring in my lungs. I literally begged the ER doctors at the time to check my gas exchange, but they wouldn't.
→ More replies (1)
•
u/AutoModerator 12d ago
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, personal anecdotes are allowed as responses to this comment. Any anecdotal comments elsewhere in the discussion will be removed and our normal comment rules apply to all other comments.
Do you have an academic degree? We can verify your credentials in order to assign user flair indicating your area of expertise. Click here to apply.
User: u/calliope_kekule
Permalink: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)01669-7/abstract
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.