The POWERFUL Dieases

No, not powerful as in “these will kill you in 24 hours” I mean powerful as in “we are on the receiving end of more charity and governmental dollars than the other guys” kind of power. The Big Kahunas of disease are of course Breast cancer, Alzheimer’s, AIDS, and Autism, I shall deal with these one at a time.

Breast cancer is a terrible disease that almost exclusively attacks women.  I love the women in my life and I would never want them to get this disease and if they did, I would want them to be cured.  Their ribbon is pink. The “CURE”  is dependent upon money for research etc.  Prostate cancer kills almost as many men as Breast cancer kills women and is more prevalent, but nowhere near as sexy. There is no Prostate cancer month and the government spends about half as much on prostate cancer as it does breast cancer.    Plus, what color would the ribbon be, if there were one, brown? You wouldn't dream of telling women they should not get screening tests but men...take you time, what's the hurry?  

Cancer sucks, and contributing for research to overcome this group of diseases is a worthwhile endeavor. Oncologists are driven or drive themselves (never ask a barber if you need a haircut) to treat patients way too long and for cases that they know are hopeless from day one.  There is a joke, if that is ever appropriate in cancer, that goes…”Why do they put nails in coffins?  To keep the oncologists away.” The American Cancer Society works hand in hand with cancer doctors and as the song goes “seldom is heard a discouraging word” when it comes to chemotherapy until the final day. As a doctor, I think we owe patients the truth not a bunch of "where there's life there's hope."  

AIDS "victims" keep looking for a cure as if it is some kind of mystery where the disease comes from.  If I had a disease that came from doing carpentry, for example, I sure as Hell would give away my hammer. I would start with prevention. And not accepting any kind of sexual rampage is OK.  To add to it, the disease did not get the benefit of epidemiology and quarantine when it first started because it was re-classified as a "disability." Our friend "reclassification."   

The psychiatric profession used to classify Homosexuality, among other things, as a disorder but some time ago they voted to reclassify it as a choice. They update a guide book to psychiatric disorders based upon their latest meeting.    It would be as if we could reclassify Hepatitis as a decision to turn yellow and therefore reduce the number of cases. OR, we could increase other conditions by the same method.  That’s what they did with Alzheimers and Autism.  They are two serious disease and when they are full blown versions they are devastating.  Unfortunately, the specialists in those area have “discovered” (read: redefined) a spectrum of Autism that includes all sorts of learning disabilities, with once distinct names, once they found out there was virtually unlimited funding for Autism and charities there were few charities for lesser neurological or developmental disorders. 

It seems that the Alzheimer’s folks have discovered this pot of gold as well. Even in the absence of any hard laboratory tests or “biomarkers” (high blood sugar in diabetes or high cholesterol in cardiovascular disease are examples of biomarkers)  or reliable physical findings of pre-clinical or pre-symptomatic disease. There are no markers that doctors can use now to establish the early diagnosis but the National Institute on Aging is working overtime on it.  So, the  “pre-symptomatic” diagnosis would be “seat of the pants” by its very nature.     

I have recently been asked how a person would know if he was just having a “Senior Moment” or being forgetful vs. whether they were getting Alzheimer’s.  The pre-clinical stage is a SWAG (scientific wild-ass guess).  This is when we think we might be getting it because we can’t find our keys for the 5^th time this week, or this day.  Mild Cognitive Impairment (MCI) is a clinical diagnosis based upon a group of observations and history. There is NO certainty just a probability.   In Dementia due to Alzheimer’s Disease, memory, thinking, and behavior changes are classic.  Specialized scans and spinal fluid analysis can affirm the diagnosis but most well trained doctors believe (as Justice Learned Hand said about when he could not precisely define pornography) ”I know it when I see it.”  The answer to everything in this field is “MORE RESEARCH” with all that entails.  In the mean time, live a cleaner healthier life which has been considered a reasonable preventive measure, and don’t worry, be happy.