COPING WITH A PRE-DISEASE DIAGNOSIS

   A pre-emptive strategy – such as adopting healthful habits to fend off heart disease and stroke – clearly saves lives but critics worry the “pre” label may turn healthy people into patients.  Concerned about what we are doing to the well, Gilbert Welch, M.D., M.PH, lead author of the book “Overdiagnosed” and a professor of medicine at the Dartmouth Medical School advises to go slow with medications.  The pre-disease concept might put pressure on doctors to try medication first rather than to try to convince the patient to make the necessary lifestyle changes.  But people in this category have less to gain from medication because medications can confuse the real situation when lifestyle change is the real need to improve general health to make them better.  The drug could do more harm than good.  The preferred treatment for most diseases is to have a healthful lifestyle.  “If the label calls attention to doing that it is a plus,” says Howard Brody M.D., Ph.D., director for the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston.  “I’m concerned that the anxiety it causes will outweigh the benefit.”  Patients wonder if there is any evidence that the condition will prevent bad outcomes, like a heart attack or bone fracture when the need is really lifestyle change to reduce a negative risk.  For example, if you are facing cancer surgery, lifestyle changes could eliminate 40 percent of colorectal cancer.

* Eat less red meat.  Red meats and processed meats form carcinogenic chemicals.  According to a 2011 meta-analysis combining the results of 21 studies it could eliminate many other cancers. Data from the U.S. Polyp Prevention Trial, it is important to eat more vegetables, fruit and fiber. A recent study using data from the U.S. Polyp Prevention trial looked at the impact of diet on l900 people with a history of precancerous polyps.  Those who met goals cutting fat and consumed at least 18 grams of fiber and 3.5 servings of fruit and vegetables per l,000 calories each day were 35 percent less likely to develop new polyps during the study.

* Exercise.  Sedentary people are about twice as likely to develop colorectal cancer as highly active exercisers.  Aim for at least 30 minutes a day of moderately intense exercise.  Don’t rely too much on drugs or supplements. All pose additional health risks.  Limit alcohol.  People who average two to four drinks a Day have a 23 percent higher risk than those averaging less than one drink a day.  Don’t smoke.  Researchers have enough evidence to conclude definitively that smoking contributes to colorectal cancer.