Hormones, breast cancer and other medical misconceptions

James Hubbard, M.D., M.P.H.

News flash.  Medicine is not perfect.  A few years ago, I finished my advice to a patient by saying, I might be wrong.  She sarcastically said she was going to go straight home and call her doctor son-in-law to give him the news. “A doctor said he might be wrong. Who knew?”

Reading the recent news about colonoscopies made me think of this.  Why do we need scientific studies to document that therapies work?  Because we can’t rely on our intuitions and preconceived notions.  Every diagnostic test and treatment needs to be scrutinized objectively.  Even the ones we’re sure of.

Only a few years ago, we touted menopausal hormone replacement therapy as a must to prevent osteoporosis and heart disease in women.  After all, the estrogen drop caused these diseases to increase after menopause.  Then a funny thing happened.  Someone did a study and looked at the data.  Turns out, HRT actually increases a woman’s risk of heart disease and breast cancer.

Same thing about colonoscopies.  I mean, we look directly at the colon through a scope.  Ninety percent accuracy for detecting cancer-causing polyps was a given.  However, an objective look at the data reveals a much lower detection rate, more in the 60 to 70 percent range.

One thing about medicine is for certain.  Change.  Now that I say that, a study will probably prove me wrong.

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6 Responses to “Hormones, breast cancer and other medical misconceptions”

  1. FatFighterTV Says:

    It’s always changing, isn’t it??!!

    FatFighterTVs last blog post..Food for Thought: Chestnuts

  2. Sagan Says:

    It’s good to be able to recognize that it’s always changing! That way we can adapt along with the changes and admit when we’re wrong.

  3. James Hubbard, M.D., M.P.H. Says:

    Fatfighter, It is a full-time job to keep up with things we thought we knew that turn out to be untrue.

  4. James Hubbard, M.D., M.P.H. Says:

    Sagan, everyone is wrong sometimes. Too many people think medicine is an exact science.

  5. Steve Parker, M.D. Says:

    Thanks for bringing this to the public’s attention. At least we look at these issues in a scientific manner and publish results that may not be flattering or that conflict with conventional wisdom. This can’t be said about many of the CAM therapies you blogged about a few days ago.

    -Steve

  6. James Hubbard, M.D., M.P.H. Says:

    Thanks Dr. Parker. I hope we see more of it with CAM

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