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Is prevention better than cure?

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Issues involving prevention verses cure have been a hot topic for many years. This article published in the September 21 issue of The Lancet discusses Bergfeldt and colleague’s findings when investigating the issues involved with new and emerging options for ovarian and breast cancer patients. They discuss surgical prophylaxis, genetic mutations, the concept of chemoprevention and ethical issues involved with these.

Bergfeldt and colleagues suggested linking increased risk of ovarian cancer to a predisposition to breast cancer, and that the removal of breasts and/or ovaries should be considered for some patients.

Surgical prophylaxis may be the ideal solution – remove the tissue at risk and you will remove the risk itself. However the association of a mutation with a particular cancer does not prevent unpredictable manifestations elsewhere.

Therefore, it needs to be asked, if removal of risk cannot be assured, is prophylactic surgery the best option?

Another issue discussed is that of genetic mutations. Although studies show that familial disease-causing mutations are rare, offering prophylactic surgery to mutation carriers who do not show symptoms is problematic ethically as well as practically, and could lead to many unnecessary operations and severe psychological effects for the individuals involved.

High risk individuals could the option of new chemopreventive drugs. Chemopreventive drugs are being investigated by the pharmaceutical companies, however, there are many ethical issues and “what if’s” involved. What if the drug doesn’t work? What if someone goes on to develop cancer after taking chemopreventive drugs? Could this have huge financial repercussions such as those we have seen with the tobacco industry being forced to pay billions of dollars in damages? Could this create a false sense of security?

Concentrating on diagnostic techniques and improved screening will lead to “conquering the disease before it happens,” however, there is huge demand in chemopreventive drugs as a result of genetic tests.


(Source: The Lancet)


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Dates

Posted On: 1 November, 2002
Modified On: 3 December, 2013

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