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State opposes reinstatement of law license to ex-WB employee Hayward

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Plains development tax break hearing request is Tuesday

<p>Appropriate screening tests can save lives</p><p>My 3-year-old granddaughter is very proud of her 20 &#8220;clean and healthy&#8221; teeth. She&#8217;s particularly insistent that you acknowledge that her 15-month-old sister Eve, whom she dearly loves, only has six.</p><p>I was a bit taken aback, but probably should not have been too surprised, when Rowan counted all 20 teeth for me earlier this month. She&#8217;s now got her numbers down perfectly through 20, no longer falling so in love with the sound &#8220;12&#8221; makes that she used it two or three times on the way to 20.</p><p>You see getting the numbers right is important whether its on your tax return, your family&#8217;s or company&#8217;s budget, your tooth count or the statistics about cancer occurrence and survival.</p><p>We&#8217;re facing an interesting challenge in medicine brought on by the increasing sophistication of diagnostic tests, widespread screening of large groups of people and the resulting detection of abnormalities, including cancer, at earlier stages than ever before.</p><p>You see, many of our statistics, preconceptions and indeed fears about malignant growths come from analysis of data collected years ago when tests were less precise, imaging cruder and cancers often found only because a hunt was started looking for an explanation of some symptom.</p><p>Remember from several weeks ago that I defined a symptom as something a person notices and brings to a medical professional&#8217;s attention. A sign is an observable physical characteristic like a sound one can hear, a mass one can feel, a rash one can see, or an odor one can smell (not much tasting involved in diagnosis these days, thank goodness.)</p><p>By the time cancers cause symptoms, they may have grown to a size, or involved structures that make treatment and cure more complicated than had they been recognized when smaller and less developed.</p><p>The statistics we developed, and the aura built up around certain diseases when most were found at late stages, after significant symptoms developed, may not be appropriate when an early, small tumor is caught incidentally, because a test, image or physical examination found it &#8220;accidentally.&#8221;</p><p>The huge advantage that we have in effectively treating and yes, often curing cancer, from early detection is the reason getting screened for problems at the right time, at the right intervals, with the right test by the right people is so important.</p><p>Now not all screening tests are right for everyone.</p><p>A big part of the professional competence of your primary care providers is their ability to match the correct tests to your circumstances. Sometimes too many, or the wrong test can actually cause more trouble than it has any hope of avoiding.</p><p>Studies that involve radiation, or dye, or anesthesia, or placing catheters, tubes or scopes into the body should all be carefully chosen so that the benefit expected outweighs the small but not zero risks that might be involved. One of the dangers to be avoided is the &#8220;wild goose chase&#8221; that following up a falsely abnormal test result can lead to.</p><p>This is why insisting on a certain test, because someone you know had it, or a blogger recommended it, or you got a postcard in the mail from a company announcing a &#8220;sale&#8221; on some screening test in a mobile truck is usually a bad idea. Better to discuss your individual situation based on age, family history, genetic testing, habits, diet, job and all the other things that make you so uniquely you &#8230; asking your medical team captain to craft a tailored list of meaningful, appropriate, worthwhile screening tests for you.</p><p>Happily, these days we have more and more guidance from professional associations, not-for -profit groups and government agencies to help us in our efforts to do the right tests, and only the right tests, at the right time, for the right reasons to find problems early without causing new ones.</p><p>Meantime, Ro&#8217;s teeth keep coming, Eve will catch up and medicine will refine our understanding and statistics based on finding problems earlier.</p><p>In the next few weeks we&#8217;ll talk about some common screening programs. </p><style>
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<div class="metaInfo"><bylineMeta><p>By Alfred Casale</p><p>To Your Health</p></bylineMeta></div><div class="metaInfo"><shirttailMeta><p>Dr. Alfred Casale, a cardiothoracic surgeon, is associate chief medical officer for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via ae@www.timesleader.com.</p></shirttailMeta></div>

Heart failure: Getting the numbers right with medical tests