Hundreds of medical studies are published regularly. Medical Guidelines are made by different physician specialty groups to assist physicians in screening and treatment of various medical conditions. These guidelines are not carved in stone and change with time as better quality studies emerge. The changes are made if the previous medical recommendation or practice is found to be ineffective and costs more harm than good.
Hormone Replacement Therapy for Osteoporosis Prevention
Hormone replacement used to be recommended in post-menopausal and pre-menopausal patients to prevent osteoporosis. Many women all over the world were advised to take estrogen to prevent bone fractures associated with osteoporosis. The Women’s Health Initiative Study was made, and one of their aims was to study the effects of the estrogen and progesterone combination. They had to stop the study three years early for the estrogen/progestin combination because of an increased risk of breast cancer, heart disease, stroke, blood clots, and overall harm. For the estrogen-alone (in women with no uterus), the study was also stopped one year early in 2004 because of increased risk of stroke and no overall benefit.
Prostate screening
PSA (Prostate-Specific Antigen) testing used to be done frequently in many men to screen for prostate cancer. This resulted in many unnecessary procedures with its attendant complications. Not for all men anymore. Here is the latest recommendation about prostate cancer screening from the U.S. Preventive Services Task Force (USPSTF). Details in laymen’s terms can be found at Choosingwisely.org
Digital rectal examination or the dreaded “rectal exam” used to be recommended as part of the screening for prostate cancer. Not anymore according to the
Breast Cancer
Self-breast examination to detect breast cancer is not supported anymore. For the latest in breast cancer tests and treatment for breast cancer, click here.
Elective Cardiac Stents
For three decades, cardiac stents used to be done on any patient having stable anginal pain (chest pain from the heart but not bad enough to be a heart attack). It was believed then that opening a diseased coronary artery disease is better than medications alone to prevent the chest pains.
The ORBITA study published in Lancet in 2017 showed that getting a stent in patients with stable angina does not provide any improvement in the exercise capacity and is not any better than a sham or placebo procedure. An editorial written by a cardiologist about the ORBITA study gave more details about the significance of the study.
It is critical to differentiate between stable angina and chest pain secondary to an acute heart attack. It is not recommended for anyone to self diagnose. A physician and an EKG are needed to differentiate that. A severe heart attack may benefit from a stent depending on several criteria.
The ones mentioned above are just a few of the recommendations about procedures, screening tests, and medications that have changed with time. It is not surprising that many people are confused and even skeptical about the medical establishment. One sure thing is that medical guidelines will continue to change in the future. More information right now is pouring in with regards to genetics, the microbiome, effects of circadian rhythm, and more. We have not even used the power of artificial intelligence and machine learning to consolidate the medical findings that span time and all the researches that are done worldwide.
The relevant question is, are there any medical recommendations out there that don’t change and have minimal to no side effects? Yes.
Medical Recommendations That are Time-Tested
- Physical Activity/Exercise
- Eating natural home-cooked foods in moderation
- Getting enough sleep
- Drinking enough clean water
- Fresh unpolluted air
- Breastfeeding
- Sanitary environment
- Not smoking
- Not getting bothered by unimportant things
- Enjoying time with your loved ones
For more information on recommendations for screening:
- www.choosingwisely.org
- U.S. Preventive Services Task Force (USPSTF)
- A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices
The contents of this article or website should not be used as medical advice. Always consult your doctor.
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