How Much Do You Want to Know?
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?When is it worth knowing our health future?? |
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The Angelina Jolie story shows both the benefit and downside of having predictive health information.? Genetic testing revealed a high risk of breast cancer and Ms. Jolie took the bold step of undergoing a double mastectomy before any cancer was found. Genetic testing will likely take significant leaps in the next decade. We may know what diseases we will likely get in our later years.
Having that information may help us take action to prevent or treat the disease earlier. Ms. Jolie took action that may have saved her from getting cancer. I say may because the odds were over 80% but not certain. Genetic testing may, however, lead us to hear things we do not want to hear. For example if we could predict Alzheimer?s would we really want to know? I assume most of us would live in fear every time we forgot something.
Many people go out and get full body MRI?s just to see if they have some hidden tumor. Unfortunately most of us have abnormalities, most of which are not serious. Cysts and other benign things lurk in all of us. Testing leads to more invasive testing to further investigate these mostly benign things.
Medicine is on the verge of being able to predict many hidden things about our health. There are positive uses for genetic tests, such as predicting which drugs will work or in finding treatable disease states. Our health care costs must come down and genetic typing may be a key factor in reducing our costs by smart targeting of drugs and in choosing effective cancer interventions such as chemotherapy.
On the other hand, what if employers pre-screened prospective employees for a high likelihood of getting costly diseases? What if insurance companies made those tests a condition of getting life insurance? There are many risks to having too much information as it relates to our future health. No one would really want to know if they are going to get a fatal disease a decade away. While knowing may help you live life to the fullest, for many it would be a depressing last ten years.
We can expect that as genetic predictive health tests get more accurate and cheaper there will be companies advertising them to us.? I would certainly want to know if I can change behavior to avoid heart disease or diabetes if a genetic test predicted it. I would want to know if a statin drug or antidepressant is right for me. The Angelina Jolie situation is a bit more troubling. Taking off a healthy part of the body to prevent cancer is a difficult decision. Genetic testing allowed Ms. Jolie to make that agonizing choice and she has the money do pay for it. I assume that as a nation, however, we cannot afford high costs of these prophylactic procedures for the average citizen.
Let?s say instead of 80%, the tests showed it was a 50% chance of developing breast cancer. Is that worth knowing? Would that knowledge just bring fear and depression? I am all for advances in genetic testing to predict disease. We, as a society, have to figure out when is it worth knowing our health future. In some cases that decision may not be so easy.
Bob Ehrlich, Chairman
DTC Perspectives, Inc.
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