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State of the Art

From the standpoint of our health, what is it that we all fear? Cancer. Or a sudden heart attack, or even worse, a stroke that leaves us disabled, paralyzed, or unable to speak or take care of ourselves. Unfortunately, modern medicine has been largely unsuccessful in allaying these fears. Once such a serious condition is diagnosed, the treatment is usually either invasive, toxic, or otherwise of limited efficacy. Our only hope relies on the chance that our doctor can detect the problem in time so that it can be cut out, bypassed, “roto-rootered”, irradiated, or killed with chemotherapy before it kills or incapacitates us. We are forced to live with the constant concerns of whether our doctor is doing the right thing, has enough time, or is lucky enough to catch a potentially lethal problem before it’s too late.

It’s no wonder that Americans are forever looking for the newest, most advanced, and most precise technology to diagnose them – thousands of people queue up and pay out of pocket for expensive heart scans, whole body CAT scans, lung scans, beam scans and “whatever-the-latest-scans” trying to alleviate the fear of two things: 1) the possibility we have something that’s being missed, and 2) the thought of losing control over our own health destiny. 

As technology increases, the focus of health has become an increasingly complex battery of screening tests that appear as “hurdles” to jump over; we need to pass our PAP smear, our mammogram, our PSA, our colonoscopy, our stress test, etc. Only after all of these tests have come up ‘negative’ are we deemed “healthy”. Health has become defined by the absence of detectable disease. The effect of this approach to health is that it disempowers us; we feel at the mercy of the medical system and its high-tech tools. We have come to believe that health is something done to us in hospitals and clinics by physicians, rather than created by us.

This belief leads to the loss of control over our health that many of us now experience. We may have even forgotten that we are active participants in our own health, in fact, the most important participants. The problem is that the current high-tech model of medicine is based on diseases – their diagnosis and treatment. As physicians, we spend years in medical school and postgraduate training studying those two things – diagnosis and treatment. We are taught the classification, as well as the signs and symptoms of diseases. This is, of course, a critical and necessary part of our education.

What we are not taught, however, is just as important, and that is how to identify, measure, create and promote health. These two concepts are not equivalent; the diagnosis and treatment of disease is not the same as the creation and promotion of health. Traditional medicine however has made the mistake of applying the disease-centered model to the assessment and management of health. Unfortunately, what may work well in the acute treatment of an illness or injury may not be applicable to the treatment of chronic illness or to the promotion of optimal health.

For example, treatment of an acute injury with painkillers and anti-inflammatories can be very helpful and therapeutic; however, applying the same treatment in the management of chronic pain or inflammation brings with it the problems of tolerance, addiction, and long-term side effects of the analgesic or anti-inflammatory medications. Likewise, this approach offers little to promote optimal health. There are many similar examples. The treatment of a severe acute allergic reaction, to a bee sting, for example, can be lifesaving, but the same treatment is not helpful in the prevention of allergy, or in the treatment of chronic allergies. The treatment for a sudden heart attack can also save lives if administered in time, but again this offers little in the way of prevention, or management of chronic cardiovascular disease.

A New Model

What is needed here is an entirely new model, a new system, and a new paradigm as a starting point. We need to focus on the promotion of health and the prevention of disease as the basis of this new model rather than the detection and treatment of disease. The old adage “if it’s not broke, don’t fix it” simply doesn’t apply when talking about one’s health. “An ounce of prevention” is more apt.

The trouble is that traditionally the word “prevention” has become synonymous with “early detection”. The two are just not equivalent. Today's comprehensive or executive "preventive" examination consists of a battery of screening tests targeting the early detection of existing disease. Stress tests check for heart disease; mammograms check for breast cancer; PAP smears check for cervical cancer; the blood pressure cuff checks for hypertension; the PSA test and prostate exam check for prostate cancer; the bone density test checks for osteoporosis; and so on and so on.

None of these tests are actually preventive in nature. One might argue that these tests may prevent unexpected or premature death from the conditions they screen for, which may be true, but these tests do not prevent the conditions they are screening for. Although important and often lifesaving, these tests are not truly preventive - they are screening for existing diseases.

• dis • ēase΄ = "A particular destructive process in the body with a specific cause and characteristic symptoms"

Not only does today's "preventive physical" lack prevention, but even as a screening method it leaves much to be desired. Amongst the best of them are the PAP smear (which can actually detect precancerous changes, before radical surgery is needed) and the bone density test (which can give an indication of risk before a disease is actually present).

Most screening tests are quite insensitive – a stress test identifies only blockages of 70% or greater in the coronary arteries; blockages of this degree have generally been building up for decades. Mammograms can only find breast cancers that have been growing already for five or more years, on average. CAT scans also only can detect tumors already present for years. Heart scans can only see plaque build-up in the arteries that has already become calcified.

Likewise, reliance on symptoms as an indicator of disease is not adequate. Symptoms tend to be a relatively late manifestation of a disease process. For someone to develop chest pains or “angina” pains due to blockage and narrowing of the arteries leading to the heart, there must be extremely advanced blockages (again over 70% of the artery or more) before symptoms occur.

By the time someone is suffering memory loss from Alzheimer’s disease, there has already been irreversible scarring in major areas of the brain. Before someone develops the characteristic tremor and stiffness of Parkinson’s disease, there has been some irreversible damage in the brain, also. Before someone becomes jaundiced from liver disease, there has already been extensive damage to the liver. So if symptoms are a poor advance warning system of problems on the horizon, and screening tests don't tell us what we want to know when we want to know it, then what can we do? Is there a way to identify, prioritize and target critical issues that can be identified before symptoms occur or before traditional screening tests can detect disease?

The answer is YES. And what’s more important, is that by targeting these critical issues we can PREVENT the development of the disease altogether. This health analysis and science of prevention goes beyond the traditional concepts of ‘prevention’, and for this reason we have called this approach ULTRAPREVENTION.