Disease Hell...What Can We Truly Prevent or Control

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Prevention has two components. The first is preventing diseases from occurring in the first place. The second is picking up abnormalities early so that they can be treated well in time to prevent those diseases from causing undue suffering or premature death and thus allowing us an increased healthspan within an increased lifespan.

Currently, the only way we can prevent diseases from occurring is by being physically active, eating sensibly while keeping our sugar and salt intake optimal, sleeping well, not smoking, not drinking or drinking within reasonable limits, vaccinating ourselves against specific infections, and living, to the extent possible, in environments with the least pollution of all kinds.

In the future, editing your child’s genome prior to or during pregnancy may become an important method of reducing the risk of future disease, but we are currently not there yet.

Let us try and understand what it is that we are worried about when it comes to diseases and illnesses.

Perhaps the most important is not wanting a stroke or a brain attack that leaves us paralyzed and/or aphasic (that is not able to speak)…I can think of no worse hell than this. The next would be a heart attack that kills you (if you are dead you are dead) but worse, leaves you disabled and unable to function well. Diabetes and high blood pressure can both cause heart and brain attacks - they can also cause other issues, but heart attacks and strokes are the worst outcomes.

Not getting a cancer would be next (after brain and heart attacks). While the word “cancer” conjures up all kinds of nightmare situations, the truth is that cancer treatment is getting better and better each day and while the process can be taxing and painful (in all senses), cancers can be tackled and managed quite well in the majority of instances. Many cancers after a certain age do not need any treatment. Cancers and cancer treatments also do not generally leave you paralyzed or disabled as brain and heart attacks often do.

Not losing your mind would be the fourth, after brain and heart attacks and cancer. Though you yourself may not be aware that you are sliding into dementia (which perhaps may be a blessing at times) there are no sure shot measures to reduce cognitive loss, short of physical activity, the food we consume and perhaps life-long learning and social connections.

The fifth is not falling and not fracturing, in short not getting a “bone attack”. The only way to prevent this as we grow old is to have better balance and muscle and bone strength and a falls-free environment around us.

The last is not going blind or deaf. While blindness is worse than deafness, both can affect your ability to live a good life and cause significant stress to those around you. These are both multifactorial problems that need a combination of regular check-ups and then different forms of treatment depending on what the cause of the vision or hearing loss is.

In short, the only way to prevent disease is to be active, to eat sensibly, to not smoke and to not drink without control, taking your vaccines and to breath good air (which is perhaps often not something we can control). That’s pretty much it.

The second part of prevention is picking up diseases early to institute measures to prevent disability and to improve our healthspan and lifespan. These include screening for high blood pressure (perhaps the single most important factor in our atmavasth quest to live long, healthy and a test we can even do on our own), high blood sugar (the second most important test and again a test we can do or get done on our own), high lipid levels, screening tests for some cancers, screening tests for osteoporosis and aneurysms and regular checks of our oral hygiene, vision and hearing. The idea is that if we pick up these diseases and adverse conditions early, we can treat them in time with medicines or other measures to allow us to live longer, healthy.

It is also important therefore to not get tested unnecessarily for diseases, just because tests are available, e.g. serum PSA after the age of 70 or MRI brains. The harm caused by most of these tests and their results, especially the downstream costs and stress of chasing abnormal findings, usually far outweighs any gain from picking up disease early, especially since we now know that in most instances, picking up diseases early, except for the ones already mentioned, only makes you a patient with that disease early, without actually improving your healthspan and lifespan.

Not only that, even if you pick up a cancer early and treat it, the treatment itself may trigger other cascades and diseases due to which you still land up suffering and dying in the same time-frame, a concept called “trading disease”. Unless we know for sure that diagnosing a disease early and treating it is associated with significant improvement in suffering during the lifespan or improves longevity with minimal suffering, there is no point in diagnosing a disease early or if you do, treating it.

When we do annual health check-ups, we do them because we tacitly accept the fact that we may have disease and we want to pick these diseases early to reduce their future ability to affect our lives. However, it is important to limit the health check-up only to those tests that actually make a difference and resist the lure to get “everything” checked, just because you can afford to do those tests.

I reiterate. While picking up disease early is good, where it makes a difference (e.g. high blood pressure, high blood sugar, etc), preventing those diseases occurring in the first place is more important. To repeat a third time in this piece, the only way to prevent diseases at this point in time without genetic manipulation is by being physically active, eating sensibly, not smoking, not drinking or drinking sensibly, taking those vaccines that make a difference and reducing the impact of adverse environmental factors to the extent possible.