A new
British Medical Journal publication,
BMJ Best
Treatments by Luisa Dillner, aims to give patients access
to the same information as given to doctors. (The book is split
in half. Individuals have the option of reading the doctors' section
as well if they want to.) Best treatment guidelines on 60 common
medical conditions are given.
The book also counters myths in many illnesses, e.g.
Breast cancer Mastectomy is not
always best in breast cancer. In early invasive breast cancer,
(where the cancer is located either only in the breast or has
spread only to nearby lymph nodes) lump removal has as good
a 10 year survival rate
Prostate cancer Where the cancer
has not spread, invasive medical treatments like surgery, radiotherapy
or hormone therapy are not always best. Because prostate
cancer is very slow growing most people will live as long by
simply doing nothing but watchful monitoring
Constipation in children Laxatives
are very effective, but only short term relief. Children must
be trained how to relax the right anal muscles and go to the
toilet regularly. Using laxatives in conjunction with training
is probably the best
Anorexia No proof that drugs or psychotherapy
really helps, but at least psychotherapy usually has no adverse
side effects
Back pain (short term) Bed rest is
not advised, and can be harmful. Stay as active as possible.
Back exercises are not advised but overall body aerobic exercise
will get more healing blood and oxygen around the body
Heart failure Exercise is not always
best, and can precipitate an attack where the heart is weak.
Drugs to treat abnormal heart rhythms should be avoided (other
than amiodarone), as should calcium channel blockers, which
weaken the heart muscle
Wisdom teeth Should only be removed
if causing problems as removal itself can cause problems
Adenoid removal Should only be considered
if frequent breathing and ear infections persist past age five
Glue ear No evidence that ear grommets
or antibiotics prevent recurrence. Long term use of antibiotics
is potentially damaging. Teaching the child to blow up a balloon
with their nose sometimes works. Most children grow out of it
Tonsil removal
No evidence that surgical removal lessens likelihood of frequent
throat or ear infections any more than antibiotics
(10655)
Jeremy Laurance. Independent