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by
Theodore Dalrymple

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June 25, 2014 - 9:00 am
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If the future were knowable, would we want to know it? When I was young, a fortune teller who predicted several things in my life that subsequently came true predicted my age at death. At the time it seemed an eternity away, so I thought no more of it, but now it is not so very long away at all. If I were more disposed to believe the fortune teller’s prediction than I am, would I use my remaining years more productively or would I be paralyzed with fear?

In a recent edition of the New England Journal of Medicine a question was posed about a 45-year-old man in perfect health (insofar as health can ever be described as perfect) who asked for genetic testing about his susceptibility to cancer, given a fairly strong family history of it. Should he have his genome sequenced?

A geneticist answered that he should not: to have his entire genome sequenced would lead to a great deal of irrelevant and possibly misleading information. But if the family history were of cancers that themselves were of the partially inherited type – more factors than genetics are involved in the development of most cancers – then the man might well consider having the relevant part of his genome, namely that part with a known predisposing connection to the cancers from which his family had suffered, sequenced.

This is not a complete answer, however. Two obvious questions arise: is additional risk clinically as well as statistically significant, and if the risk is known can anything practicable and tolerable be done to reduce it? There is no point in avoiding a risk if to do so makes your life a misery in other respects. You can avoid the risk altogether of a road traffic accident or being mugged on the street by never leaving your house, but few people would recommend such drastic avoidance.

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All Comments   (13)
All Comments   (13)
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JillPZook
My classmate's sister makes $84 /hr on the computer . She has been unemployed for 7 months but last month her income was $15840 just working on the computer for a few hours.
browse around this website
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15 weeks ago
15 weeks ago Link To Comment
I’m going to die. I know that. I don’t dwell on it and try to live a healthy lifestyle. I don’t go over board with that and have my “vices.” Get you mind out of the gutter, if that’s where it went. I eat BACON! Once in awhile, I have a cigar. I like my libations.

When it was discovered I had a form of cancer, I did what was necessary. When it was discovered I had a still different form of cancer, I did what I needed to do. To the extent possible I was at peace with God and neighbor. I live with the understanding of “when” I die, not “if” as I sometimes hear people remark. Having fore knowledge of the possibilities of developing a disease is not something I can see as a benefit. Maybe at some future time, the science will be much more exact. For now, I’ve enough worries, so I don’t need anything to add to the pile. Besides, I could walk out the front door and get run over by a car. And, I would have wasted all that time worrying.
16 weeks ago
16 weeks ago Link To Comment
The chances of false positives are very high.

My physician told me that according to the latest research, each of us has DNA with alleles for an average of EIGHT life-threatening illnesses.

So if you get your DNA sequenced, be prepared to be told you're at risk for half a dozen or more life-threatening illnesses. WE ALL ARE. That's why we die eventually.

Which disease you actually will get will depend on exogenous factors like lifestyle, environment, or just sheer bad luck. But you will get one.

But do you want to practice defensive living (analogous to defensive driving)? If you're at risk for breast cancer, do you really want to get a double mastectomy "just in case?"

16 weeks ago
16 weeks ago Link To Comment
I think this mass testing is mostly a money-making scheme because the information you receive is too little to act on. I think it will only feed the health freaks who use the info to bully others. DNA testing makes sense only if you have a specific family history and if the knowledge of a genetic predisposition would allow you to take measures to prevent the disease.
Can you imagine how a crazy helicopter mother could ruin her child's life by dictating every bite he or she takes and every possible chemical he or she might need to be protected from?
16 weeks ago
16 weeks ago Link To Comment
The emphasis on body, self & personal status is excessive, due in large part to the prevalence of pill pushers and money raising ads about sundry dis-ease all over your tee vee all the time.

It is not healthy to go through life obsessed over your health or obsessed period.
16 weeks ago
16 weeks ago Link To Comment
Interestingly I experienced here in Germany some days ago during a routine abstraction of blood for diabetic problems a request to supply blood for DNA testing by central med. whatever of Germany. The results have to do with cancer (which I have had), which will be giving to me alone, unless I give permission for anonymous uses of my blood for further study. I did so. What this is supposed to mean is not clear yet. However, for whatever advantages it might supply for public health, it will be making me potentially more transparent. And that bothers me.
16 weeks ago
16 weeks ago Link To Comment
The only way I'd have such a test performed would be if I had the results in hand, and then would blow the facility to absolute smithereens.
16 weeks ago
16 weeks ago Link To Comment
Genetics is only part of the equation.
Lifestyle accounts for some to most.
16 weeks ago
16 weeks ago Link To Comment
Another part is possible epigenetic changes that occurred when you were still in the womb.
16 weeks ago
16 weeks ago Link To Comment
What's astonishing is the epigenetics passed on to us from our parents, grandparents, and possibly earlier generations.
16 weeks ago
16 weeks ago Link To Comment
Health analysis based upon dna testing is very much in its infancy. There are many dna groups researching the links between dna and health. But to take just the case of 23andme.com, who offered dna based health information, they've been ordered by the government to cease offering that service due to government uncertainty that the information is accurate. While 23andme, in my opinion, should not be restricted from providing their health advisory service, it is clear that this field of study is not an exact science yet. As the article suggests there are a lot of factors that influence whether one has an inheritable health risk, most having nothing to do with dna. I've had dna testing done and my health risks assessed. When you get done reading all the fine print associated with the analysis, you'll begin to realize how little can be said with any confidence. While the effort to produce a dna analysis has more scientific jargon and procedural steps associated with it, in the end, today at least, the certainty of the results is not far from that of reading your palm or consulting Tarot cards. Another big dna testing service offered is in ancestry matching. I wonder how accurately that service is performed today?
17 weeks ago
17 weeks ago Link To Comment
My grandfather died of esophageal cancer, my father died of esophageal cancer, my sister was diagnosed with Barrett's esophagus several years ago and went through a series of ablation procedures before having the lower part of her esophagus removed.

One factor that may play in my favor is that I have never been a consumer of tobacco or alcohol, or maybe it won't. Either way, if there was a test that had a reliable measure of my chances I would take it.

17 weeks ago
17 weeks ago Link To Comment
And so did Angelina Jolie, who can afford great medical care etc. Plus, I understand she is going for the full on ovarian removal.
16 weeks ago
16 weeks ago Link To Comment
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