We all like to think we're going to die a peaceful death, maybe in our sleep, after a long, fruitful and healthy life.
But not everyone is that lucky.
Health statistics predict this year about 500,000 Americans will die of heart attacks, 164,000 of lung cancer and 60,000 due to colon cancer.
Some of these deaths, however, don't have to happen, says Dr. John Corso, a Bend, Ore.-based general internist and author of "Stupid Reasons People Die." The book, released last month, looks at the diseases that potentially can be prevented or successfully treated and that cause most premature deaths.
"Everybody is going to die, but there are people dying in the prime of life," Corso says. "I was on call in the emergency room when a 45-year-old came in with a heart attack. If someone had talked to the guy and heard his symptoms and family history, we could have found it and stopped it. That's my greatest frustration."
Corso is an advocate of preventive medicine and spending enough time with patients to listen and educate them about being proactive. While many doctors spend 15 minutes with patients, of whom they see thousands each year, since 2001 Corso has limited his load to 200. Each patient pays a regular monthly fee of $100. As a result, Corso schedules hour-long visits, talks to them over the phone once or twice a month and generally keeps an empty waiting room.
Preaching prevention
Corso’s recommendations often include screenings for people above certain ages or who have certain risk factors, such as a history of smoking or chronic heartburn.
But he also tries to raise general awareness about less common killers, such as malignant melanoma and inflammatory breast cancer, which can be stopped if people know what to look for.
Many don't realize, for instance, that malignant melanoma isn't always the result of accumulated sun exposure. It can pop up in places that rarely see the light of day and occur at any age. While it represents only 4 percent of U.S. skin cancers, it's responsible for the majority of skin cancer deaths, Corso says. But it can be caught early if couples and families literally watch each other's backs — or by asking your doctor or dermatologist to check your skin.
And while everyone knows sleep apnea is a terribly disruptive disorder, causing people to choke and snort every time their airways are constricted during sleep, they may not know about the potential long-term health consequences. Not only does sleep apnea cause chronic exhaustion, it also can lead to heart failure. Over the years, apnea-induced low oxygen levels can harm the lung's blood vessels, creating high blood pressure in the lungs and straining the heart.
Strokes, heart attacks, abnormal heart rhythms, uncontrollable high blood pressure and worsening diabetes all occur more commonly in patients with sleep apnea, Corso says. Other consequences might include depression, memory loss, headaches, irritability and a low sex drive.
That's why it's important for people, even those who perceive themselves to be healthy, to get regular checkups, says Dr. Boyd Lyles, corporate medical director of U.S. Preventive Medicine, a company working to organize and promote medical prevention in America.
"So often patients, this is particularly true of men, take the head-in-the-sand approach," Lyles says. "Women tend to be proactive about their health but men may say, 'I don't want to know what's going on.' That approach does not work."
No magic cure
But while regular checkups play an important role in your health, Lyles points out that these and other lifestyle choices — such as not smoking and taking vitamins daily — don't exactly make you bulletproof.
And undergoing every screening medicine has to offer may not guarantee you'll live to 100 either. In the medical community, there's some debate about the promotion of screenings, which cause anxiety and, even if they lead to a diagnosis, may not help extend a patient's life.
Corso has heard the debate and says the more invasive a screening test is, the more he looks for data and studies showing it has a life-saving impact. If a test has little or no downside, except for cost, and a possible upside, he will likely recommend it, provided that the patient is willing to accept potential uncertainty and the need for follow-up tests over a period of time.
Dr. Ed Boyle Jr., who specializes in general thoracic and peripheral vascular surgery at Oregon's St. Charles Medical Center, and is a proponent of early lung cancer detection, thinks patients should at least know what's available to them so they can talk to their doctors and make informed decisions.
Your doctor may not think a certain test is appropriate, but should be up for listening to your request and explaining his or her reasoning.
"If you have a doctor who is annoyed by you asking these kinds of questions," says Boyle, "you might get a new one."