Opinion about over-diagnosis
Dear Dr. P,
I have been enjoying your columns for a long time. As a doctor of oncology, I would like to suggest my opinion on your recent column “Anxiety over cancer surgery.” I think that the thyroid cancer patient’s case could be an important issue of “over-diagnosis,” which has been disputed in the medical field recently.
Especially among thyroid cancers, in the case of a papillary carcinoma less than 1cm in size, it could be another option to delay the operation and observe the process of the tumor carefully. The thyroid cancer operation is relatively safe, but it is not without complications. It could induce acute inflammation and bleeding as short-term complications, and hypothyroidism, vocal cord paralysis and parathyroid disease as long-term complications.
Of course, medical specialists could have different opinions regarding the method of treatment in this patient’s case, but we need to consider a more professional opinion about the treatment. Just like the thyroid cancer, there are many cases where “watchful waiting” should be applied, such as in prostate cancer.
Yours sincerely,
From Shin Sang-won, professor of oncology at the Korea University Medical Center’s Anam Hospital
Dear Professor Shin Sang-won,
Thank you for your thoughtful and invaluable suggestion.
As a matter of fact, I have been eager to hear opinions from experts from this field because I am neither an oncologist nor internal medicine doctor.
In my case, I’ve been deeply inspired by the book of “Nisi Natural Health Method” since I was a pre-medical student back in college. I have been practicing complementary medicine for more than 30 years. Even if I catch a cold, I don’t take any medicine. According to the Nisi method, “the symptoms are the treatment itself.” For example, the usual fever from the typical cold is a natural defense mechanism of the body to kill the virus. So, we don’t have to decrease the body temperature by the drug, rather we need to increase the body temperature by methods such as using a hot pack or warming the body.
I believe that natural recovery by the human immune system is the most important factor in fighting many different kinds of disease including cancer, and prevention is the best medicine for it. I ask for your continuous interest and participation for my columns.
Hello, Dr. P,
I have a Chronic Pain disease, and was recommended to seek counseling to cope with stress, life changes. Do you work with these types of issues? If so, I would like to schedule an appointment as soon as possible, I am having a hard time dealing with all of this.
Thank you.
Dear Sender,
There are many cases of chronic pain disorder, which are very difficult to treat with psychiatry. Since it’s chronic, you must have been suffering from this symptom for a long time.
The prevalence of pain disorder appears to be common. Recent work indicates the life time prevalence is approximately 12 percent, it has been estimated that 10 to 15 percent of adults in the United States have some form of work disability because of back pain alone in any year.
In my experiences with pain disorder patients, they ask for more potent analgesics including synthetic narcotics, but it is not recommendable because of dependence and tolerance although it is effective to control pain at the beginning.
The SSRI (selective serotonin reuptake inhibitor) or antidepressant is more effective than analgesics in some cases like yours. I have been using a certain remedy (the mixture of classical antidepressant and anti-anxiety medicine), and sometimes it is very effective for some chronic pain disorder patients, especially over a longer period of time.
In the case of the back pain, applying the kurunta, the yoga instrument which has been used in India for about six hundred years, is also effective. (I already introduced the kurunta in The Korea Times a few months ago).
I think you need to combine the psychotherapy or counseling together with medicine to understand the psychological origin of the chronic pain disorder.
I hope you can overcome your pain disorder successfully.
Park Jin-seng is a psychiatrist who runs a clinic for foreigners in Seoul and operates personal therapist forums on www.lifeinkorea.com. Please submit questions for Park to mdoctor@korea.com or call the hotline at 02-563-0678. Those who have their questions selected will be presented with a copy of “Finding Yourself within Love” (Korean e-Book) that he wrote.