Medicine is advancing at breakneck speed, with once-unthinkable treatments and technologies now becoming reality.
These innovations have led to miraculous new treatments: Scientists can now target and fix rare inherited diseases with gene editing, use mRNA technology to create and update vaccines faster during crises, and personalize cancer treatments with targeted therapies based on a patient’s unique genetic code.
That doesn’t mean every breakthrough is as revolutionary as it sounds. Here are three that doctors say deserve a closer look.
Blood tests for colon cancer screenings
Colorectal cancer — which includes cancers of the colon and rectum — is the second-leading cause of cancer-related death in the US for both women and men combined, according to the Cancer Research Institute.
Rates are skyrocketing among young adults by nearly 3% per year, making early detection increasingly important.
While a colonoscopy is the gold standard for both preventing and detecting colon cancer, it requires prep — drinking strong laxatives to empty the bowels the day before — as well as sedation and an internal scope.
So when the Shield Blood Test hit the market as the first FDA-approved blood test for primary colorectal cancer screening, it received huge national media attention and backing from major medical organizations including the American Cancer Society.
But Dr. Mason Pimsler, an internist at NYC Health + Hospitals/Lincoln and global medical correspondent for WABC RADIO 770, told The Post that the test has significant limitations.
Specifically, while the test is generally successful at identifying colorectal cancer in stages 2-4, according to its own fact sheet, it has “limited detection” of Stage 1 colorectal cancer, catching just 55%-65% of it.
It’s even less sensitive to precancerous legions, failing to detect 87% of them. Shield says that one out of 10 patients with a negative test may actually have “may have a precancer that would have been detected
by a screening colonoscopy.”
“When you go for colon cancer screening, you want to know if there’s precancerous growths to be removed so you don’t get cancer,” Pimsler said.
“If you went for the colonoscopy or virtual colonoscopy, and they picked up a precancerous growth, then you could get it removed,” he explained.
“But if you went for the Shield … and it came up normal, that’s not giving you much comfort because it could be a precancerous growth growing there, and a lot of people do have polyps,” he added referring to neoplastic polyps, the type that can turn into cancer over time if left untreated.
At-home Alzheimer’s blood tests
More than 7 million Americans are living with Alzheimer’s, and that number is projected to rise to nearly 13 million by 2050 as the populations ages. At age 45, the lifetime risk of developing Alzheimer’s is about 1 in 5 for women and 1 in 10 for men.
At-home or direct-to-consumer Alzheimer’s blood tests allow people to order biomarker kits online or provide a finger-prick sample to assess biomarkers associated with the disease without initially visiting a specialist.
But Pimsler, along with other medical groups including the Alzheimer’s Association, warns about false positives, unclear results, lack of clinical oversight and the emotional distress that can come without proper counseling.
A positive test “does not guarantee you’re going to have the disease,” he noted. “So you’re putting people through stress and anxiety, thinking, ‘Will I get this disease?’”
“Especially my patients with anxiety disorders, it makes them a lot worse,” he said.
Unlike a disease such as colon cancer, knowing whether you carry Alzheimer’s biomarkers cannot prevent, treat or manage the disease on its own, Pimsler added.
Tests to see how your genes may affect psychiatric medication
One of the biggest hurdles in psychiatric treatment is the trial-and-error phase of finding the right medication.
GeneSight was created to analyze how an individual’s genetic makeup may affect their response to dozens of FDA-approved psychiatric medications using a quick, painless inside-the-cheek swap. The results are returned to clinicians in an easy-to-read, color-coded report.
But according to Dr. Pimsler, it’s “not worth the paper it’s written on.”
“Some psychiatrists use that to advertise for themselves that they’re going to find you the right antidepressant,” he argued. “It’s BS. The test is useless.”
As Pimsler explained, the test doesn’t replace the clinical trial-and-error process involved in finding an effective medication, nor can it identify a single “cure-all” pill. Clinical judgement, symptoms, medical history and other individual factors still ultimately guide prescribing decisions.
The FDA has also cautioned that psychiatric pharmacogenomic tests like GeneSight may have limitations and should be interpreted carefully.
