Here’s a little-known, and inconvenient, truth about disease.  When you are diagnosed with a specific disease, such as asthma, the doctor really means that your symptoms in the main fall within a common grouping that allows him to label you ‘asthmatic’.  Certainly, your ‘asthma’ will have unique features that fall outside of the spectrum, but the majority of your symptoms are within the accepted classification.

Once conveniently labelled, the treatment can begin, and you are prescribed drugs to treat asthma.  Unfortunately, the drugs don’t treat your version of asthma, just a general consensus view of the disease.  That’s why, as GlaxoSmithKline admitted a year or so back, drugs work in only one-third of cases.

Now, even The Lancet says it’s time to drop asthma as a term.  Asthma isn’t a single disease; instead, the symptoms are a common manifestation that mask a range of possible causes, often allergic, says the journal.

This thought started occurring to doctors with the alarming rise of asthma cases in children over the past 20 years.  Recent studies have discovered that the cause is some allergic reaction to the environment.  But, says the journal, “the harder one looks, the more questions arise.  Hardly a week goes by without anxious parents being confronted with yet another association that supposedly either protects from or predisposes to the development of asthma.”
 
Even drug trials are hampered by the problem, because they are rarely matching groups that have asthma from a common cause.  In 1995 a landmark study discovered that children don’t always go on to develop ‘classic’ asthma, as those whose asthma is caused by a virus stop wheezing when they reach school age.

So, just as doctors in the 19th century realized that fever is not a disease but a symptom, those in the 21st century may have to come to the same conclusion about asthma.

Wouldn’t it be something if they applied the same thinking to a few more disease groups?  If they did, it would mean the end both of medicine for the masses, and the industrialization of pharmaceuticals.  So forget that, then.

(Source: The Lancet, 2006; 368: 705).


E-news broadcast 31 August 2006 No.288 [Subscribe]