The Case for Routine Monitoring

It was with some sadness I read the story of Iain Banks' diagnosis of terminal cancer. I've not read any of his books (though I've been meaning to), but I have recently seen him in a Google Hangout (along with Alastair Reynolds and Peter F. Hamilton) and in a 'Five Minutes with...' interview on the BBC.

In both cases he appeared to be more than just an intelligent and thought-provoking man, but one who was energetic and full of zeal. Which makes the news even more shocking, because he appeared perfectly healthy.

Gall bladder cancer is an extremely rare condition, with fewer than 700 people being diagnosed in the UK each year (1,000 according to the NHS).  It's more common in women than men and in people over 70.  Iain is 59.

As with many cancers, if caught early enough it may be possible to remove/treat it, but like many other cancers it usually remains undetected until it causes problems, and therefore symptoms, in some other organ.

In his post, Iain explains that he was diagnosed after his doctor noticed he had jaundice. It was caused by the cancer blocking his bile duct. Jaundice is diagnosed by testing the patient's urine and blood.

I have some experience with cancer. My dad was diagnosed with Non-Hodgkins Lymphoma and Thyroid cancer after a lump appeared in his neck (the latter only discovered after they scanned for the Lymphoma, normally it's only detected in a postmortem). He had the aggressive strain, which meant it was spotted before it had spread too far, many cancers grow undetected for years and are only found when it's too late.

At the moment it's hard to detect them without performing blood tests and, ultimately, a battery of scans. Even then it's hard (my dad has had to have several to pick up whether it was completely removed by his chemo).

I've said before that constant monitoring of our health will become a reality in the future, it's something that must happen to catch the illnesses that lurk for years, finding these things early can be the difference between life and death.

Would it have helped in this case? It may have raised the flag on the jaundice earlier, maybe there were other symptoms that were missed that it would have identified as well. Due to the undetectable nature of most cancers though, probably not.

What we need to get working on is a better way to detect problems, whether that's in blood, urine or using some sort of home scanner. Treating cancer is one battleground, one in which we've had some success. Detecting cancer is another, and one that seems to have a long way to go.