Beware of Unnecessary Surgery

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“Before You Let Them Cut You, Try Non-Surgical Therapies First” was the lead story in the first issue of my Health & Healing newsletter, and unnecessary surgery is a theme I have returned to again and again over the years—for good reason.

As I stated in that opening article all those years ago, “The medical profession tends to promote what is good for the profession, not what is necessarily good for the patient.” This came as a shock to me when I first ventured out on my own and started learning about natural therapies. I figured that once other physicians found out about these safe, inexpensive treatments, they would also use them to help their patients. But after decades of seeing tens of thousands of patients scheduled for unnecessary surgery, I’ve found that this was not the case.

I want to make you aware of some of the cold, harsh realities of the conventional medical world so that you can make informed decisions about your health care and avoid undergoing an unnecessary surgery.

Aching Knees, Shoulders, and Backs

Every year, hundreds of thousands of patients with degenerative osteoarthritis undergo arthroscopic knee surgery, in which a tiny camera and instruments are inserted through small incisions to remove damaged cartilage (meniscus)—even though it is no more effective than sham (placebo) surgery. Studies show it's not worth the risk. Clinical practice guidelines issued by international experts in 2017 warn that risks outweigh benefits and make a “strong recommendation against the use of arthroscopy in nearly all patients with degenerative knee disease.”

A common treatment for shoulder impingement syndrome, which is diagnosed in about half of patients with shoulder pain, is arthroscopic subacromial decompression. This surgery involves smoothing the underside of the acromion (a small bone in the shoulder) to relieve pressure and irritation on the rotator cuff tendon. However, in a 2018 placebo-controlled trial, it worked no better than “pretend” surgery. Patients followed for two years after decompression or a sham procedure had similar improvements in pain at rest and with activity.

A large and growing body of research concludes that spinal fusion and laminectomy for low back pain, vertebroplasty for spinal compression fractures, and other surgeries for back pain have modest advantages at best over intensive rehabilitation and non-surgical management. Good outcomes seem to be hit or miss, and doctors cannot predict which lucky few might get real relief—and who will be made worse by surgery.

The Heart Surgery Industry

Angiogram (cardiac catheterization) is an invasive procedure that requires snaking a catheter into the coronary arteries to look for blockages. Although it is performed a million times a year, angiography is not indicated for patients with asymptomatic or stable heart disease (chest pain only when exercising or under stress and relieved by rest or nitroglycerin). Furthermore, this intervention is a gateway to additional, often unnecessary heart procedures. If you’re not interested in a coronary artery stent or bypass, don’t have an angiogram.

The medical literature makes it clear that percutaneous coronary intervention (PCI or angioplasty)—clearing out and propping open blocked coronary arteries with metal stents—is entirely inappropriate in patients with stable heart disease, even if they have a mildly abnormal stress test or blockages seen on angiography.

In the recent ORBITA trial, patients who had severe coronary artery blockages and were taking medications for angina were treated with either PCI or a sham/placebo procedure. Six weeks after surgery, there were no significant differences in chest pain or exercise tolerance between the two groups.

Blockages in the carotid arteries that deliver blood to the brain are considered to be a risk factor for stroke and are often treated with carotid endarterectomy to remove plaque buildup and restore blood flow. This surgery may be appropriate if blockages are severe and you’ve had a stroke or frequent transient ischemic attacks (mini-strokes). Otherwise, benefits are small and risks considerable.

Other Overused and Unnecessary Surgeries

Prostatectomy (surgical removal of the prostate gland) can be lifesaving for aggressive cancer, but not for localized prostate cancer.

In a New England Journal of Medicine study, 700 men randomly assigned to have prostatectomy or watchful waiting (observation and monitoring) were followed for 20 years. Survival rates and deaths from prostate cancer were similar in both groups.

A surprising number of women with early-stage cancer in one breast opt for double mastectomy, even though the American Society of Breast Surgeons recommends against it. These women have a low risk of developing cancer in the other breast, and removing both breasts has little, if any effect, on their life expectancy.

Nearly one in three babies born in the US is delivered by caesarean section. Ideal rates, according to the World Health Organization, are 10–15%, as there is no evidence that rates above 10% improve outcomes for mothers or babies. C-section is a major operation that increases maternal risk of infection, hemorrhage, and subsequent delivery complications. It also appears to raise risk of asthma and obesity in offspring.

Every year in the US, 600,000 women have a hysterectomy and by age 60, one in three will have had their uterus surgically removed. The ovaries are often removed as well, despite data clearly linking this to worse long-term health, including increased risk of osteoporosis and heart disease. There is much debate as to how many hysterectomies are inappropriate. However, the UK’s National Health Service has targeted hysterectomy for heavy menstrual bleeding as one of 17 “ineffective” or “risky” procedures slated to be dramatically reined in.

Proceed With Caution

Why are there so many unnecessary surgeries? It’s not that doctors are unaware of the problem. Surveys reveal that most physicians realize their responsibility in assuring that patients do not receive superfluous medical care. But they also admit to prescribing tests and procedures that are not needed, citing patient insistence and fear of malpractice as primary reasons. Money also factors in. When doctors benefit financially from unnecessary procedures, they’re more likely to perform them.

Surgery, including elective procedures, is sometimes necessary, but I urge you to carefully consider all the pros and cons. Never forget that with any invasive procedure, things can go terribly wrong. Medical errors in hospitals are the third leading cause of death in the US, responsible for 700 deaths a day.

If a procedure is elective and you're on the fence about what to do, consider alternatives first.

Alternatives to Consider

For musculoskeletal problems, the nonsurgical, orthomolecular approach I used for years in my clinic—and that helped many people avoid unnecessary surgery—involved lifestyle changes, nutritional supplements, and noninvasive therapies.

For starters, make sure you’re eating a proper diet. The best diet for your bones, joints, and muscles is the same diet that I recommend to preserve the health of your heart, brain, and other organs: nutrient-rich vegetables, fruits, legumes, and nuts and seeds along with cold-water fish and lean poultry. This diet provides adequate protein to maintain muscles and an abundance of antioxidants, B vitamins, and minerals to fortify bones and combat the inflammatory processes that accelerate the aging of your joints.

Beyond diet, I also recommend taking supplements for joint health, such as glucosamine and curcumin. If these lifestyle changes and targeted supplements aren’t enough to correct the problem, consider noninvasive clinical therapies that have been shown to alleviate pain and restore joint health and function, such as prolotherapy, stem cell therapy, chiropractic, and infrared light therapy.

For heart issues, consider EECP, a nonsurgical therapy with incredible benefits for the cardiovascular system. It is an excellent option for any condition in which poor circulation and impaired arterial function play a role.

Dr. Julian Whitaker

Meet Dr. Julian Whitaker

For more than 30 years, Dr. Julian Whitaker has helped people regain their health with a combination of therapeutic lifestyle changes, targeted nutritional support, and other cutting-edge natural therapies. He is widely known for treating diabetes, but also routinely treats heart disease and other degenerative diseases.

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