No man is an island, and no disease should be viewed in isolation. But with increasing specialization, that's exactly the path modern medicine is taking, and at a cost.
The dangers of specialization were highlighted in a recent study of 1,421 patients with colorectal cancer. They were all treated 'successfully' with laparoscopic or open (standard) surgery, and yet 48 of them died while in hospital, and the disease returned to 497 others.
How could this be if the surgery was a complete success? The surgeons had failed to recognize four key factors that contribute to mortality levels, say researchers: emergency surgery, loss of more than 10 per cent of body weight, neurological problems, and age. Each independently increases the risk of post-operative death and, in quite a few cases, patients had more than one of these risk factors. And what about the patients whose cancer returned? Again, specialists failed to identify six risk factors that might have given them a clue about the patients more likely to suffer a relapse. Researchers identified these as: age, neurological problems, hypoalbuminemia, cardio-respiratory problems, long duration of operation, and peritoneal contamination.