Jason H. Wasfy is a cardiologist at Massachusetts General Hospital and an instructor in cardiology at Harvard Medical School.
Afew months ago, my 65-year-old mother had “screening” blood tests, which showed inflammation of the liver. She was healthy and had no symptoms of liver disease. The cause of the inflammation was unclear. To investigate, doctors ordered more tests.
As a physician, I have seen how excessive testing can lead to worry and more tests. That seemed to be transpiring — but this time, the patient was my mother.
An ultrasound showed that her liver was healthy. But the same ultrasound also discovered a small, fluid-filled cavity in one of her kidneys. The radiologist recommended a CT scan — a detailed series of X-rays that create three-dimensional images of the entire abdomen — to evaluate the remote possibility that the cavity might be cancerous.
The CT scan, unfortunately, did not settle anything. Like the ultrasound, it did not rule out the possibility of cancer in the kidney. So the radiologist recommended an MRIof the kidney. But that wasn’t all. The CT scan detected other small abnormalities, each of which required more testing. A small spot in the lower part of her lung required a PET scan, which involved injecting a radioactive substance that can highlight cancer cells in certain organs. A spot in the spleen was also possibly cancerous and required a separate MRI. The CT scan of her abdomen simply prompted another series of tests, each of which seemed to resolve nothing.