Medicine must treat and, if possible, cure diseases or conditions. There was already a form of medicine in prehistoric times. Plants and herbs were used for this. Modern medicine has more options than just administering herbs or medicines. Surgery, radiation, chemotherapy, hormone treatment, etc. are all means to cure the patient or halt the disease process. But sometimes illness arises that is caused by medical intervention. This could be a wound but also a serious illness such as Addison’s disease or cancer. These are iatrogenic diseases.
What does iatrogenic mean?
As long as humans have existed, there has been medicine. In the past, this was of course different than it is now and diseases were often attributed to the work of evil spirits or demons. Curing diseases was then mainly aimed at combating or appeasing these demons. In prehistoric times, certain medicinal plants and herbs were already used to cure ailments. This probably started from the unconscious: prehistoric man was more self-reliant than modern man. Sometimes a hole was drilled in someone’s skull to allow the evil spirits to escape. This was applied to people with an intellectual disability or a psychological disorder.
Modern medicine means that more and more diseases can be cured or stopped. Diseases that are as old as humanity, but also relatively young (modern) diseases. More than half of people who get cancer are declared cured after five years (figures from 2015). Cancer is a disease that is almost always fatal in the short or long term, so a cure rate of more than 50 percent is a good result. Due to medical developments, this percentage will only increase further.
Although medicine is aimed at curing or alleviating diseases and complaints, medical treatments can also cause diseases or symptoms to arise. We call this phenomenon iatrogenic. This phenomenon already occurred in prehistory, and still occurs in modern medicine. This is not about malicious intent on the part of the practitioner or doctor, but about the unwanted and unintentional development of symptoms due to medical treatment.
Iatrogenic botulism
Botulism is a serious form of food poisoning. The body does not respond to the bacteria or fungi it ingests, but to the toxins that the bacteria produce. These are toxins. Diarrhea and a dry mouth quickly develop. The nerve cells are affected, causing paralysis. The breathing muscles can also become paralyzed. Botulism can therefore be fatal.
Sometimes botulism is iatrogenic. This occurs after use or overdose of botulinum toxin that is not registered. Botulinum toxin is used in the Netherlands under the brand name Botox. In other countries this drug is sometimes used without medical examination. It can also happen that too much is used (overdose). In this case we speak of iatrogenic botulism.
Addison: sometimes also iatrogenic
Addison’s disease or bronze disease is characterized by changes in skin pigmentation. Symptoms are often fatigue, low blood pressure, weak muscles, dizziness, dehydration and especially changes in pigmentation in the skin and mucous membranes. The cause is often an infection, tuberculosis or sometimes a tumor. But Addison’s disease can also be iatrogenic. The adrenal cortex no longer produces cortisol.
The adrenal glands can be damaged by surgery on the kidneys or the adrenal glands themselves. The adrenal glands are also sometimes surgically removed. What causes this will vary. The fact is that damaged or removed adrenal glands can cause Addison’s disease. We call this iatrogenic Addison’s. In dogs, Addison’s disease sometimes occurs after treatment for Cushing’s disease. Remarkable, because Addison’s is rare in dogs.
DES
The artificial female hormone estrogen was prescribed to many pregnant women between 1947 and 1977 under the name diethylstilbestrol (DES). It was supposed to prevent miscarriages. but unfortunately, around 1970 it became known that it could not prevent miscarriages and had adverse effects on both mother and child. Yet it was still used until the end of 1976. Mothers who used DES had an increased risk of breast cancer. For DES sons, this involved testicular abnormalities. The misery was even greater for DES daughters: abnormalities of the uterus, cervix, fallopian tubes, increased discharge and increased risk of cervical cancer, breast cancer and vaginal cancer. All these abnormalities and diseases that arise are therefore iatrogenic.
Iatrogenic wound
A wound can also be iatrogenic. Consider an operation in which an incision (cut) must be made in the skin. This incision is closed using suture material. When the wound has healed, we no longer call it iatrogenic. But the wound can also become infected. In this case we speak of a chronic iatrogenic wound. This must always be treated, because bacteria can penetrate deeper and deeper into the body.
Radiotherapy
Radiation therapy or radiotherapy is used for various diseases, but is best known for its use in cancer. It shrinks the tumor and can sometimes make it disappear completely. Cancer cells are destroyed. It is therefore an important treatment method for various forms of cancer. Sometimes a new type of cancer is created by radiation. This is because radiation also destroys the body’s own cells or causes changes in the DNA. In this case, the new cancer is iatrogenic.
Chemotherapy
The same applies to chemotherapy or chemotherapy. This is also mainly used for cancer, but also for various infectious diseases such as malaria or a worm infection. A chemotherapeutic agent is a substance that is produced synthetically. It causes cell division to be disrupted. This applies to the body’s own cells but also to cancer cells. Because the body’s own cells recover faster, cancer cells can be tackled effectively. Unfortunately, chemotherapy also has a number of adverse consequences. For example, it can actually be carcinogenic. There are patients who have been declared cured of their form of cancer, but years later develop a new form of cancer in return. This is sometimes iatrogenic cancer, caused by the side effects of chemotherapy.
