Nearly every day, a patient — sometimes a few of them — come in worried about the same thing: the Big C. It can be like a cliché from a television show, but some even whisper the word: “Cancer.”

Nearly everyone knows someone who has suffered through chemotherapy or lost a loved one. Many have experienced these things themselves. A lot of people want to know if there is a blood test that will tell them if something is wrong in the hopes there is an easy way to test their whole body to find out if they are at risk for lots of cancers at the same time.

This isn’t surprising. After all, the latest statistics from the Centers for Disease Control say that more than half a million people die from some form of cancer in the United States each year. And there are all of those guidelines suggesting colonoscopies, mammograms, prostate testing, lung scans and much more. Just keeping up to date on those guidelines can be a challenge for medical experts.

We need to give more attention to recognizing heart disease before sudden attacks that often prove fatal.

Flickr: Nicolas Raymond

But there is a danger worse than cancer. Most people don’t realize that they are more likely to die of heart disease, than all types of cancer combined.

Hawaii oncologist Dr. Ian Okazaki says that people are 10 times more likely to die from heart attacks than colon or breast cancer, but everyone fears the suffering that cancer patients go through. It’s out there for all to see. When it comes to heart attacks, there are often no signs until it happens. Sometimes, not even then.

Heart disease has been a worsening problem among women for more than 30 years. One in three women die from it, while one in four men do. Worse, more than half of the men who die have no symptoms of heart disease beforehand. None.

So why aren’t we doing more to develop screening tests for heart disease so we can advance, as we have in diagnosing cancer?

Just this past year mammograms have gone 3-D, colonoscopies might be replaced by fecal DNA testing heralded as the next big advance for colon cancer detection, and even CT scans of the lungs are recommended for one-time heavy smokers to promote early diagnosis of potentially fatal lung cancer.

What about heart attacks? Well, the technology we have today is great if you have symptoms. But by then, for many people, there isn’t much that can be done.

So why can’t we scan the heart like we scan the rest of the body and figure out who is the most likely to face trouble.

It’s not that we haven’t tried. Years ago while I was in training at the Mayo Clinic in the late 1990s, initial studies were being done with a CT scan that looked at calcium build-up in the heart, giving a score that could predict risk for a heart attack in the near future. Emergency room doctors were using CT scans to determine who needed to be monitored in the hospital overnight versus those who could probably go home without much concern.

The test was believed to be fairly accurate, but still, not a perfect model of the blockages that develop in the arteries to the heart, which is often a warning sign of trouble to come.

Then came along the CT angiogram, a less invasive alternative to the traditional angiogram, which involved threading a catheter through the arteries in the groin all the way to the heart. Both tests injected dye into the body to see where blockages were hiding and whether they needed to be opened before something bad, like a massive heart attack, happened.

But even now, it’s hard to find a medical center doing CT angiograms, and it is not usually covered by insurance, even with a diagnosis of heart disease.

But that’s where technology for prevention seems to have stopped. Of course, after someone has heart problems, there are all sorts of fancy devices that can be inserted into the blockages — if they are discovered in time.

Stents, now even ones with medicine embedded in the metal, can be deployed to affected areas, but only a lucky few will have these placed before their heart suffers permanent damage from some type of attack.

But what happened to prevention?

These days, the tests that we have done for the last 50 years are the same ones we use to determine heart attack risk. Cholesterol testing, blood pressure, sugar tests; these are the mainstays of risk assessment.

No 3-D images, no virtual reality of the arteries, nothing more than a reliance on symptoms and outdated results of stress testing. Although helpful, even stress tests can only detect blockages by pushing the heart beyond its capacity — under medical supervision, of course.

In this era of medical advances, we need to find a way to accurately diagnose those at risk and find better interventions than we have right now. Aspirin, cholesterol medication, blood pressure pills; these can all be lifesaving, but it seems like that’s all we have, and even with that, we don’t have studies demonstrating that taking these pills prior to having a heart attack are really the best answer for prevention.

If we follow the statistics, more people die of heart disease than any other cause in Hawaii, the United States and the world.

It makes sense to do research to find a new technological breakthrough that might save a lot of lives — and hearts — from great suffering.