Aug 14, 2023 - Economy

Venture capitalist's cancer scare highlights debate over full-body scans

Illustrataion of a doctor holding an MRI scan of a one hundred dollar bill.

Illustration: Gabriella Turrisi/Axios

Robert Nelsen is one of the most successful biotech VCs ever, having backed over three dozen companies that reached billion-dollar valuations. He's also a thyroid cancer survivor who credits early detection to a company in which his firm, Arch Venture Partners, never invested.

Why it matters: There is a simmering medical debate over the value of full-body scans, like the one Nelsen received, and the growing cohort of venture-backed startups that provide them.

  • Advocates argue that such scans can find abnormalities that would typically be missed by a standard physical exam, including conditions that could lead to catastrophic events like aortic aneurysms.
  • Opponents argue that such pricey scans have not been shown to be cost-effective, particularly because they can result in false positives that result in unnecessary follow-up care and/or interventions.

What to know: This is a chicken-and-egg situation. More scans are needed to prove out their value — and possibly help get insurance to cover the high costs — but discouraging their usage will result in fewer scans.

  • Moreover, additional scans could help train AIs to better identify both acute abnormalities and false positives.
  • Some of the providers, like Prenuvo and Ezra, utilize existing MRI technology. Another called Neko Health has developed its own tech stack based on lasers and sensors.

Back to Bob: Nelsen says that he has a family history of cancer, so began getting annual Prenuvo scans around 10 years ago.

  • The early scans showed a nodule in his thyroid, but doctors didn't believe it was problematic. Then a scan in 2018 showed that the nodule had changed, which isn't supposed to happen in healthy people.
  • "When I went into Stanford for surgery, I asked how many patients they'd had with five years of longitudinal data on their thyroid, and they said I was the first," Nelsen tells Axios. "The medical profession is trained to be reactive, not proactive."
  • He adds that the scans also discovered a small scar on his brain, which he assumes came from falling off his bike and getting knocked out when he was 11 years-old.

Elsewhere: Hjalmar Nilsonne is CEO of Neko Health, which he co-founded with Spotify CEO Daniel Ek. Both of his parents are medical school professors, while his brother is a physician.

  • "For my entire life, I've heard that you should only check for things once there is a symptom," he says. "But often that means that the problem has been there for years, and is now at an advanced stage."

The bottom line: One knock on full-body scans is that it's mostly a concierge service being utilized by venture capitalists, celebrities, and other wealthy health hackers. And that's fair.

  • But if venture capitalists maintain their interest, then costs might get subsidized to the point where there are enough scans done to determine whether or not it's a useful technology for the broader population.
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