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ru24.net
Thecut.com
Октябрь
2023

Prenuvo Wants to Put Your Mind at Ease

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Like many of Prenuvo’s customers, Elle Oglesby heard about it on Instagram. “I was kind of immediately sold,” she says, after coming across an influencer who pushed the full-body MRI scan in an effusive, infomercial-style video: “If you want to take control of your health, book your Prenuvo scan today!” Oglesby suffers from migraines, for which she’s undergone several MRIs. But the headaches were getting worse, and Prenuvo’s technology, she learned from the company’s website, was purportedly superior — “They have some sort of revolutionary machine, supposedly.” After scrolling through more endorsements, the 48-year-old mom of four was convinced a Prenuvo scan might tell her something her other MRIs had not. “I have young kids, so I just wanted to make sure that there wasn’t anything I didn’t know about,” she says. “I just wanted to make sure I didn’t have a cancer somewhere.”

Last December, Oglesby booked a full-body MRI scan at Prenuvo’s Dallas location for $2,500 (the company does not take insurance). Two weeks later — the Friday before a long New Year’s Eve weekend — she got a call from a Prenuvo customer-service representative who explained that Oglesby’s scans had not come back clear and that a nurse practitioner would call her to review them next week. “I was like, well, what was found?” says Oglesby. “They were like, ‘Well, we can’t tell you that.’” The following Tuesday, she got the call. Her scans showed a lesion on her kidney, which the nurse advised her to look into. More urgent was a round, quarter-size circle on the left side of her brain. “An indeterminate lesion of the brain can potentially be a benign or a malignant lesion,” read the results. “Unfortunately we are unable to determine the exact nature of the lesion.” The nurse told her to follow up with a neurologist, then hung up.

Oglesby sent the report to her neurologist, who scheduled her for a dedicated brain MRI. Then she started to panic. “I was totally freaked out. I was thinking, What if I die and leave my kids without a mom?” As she awaited the new results, an ultrasound revealed the kidney lesion to be some scar tissue — nothing to worry about. Then the brain MRI also came up clear. The additional testing — which insurance didn’t cover since Oglesby hadn’t met her deductible — cost her another $2,500 out of pocket. When she asked a Prenuvo customer-service representative about the discrepancies, they couldn’t give her an answer.

But Oglesby was still worried Prenuvo had caught something her other MRIs had missed. “Because that’s what they say, right? They say, ‘Our machine picks up things down to one centimeter that other MRIs don’t.’” For the next two months she tried to contact Prenuvo, to speak to the radiologist who did her report or any radiologist, really. But she had trouble getting past customer service, and was eventually told by a rep that a chat with a radiologist would cost another $4,000.

Prenuvo bills itself as “the most precise, comprehensive whole body MRI scan that exists today” and claims it can detect “up to 500 cancers and diseases.” It isn’t the only company of its kind, though it has raised the most money since its 2018 founding — more than $70 million from investors including Cindy Crawford and 23andMe billionaire Anne Wojcicki. Its leadership team includes a chief marketing officer from Juul, a communications lead from TikTok, and a head of expansion from WeWork; it has eight locations with up to 12 slated to open in the next year. According to Bloomberg, dozens of companies have begun offering Prenuvo’s “potentially life-saving” scans as a corporate perk.

And whatever your algorithm, there’s probably someone in your feed promoting Prenuvo. In addition to countless microinfluencer nonentities, the start-up has been endorsed by Kim Kardashian, country singer Chris Stapleton, and an endless list of Real Housewives and Victoria’s Secret models. Kris Jenner’s Prenuvo scan was the focus of her story line in a recent episode of The Kardashians, and E! presenter Maria Menounos says Prenuvo caught her stage-two pancreatic cancer, saving her life. On Instagram, Prenuvo’s tagged images are full of photos of these people in a kind of “Prenuvo pose”: The patient in branded scrubs, perched daintily in front of Prenuvo’s sleek, white, branded MRI machine. Influencers’ endorsements, which usually include a $300 discount code, sound eerily similar — the phrase “peace of mind is priceless” recurs so often it seems to be the company’s unofficial tagline.

But some people, after being scanned by Prenuvo, are left with more anxiety than they had before. A number of patients I spoke with said they received inaccurate reports or were advised to undergo additional testing on false positives, shelling out money for further treatment only to discover there was nothing wrong in the first place. When I asked Dr. Matthew Davenport, a radiologist and vice chair of the American College of Radiology’s quality and safety commission, about Prenuvo, he was wary. The company, he says, is “creating an economy by identifying findings that likely would never hurt an otherwise healthy patient, and turning them into ‘patients’ with findings that nobody really knows what to do with.”

This is just one of the reasons professional medical societies like the American College of Radiology and the American College of Preventive Medicine (ACPM) advise against full-body MRI screenings for healthy people. “You take a healthy patient — who would otherwise be completely fine — and you treat their anxiety by charging them $2,500 and telling them they have things inside their body,” Davenport says. “You take a really nervous person, and you sell ‘em something and promise the moon, and it cannot deliver.”

He notes that results unrelated to the patient’s chief concern are common with MRI; as many as 20 to 40 percent of older patients get these “incidental findings.” “The vast majority of these are false positives and are totally benign,” says Davenport. “Or it might technically be a cancer under a microscope, but it’s so low risk, if it had never been identified in the first place, it would never hurt the patient.” The trouble is that these results are flagged on radiology reports, and are identified as important when they are not. The subsequent testing, biopsies, and procedures (not to mention the stress of thinking you might have a deadly cancer) are what become harmful to the patient. “When you take an imaging test and apply it to a low-risk population, what you end up finding is dominated by low-risk stuff that would never hurt you, but finding it forces your doctors to do stuff about it.” This has, historically, caused population-level harm — a thyroid-cancer screening program implemented by the government of South Korea in the aughts, for example, failed to reduce thyroid-cancer deaths, instead leading thousands of people to suffer from thyroidectomy complications.

When reached for comment, Prenuvo said some medical details of patient accounts were “factually incorrect” but declined to comment further regarding specific patients, citing privacy concerns. “Screening is all about stratifying risk and we feel very confident about our techniques and our rate of accuracy,” CEO Andrew Lacy wrote. “When we see something particularly concerning, it is our responsibility and in the service of our patients to be cautious and recommend a follow-up. This is how we’ve alerted on average 1 in 20 patients to potentially life-saving findings.”

Several patients said that when they approached Prenuvo about inaccurate results or asked to speak to medical professionals, they never heard back or were tossed to various customer-service representatives. That was the case for Rachel Siatkowski, a 41-year-old Illinois woman who began to have trouble walking nine months ago. After multiple specialists failed to diagnose her, she came across Prenuvo on TikTok. She booked a scan in the company’s Chicago location — a four-hour drive from her home — and stayed the night in a hotel. She’d been frustrated by the slow pace of the traditional health-care system, and Prenuvo’s booking experience was quick and easy (you need a doctor’s referral, but Prenuvo will provide it). When she arrived, she was impressed by Prenuvo’s pretty office and post-scan snacks.

Siatkowski was hopeful Prenuvo would be able to help her until she got her results, which were riddled with inaccuracies — for example, it said she had a piece of hardware in her foot, though she has none. It also missed her scoliosis, which previous MRIs had indicated. When she called Prenuvo to report the mistakes, she says it was two weeks until she heard back, and though she asked to speak to a medical professional, she faced a wall of customer-service reps: “Nobody of authority actually contacts you,” she says. According to Siatkowski, the reps insisted her results were accurate, and said Prenuvo’s radiologists had noticed the scoliosis but didn’t think it was worth including in the report. “They prey on people like me, who are in some sort of medical crisis and desperate for answers,” she says, “and they’re like, Oh, here, we can help.” 

Influencers’ endorsements sound eerily similar — the phrase “peace of mind is priceless” recurs so often it seems to be the company’s unofficial tagline.

Oglesby, the Dallas-based woman whose Prenuvo scan falsely indicated a brain lesion, says she only heard back from the company after leaving negative reviews on social media, where other Prenuvo customers have complained about false positives and inaccurate reports, as well as being scanned at third-party facilities by people and machines unassociated with Prenuvo. (On Yelp, Prenuvo’s CEO has responded directly to reviews, asking people to update negative ones.) In March, three months after her first scan, she got a phone call from one of Prenuvo’s operations managers, who invited her back for a complimentary scan. “That’s the only time I actually heard back from someone,” says Oglesby. “So I went back in, and they rescanned my brain, and there was nothing there.”

Prenuvo’s most enticing assurance is that it leaves customers with what it calls “a clean bill of health.” “The reason I got a Prenuvo scan is because I’m a hypochondriac,” says Isamar Avery, a 32-year-old social-media marketer based in Miami. After combing through the company’s social-media accounts (which are full of posts that say things like, “Do you always feel tired? It could be more serious than you think”), she booked a scan. “I read so many testimonies about people who found cancer and pancreatic cancer — I think Maria Menounos was one of them — and I was like, Oh my god, it’s not just a fad.” Her scan told her that there was a mass in her brain, though an MRI she underwent a year before, after hitting her head, had been clear. She’s now undergoing additional testing. “I’m proud of myself for taking control of my health; I’m proud of myself for spending over $2,000, ‘cause it ain’t cheap,” she pauses. “But peace of mind is priceless.”

Prenuvo, however, is just an MRI, and there are all kinds of diseases MRI can’t detect, like coronary artery disease, the leading cause of death in America. The most common and lethal cancers — including lung, prostate, skin, and colon — are also not screened for with MRIs, says Dr. Jeff Weinreb, director of MRI services at Yale–New Haven Hospital and a professor of radiology and biomedical imaging at the Yale School of Medicine. “It provides a false sense of security,” Dr. Mirza Rahman, president of the ACPM. “You could think, I had the full body scan, and they said I was fine.

Even when Prenuvo does correctly identify a finding, the experience isn’t as comforting as social media suggests. Katie Nelson, a 38-year-old tech worker based in the Bay Area, was scanned by Prenuvo along with her husband. His radiology report indicated a low-grade brain tumor that would have eventually led to headaches and seizures. In August, he got the tumor removed, preempting symptoms.

This is the best-case scenario for Prenuvo: The Nelsons were alerted to what could have become a life-threatening diagnosis. But everything that happened after that, she says, was a mess. First, the couple was informed of the possibilities in a brief and confusing phone call with a Prenuvo nurse practitioner. “She called it ‘a clump of cells,’” says Nelson. “Which is one unique way to say ‘brain tumor.’ Like, please use language that we understand — that explanation was so piss poor.” Then, her husband’s radiology report described the mass as either a glioma or glioblastoma — two very different kinds of brain tumors. Glioblastoma is the most aggressive, and, as Nelson points out, “one of the most terrifying, worst cancers you can be diagnosed with.” The prognosis is low — about ten months.

At this point the Nelsons were terrified; they were also on their own. Although the company had asked for their primary-care information, it never made contact — in fact, Nelson had to “go to Best Buy and buy a CD writer like I was in the ’90s” to upload and share the scans with her husband’s physicians (Prenuvo says it does send patient reports to doctors when requested). His doctors subsequently diagnosed him with a much more treatable grade-II glioma and were shocked that glioblastoma had ever been suggested. (Dr. Jennifer Moliterno-Gunel, a board-certified neurosurgeon at Yale Medicine, says the two tumors look very different on an MRI and that it’s unusual to have glioblastoma on a report unless the radiologist is certain. “It sounds to me like that wasn’t a very knowledgeable radiology report,” she says, “and underscores the fact that this is a very crude and preliminary screening test.”)

Ruling out lethal brain cancer was a relief to the Nelsons, but their experience with Prenuvo, in retrospect, was a poor one. “I would’ve loved advice, like, ‘Hey, what insurance do you have? How can we help you navigate something this big?’” says Nelson. Her husband’s tumor could come back, and he will be “forever scanned, every six months, just like getting a teeth cleaning.” Just not with Prenuvo.

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