Sara Szal MD<\/span> <\/span><\/p>\n Busy Philipps is an actor, writer, podcast host, and former star of <\/span>Freaks and Geeks<\/span><\/em>, <\/span>Dawson\u2019s Creek<\/span><\/em>, and <\/span>Cougar Town<\/span><\/em>. If you are between 30 and 50, you may feel as though you grew up with her. She has been refreshingly public about the messy parts of adulting: parenting, divorce, body changes, anxiety, and perimenopause.<\/span><\/p>\n By her account, she was healthy. No headaches, seizures, or weird neurological symptoms that would have prompted a brain scan.<\/span><\/p>\n Then, one day after her former <\/span>Dawson\u2019s Creek<\/span><\/em> co-star James Van Der Beek died of colon cancer at age 48, Philipps finally went through with a Prenuvo whole-body MRI she had been postponing. The scan found a 2.6-centimeter mass in her frontal lobe. A biopsy identified it as a oligodendroglioma, a rare, slow-growing brain tumor. She underwent surgery and recovered.<\/span><\/p>\n Her story is one that many of us carry in the back in midlife: <\/span>What if something is growing inside me right now? What if I feel fine only because it has not become advanced enough to make itself known?<\/span><\/em><\/p>\n Between friends with breast cancer, colleagues with colon cancer, and celebrities announcing diagnoses that seem to come from nowhere, the promise of looking everywhere at once can feel less like luxury medicine and more like responsible adulthood.<\/span><\/p>\n Philipps has spoken publicly about how close she came to never scheduling the scan. It is the kind of story that persuades people to book one, and understandably so. However, it is also why we need to examine whole-body imaging carefully.<\/span><\/p>\n \u201cA scan found my cancer before I had symptoms\u201d is a powerful and important narrative but it\u2019s not necessarily the proof to convince us that screening healthy people with whole-body MRI leads to better outcomes, fewer deaths, or more years lived well.<\/span><\/p>\n A handful of companies have built an entire business model on one promise: scan your whole body, before you have any reason to, and catch cancer or disease while it\u2019s still curable. Here, as of this week, is what\u2019s actually on the market.<\/p>\n Prenuvo is the one Busy Philipps used, a roughly hour-long, radiation-free whole-body MRI. A standalone scan runs $2,499, or $1,199 for their shorter \u201cFocused Scan,\u201d though these days they push most customers toward annual memberships instead, ranging from $1,199 to $5,897 a year, which bundle in blood panels and repeat imaging (<\/span>prenuvo.com<\/span>).<\/span><\/p>\n Ezra, by contrast, starts lower: an MRI-based scan starting at $499, or $899 for a fuller scan if you join their affiliated Function membership, with add-ons for spine coverage and a fuller neuro-and-skeletal workup running up to $3,999 (<\/span>ezra.com<\/span>).<\/span><\/p>\n Neko Health is the newest and the cheapest competitor, opening its first U.S. location in New York City on September 24. At $499, it\u2019s meaningfully more affordable than either of the above, but here\u2019s the catch: it is not an MRI. Neko uses a proprietary, radiation-free scanning rig to capture skin, cardiovascular, and metabolic data, paired with bloodwork and a same-day consult with a clinician (<\/span>nekohealth.com<\/span>). It\u2019s a different tool, built for a lighter-touch kind of screening than Prenuvo or Ezra offer.<\/span><\/p>\n Then there\u2019s GRAIL\u2019s Galleri test, which isn\u2019t imaging at all, but a single blood draw, that looks for DNA fragments shed by cancer cells. It\u2019s designed to flag signals across more than fifty cancer types, several of which have no standard screening test today. It lists for $949, it is not diagnostic on its own, and a positive result requires follow-up imaging or biopsy before anyone knows anything for certain. Insurance, for what it\u2019s worth, usually won\u2019t pay (<\/span>galleri.com<\/span>).<\/span><\/p>\n Share<\/span><\/p>\n Every one of these companies leans hard on stories like Busy Philipps\u2019. The stories are true, the narratives are moving, and they are very effective marketing. What tends to get left out of the marketing copy is that none of these tools has ever been shown, in a randomized trial, to help asymptomatic, average-risk people live longer.<\/span>1<\/sup><\/p>\n The largest meta-analysis of whole-body MRI screening in people without symptoms, pooling more than nine thousand participants, found a cancer detection rate of roughly 1.6 percent.<\/span>2<\/sup> <\/span><\/p>\n A 2026 Cochrane review, looking specifically at whether whole-body MRI or CT reduces death or serious illness came up empty. Mostly the outcome data simply doesn\u2019t exist yet, either for or against.<\/span>3<\/sup><\/p>\n That gap is the real story. Money, attention, and innovation are flowing toward scanning healthy, curious people who can pay out of pocket, while colonoscopies, mammograms, and the other screening tests that already have decades of mortality data behind them stay underfunded, underused, and out of reach for the people who need them most. That is the indictment: not that whole-body scanning is fraudulent, but that the current system rewards novelty and self-pay convenience over what has already been proven to save lives.<\/span><\/p>\n What does reliably show up is incidental findings. Roughly a third of scans turn up something that needs a second look,<\/span>4<\/sup>and in some protocols that number climbs past sixty percent.<\/span>5,6<\/sup> <\/span><\/p>\n Of the findings that get chased down with further testing, about one in six turns out to be a false alarm, nothing at all.<\/span>5<\/sup> <\/span><\/p>\n On the flip side, whole-body MRI is, somewhat counterintuitively, not especially good at catching some of the most common and most screenable cancers (breast, colon, and thyroid),<\/span>4<\/sup> which means a clean scan can create a false sense of security, one that leads people to skip the screening tests that actually do have mortality data behind them: colonoscopy, mammography, low-dose CT for eligible smokers, cervical screening. <\/span><\/p>\n This is super important for you to understand: we cannot skip these proven and potentially life-saving screening tests.<\/p>\n Summary:<\/strong> Whole-body scanning companies (Prenuvo, Ezra, Neko, Galleri) market on emotional “early detection saved my life” stories like Busy Philipps’s, but no such tool has been shown in a randomized trial to help asymptomatic, average-risk people live longer, and the data show a modest ~1.6% cancer detection rate alongside a real risk of incidental findings, false alarms, and missed common cancers. In this post, I argue the real problem is that money and attention are flowing toward self-pay novelty scanning while proven, mortality-reducing screening like colonoscopies and mammograms stays underfunded and underused. I\u2019ve decided to get scanned myself but land on a measured position: know what you’re buying, line up a doctor first, don’t skip proven screening for a clean scan, and treat this as an early, imperfect step toward more individualized medicine.<\/span><\/em><\/p>\n<\/blockquote>\n I\u2019ve decided to get scanned, but I\u2019m going in with my eyes open about what that means in practice: it will, in all likelihood, find something. A cyst, a nodule, a \u201cspot\u201d that\u2019s probably nothing, probably.<\/p>\n Then the harder part starts: deciding, with my doctor, whether to watch it, biopsy it, or simply let it go, all while knowing that chasing down every incidental finding can create its own cascade of tests, cost, and stress, and that cascade may not actually benefit me at all.<\/p>\n My partner, <\/span>BradJacobsMD<\/span>, offers whole-body imaging to his patients at BlueWave Medicine, and in his first hundred patients, he caught at least seven early-stage cancers. That number is real, and it\u2019s part of why I trust this enough to try it myself. But I want to be just as straight with you about what that number does and doesn\u2019t prove. <\/span><\/p>\n A seven percent detection rate is well above the roughly 1.6 percent seen in average-risk research cohorts, which likely says more about who\u2019s walking through his door, patients who tend to be older, more affluent, and more likely to have a family history, than it does about the test outperforming the broader data.<\/span>7<\/sup><\/p>\n \u201cFound a cancer\u201d is not equivalent to \u201csaved a life.\u201d <\/strong>Some of what gets caught, low-grade prostate or thyroid cancer especially, may never have caused harm if it had simply been left alone. Without years of follow-up, we can\u2019t yet say how many of those five detections changed an outcome, versus how many simply handed someone a diagnosis, and the anxiety that comes with it, that they never actually needed. <\/span><\/p>\n That anxiety is another critical point. An ambiguous finding puts your nervous system into a similar threat state as a real one with cortisol up, sleep disrupted, attention narrowed, days or weeks before you have enough information to know whether any of it was warranted. If you already do the work of regulating your nervous system, this is the kind of stressor worth considering in advance, instead of absorbing it later by surprise.<\/span><\/p>\n There is one place where this technology has established evidence behind it, and that\u2019s hereditary cancer syndromes like Li-Fraumeni, where annual whole-body MRI is genuinely standard of care, plus staging for cancers like multiple myeloma.<\/span>8<\/sup> That, though, is a fundamentally different conversation than screening a healthy forty-year-old with no family history and no symptoms.<\/span><\/p>\n Quick one for the <\/span>free subscribers<\/strong>: the annual paid subscription dropped from $125 to $99, and it\u2019s only staying there another week or so before it climbs back. If you\u2019ve been on the fence about going paid for the full protocols and deeper stuff, this is the easiest that math is ever going to look. $99 for the year. Do it before I change my mind (I won\u2019t, but pretend I might). xo, Dr. Sara<\/span><\/em><\/p>\n<\/blockquote>\n If you\u2019re average-risk and asymptomatic, I\u2019m not going to tell you whole-body scanning is a scam, and I\u2019m not going to tell you it\u2019s a lifesaver either, because, honestly, we don\u2019t yet have the data to say either one with confidence. <\/p>\n What I can state: <\/span>know exactly what you\u2019re buying, know that a finding is not a diagnosis, line up a doctor before you scan, not after, and don\u2019t let a clean result talk you out of the screening tests that already have decades of evidence behind them. <\/em><\/p>\n Curiosity about your own body is a reasonable thing to pay for, just don\u2019t mistake it for certainty.<\/p>\n Zoom out, and this is really a proxy fight for a bigger shift already underway in medicine: moving away from one-size-fits-all guidelines built for an average patient who does not actually exist, and toward individualized, risk-stratified care built around your specific history, biology, and goals. <\/span><\/p>\n Whole-body scanning is a crude, expensive, early attempt at that shift, and it is not yet the right tool for everyone. But the instinct behind it, wanting your own data instead of waiting for symptoms to force the question, is exactly right, and it is the same instinct I want this Substack newsletter to keep feeding.<\/span><\/p>\n If you want to go deeper on any of this, including the overdiagnosis data on the specific incidental findings these scans turn up most often, prostate and thyroid nodules especially, let me know, and I\u2019ll do a follow-up.<\/p>\n Have you had whole body imaging?<\/em><\/p>\n\n
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