A recent Wall Street Journal article http://online.wsj.com * noted “Removing the word “cancer” from the terminology used for many slow-growing lesions in the breast, prostate, lung, skin and other body areas could ease patients’ fears and reduce the inclination of doctors to treat them aggressively, says a panel of experts advising the National Cancer Institute.”
“….new diagnostic technology is finding ever smaller abnormalities that are unlikely to be lethal, but are being labeled cancer and treated as if they were. The result: billions of dollars in unnecessary surgery, radiation and chemotherapy.”
“Unfortunately, when patients hear the word cancer, most assume they have a disease that will progress, metastasize and cause death. Many physicians think so as well, and act or advise their patients accordingly…,”
Rather than calling them cancer or precancer, the group suggests the term “indolent lesions of epithelial origin,” or IDLE.
Concern over potential overdiagnosis has caused dilemmas for years. An estimated 85% of early prostate cancers are thought to be so slow-growing they wouldn’t cause harm in a patient’s lifetime, but about 90% of these men opt to treat them aggressively—despite the risk of side effects such as incontinence and impotence.
The Lancet article says the same issues exist in breast and other cancers. Studies suggest that as many as 30% of the breast cancers discovered via mammograms in recent years may have been treated unnecessarily.
In skin cancers, the panel said 2.2 million Americans are diagnosed with basal and squamous-cell skin cancers annually, up more than 50% in the past decade. Many of those lesions are removed with surgery that can be disfiguring, though they are rarely fatal if left alone.
In lung cancer, CT scans find many more early-stage tumors than chest exams do, but the smallest have only a 1% to 5% chance of being cancer, the article says, which is why the U.S. Preventive Services Task Force recently recommended that only people at highest risk for lung cancer have CT screening routinely.
* to read the full WSJ article “Rethink the word ‘cancer,’ panel says Aim is to reduce aggressive treatment of slow-growing lesion” by Melinda Beck, highlight and click on open hyperlink http://online.wsj.com/news/articles/SB10001424052702303417104579542220858916560
+ “ Scientists Seek to Rein In Diagnoses of Cancer” by Tara Parker-Pope http://well.blogs.nytimes.com/2013/07/29/report-suggests-sweeping-changes-to-cancer-detection-and-treatment/?_r=0
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