The word "cancer" conjures up many images, among them fear, death, disability, chemotherapy, radiation, mutilation and anguish.
And although a cure to this multifaceted, complicated and often stealth-like disease might still be frustratingly elusive, a prominent group of scientists, along with the backing of the National Cancer Institute, is recommending something new: that the definition of cancer be changed. With this change, it's inevitable that what might follow is a change in detection, treatment and future research.
I've known many women with a condition known as ductal carcinoma in situ (DCIS), which is considered the earliest form of breast cancer and not life-threatening. DCIS occurs when there are abnormal cells in the lining of milk ducts in the breast. Some women are treated with radiation; others are treated more aggressively with lumpectomies or mastectomies.
Why? Although DCIS seldom spreads, it can—and at this time there's simply no way to know which lesions could become invasive and turn to a more threatening form of breast cancer. Women with DCIS are at greater risk for developing more aggressive forms of breast cancer in the future. As screening becomes more frequent and more precise and sensitive, many more pre-cancers are being found, suggesting that some of those may never have needed to be treated.
Because many doctors agree that many premalignant conditions are not cancer, the recommendations are that the terminology should be renamed and the word "carcinoma" be eliminated to make this type of diagnosis less frightening and to prevent overtreatment where it may not be needed.
Tara Parker-Pope, in her article in today's issue of The New York Times (http://well.blogs.nytimes.com/2013/07/29/report-suggests-sweeping-changes-to-cancer-detection-and-treatment/?ref=health&_r=0) writes:
"The group, which includes some of the top scientists in cancer research, also suggested that many lesions detected during breast, prostate, thyroid, lung and other cancer screenings should not be called cancer at all but should instead be reclassified as IDLE conditions, which stands for ‘indolent lesions of epithelial origin.'"
As a cancer survivor, I'm not sure how I feel about this. I understand that overdiagnosis is rampant, and health care costs are soaring out of control. It's clear that eliminating countless unnecessary medical procedures can possibly save millions of dollars, and hundreds of thousands of patients can be spared potentially dangerous or even life-threatening complications from these procedures.
One thing I think should be considered is the comfort level and personality of the patient. If you were told you had some abnormal cells in your breast, lung or other body part, and there was no definitive way of knowing whether or not they would take a turn for the worse and progress into life-threatening malignancies, what would you do?
Would the terminology the doctor uses affect your comfort level and alter your medical decisions? Would simply changing the language give you a different perspective on your condition?
Perhaps it's also a matter of communication and access to the most up-to-date and reliable medical information.
What do you think?
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