Misnamed cancers lead to unneeded treatments

A group of scientists advising the National Cancer Institute has recommended changing the definition of cancer and eliminating it from some diagnoses, according to the Journal of the American Medical Association. The group feels that including the word carcinoma or cancer in certain diagnoses that are not actually cancer frightens patients and may lead them to seek unnecessary and potentially harmful treatments. The report addresses growing concern among physicians and other experts that many patients are undergoing surgery to remove premalignant and cancerous lesions that grow so slowly they are unlikely to ever cause harm. One example of this is ductal carcinoma in situ, which many doctors agree is not cancer. However, because is often referred to as cancer, patients often undergo removal of the breast to treat the condition, which may be unneeded. Other examples occur with legions found on the prostate, thyroid, and lung. The group recommends calling these conditions indolent lesions of epithelial origin (IDLE), instead. Other physicians are resistant to removing the cancer tag from certain conditions because they cannot accurately identify which lesions will become aggressive, deadly cancers. Larry Norton, MD, medical director of the Evelyn H. Lauder Breast Center at Memorial Sloan-Kettering Cancer Center, told The Boston Globe, “Which cases of DCIS will turn into an aggressive cancer and which ones won’t? I wish we knew that. We don’t have very accurate ways of looking at tissue and looking at tumors under the microscope and knowing with great certainty that it is a slow-growing cancer.” The report’s authors suggest a multidisciplinary panel (i.e., pathologists, with input from surgeons, oncologists, and radiologists) meet to address the issue. What do you think?