Avoiding overdiagnosis and overtreatment

First of all, I would like to thank a dear friend for sending me the article that I’m about to discuss. Here’s the link to the abstract: http://goo.gl/0gKKsL. Unfortunately, it is not an open access article, so I decided to go ahead and list a few food-for-thought points…

Let’s jump right in. A group of expert advisers for the National Cancer Institute recently recommended that the definition of “cancer” be revised. They also suggested refining the way cancer is found and treated in order to avoid the overdiagnosis and overtreatment of non-life threatening conditions. 

One of the group’s suggestions is that the word “cancer” NOT to be used to describe smoldering/indolent/inactive or low-risk “lesions.” The word “cancer” should be used ONLY to describe conditions that are likely to progress and that should be treated…that is, only life-threatening conditions.

Aha! 

Think back to the moment when your doctor told you that you had “cancer.”

Boy, I can still remember how I felt back in 2005 when I read those two words, “multiple myeloma,” on my BMB test result: FREAK OUT! PANIC! OH NO, I’M GOING TO DIE! I thought my life was over…

At the time of my diagnosis, it was not explained to me that people with inactive myeloma can lead healthy lives and never ever progress to an active stage…I didn’t know that my risk of developing the active form of this cancer decreased every year…Right now, at year 8, I think my progression risk is about 3% a year…a big drop from that initial, whopping 10%.

Of course, by now you know what I think of statistics… 😉

(Incidentally, it occurred to me that someone might bring up the point that the expression “multiple myeloma” doesn’t contain the word “cancer.” True. But our doctors refer to it as “cancer.” And we are told that it’s cancer…a lethal cancer of the bone marrow...)

According to a member of the above-mentioned group, the danger is that people who are told they have CANCER choose to undergo treatments that may be too aggressive and premature. In other words, fear can lead us to make bad treatment decisions. And, let me add, it can lead us to participate in clinical studies that could really diminish our quality of life (see my previous post)!!!

This shouldn’t be allowed to happen. 

By the way, the article tells us that while screening for cancer has been on the rise in the past few decades, this has not corresponded to a drop in mortality rates, with a few exceptions (the removal of precancerous colon polyps, e.g.). A significant point…

Okay, so what shall we call an indolent condition…a condition that may never become life threatening? Why don’t we give it a pleasant-sounding name? Any suggestions?

Let’s see. Imagine your doctor saying, “Ah yes, you have a condition called ‘B cell burp’…No big deal…Check out Margaret’s Corner…here’s a bottle of curcumin and here are the instructions for taking it, together with a few dietary/supplementation suggestions…and I’ll see you in six months.” 😉 

Or, since cancer is a growth of abnormal cells, we could call its inactive state something like “abcell.” 

Bcellburp and abcell don’t sound that scary, do they?

3 Comments

  1. How about just blood abnormality/ Because it ain’t normal and it DOES progress in high risk patients – and patiens need to know that as well..

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