Scientists call for stricter definition of cancer

A panel of scientists from the National Cancer Institute is recommending changes in how cancer is defined and treated, calling for the elimination of the word “cancer” in some diagnoses in order to curb patients’ anxieties over slow-growing forms of the disease that may lead them to get unnecessary or harmful treatments.

The NCI panel summarized its recommendations in an article published on Monday in the Journal of the American Medical Association, focusing on what it says is the over-diagnosis of certain kinds of non-fatal, slow-growing tumors.

Doctors, scientists and patient advocates have been concerned that hundreds of thousands of patients are undergoing needless and sometimes disfiguring or harmful treatments for premalignant and cancerous lesions that are so slow-growing that they’re unlikely to ever cause harm //THIS GRAF IS FROM THE NYTIMES STORY – NEED TO TALK TO EXPERTS TO GET THIS INDEPENDENTLY VERIFIED.//

Increased cancer awareness and cancer screenings have led a surge in early-stage cancer diagnoses in recent decades, but later-stage cancers haven’t proportionally decreased along with those screenings and early detections, the panel says.

“Although no physician has the intention to overtreat or overdiagnose cancer, screening and patient awareness have increased the chance of identifying a spectrum of cancers, some of which are not life threatening,” the authors write.

In other words, cancer is a broad term, and some fast-growing types are fatal, while others don’t cause patients significant harm. But because the word “cancer” is so loaded, “cancer is still perceived as a diagnosis with lethal consequences if left untreated,” the authors write, causing doctors to feel like they should treat cancers that are unlikely to ever harm patients.

In particular, breast and prostate cancer screenings have a greater tendency to detect more kinds of cancers that don’t always require treatment.

Colon and cervical cancer screenings, on the other hand, more often lead to early detection of aggressive, harmful types of cancers and have also reduced late-stage forms of the disease.

What’s more, certain kinds of cancer, like Barrett’s esophagus and ductal carcinoma of the breast, are extremely slow-growing and non-fatal, and the detection and removal of those types of tumors don’t actually help to decrease the incidence of invasive cancer.

In order to change the overdiagnosis and overtreatment of cancer, then, the panel suggests changing the language surrounding certain kinds of slow-growing cancers. The term “cancer” should be reserved only for types of the disease that are lethal if left untreated, they write. Some types shouldn’t be called cancer at all, and instead should be labelled as “indolent lesions of epithelial origin,” or IDLE.