I was interested to hear about the study from researchers at the University of Sydney and Bond University here in Australia, that concluded that some early-stage cancers could potentially be re-classified as something other than cancer. The reason to do this would be to stop specialists and patients jumping to the most extreme treatment options which may end up causing more harm than good. The specific examples mentioned in the study, published in the BMJ on August 12th were low-risk papillary thyroid cancer, Stage 0 DCIS breast cancer, and slow-growing prostate cancer. The researchers argue that these are conditions are being over-diagnosed as cancer, and often require monitoring, not serious and often life-changing surgeries e.g. mastectomy, prostatectomy, thyroidectomy. They’ve based this looking at patient outcomes over years, to determine if surgical and other invasive interventions at these very early stages of disease, have made a material difference to the benefit of the patient.
Of course, there’s statistics, which is what this analysis is based on, and then there’s people. The word “cancer” carries very negative associations so it makes sense that when you hear it, you want it FAR AWAY from your body. But I wonder if you were told you had a pre-cancerous condition rather than cancer, would you be more or less inclined to agree to surgery? The data shows that when people hear the “C” word, they are more likely to opt for “radical” excision. Perhaps it comes down to educating people more about what words like “stage” and “grade” mean, as these nuances are not often discussed within broader communities. And we’ve been trained to perceive early detection of cancers as a good thing, and I still think it should be the goal. Hashtag, “it’s complicated”!
So what happens next with this information? Well, nothing right now. The big cancer advocacy groups like the Cancer Council have expressed concerns over how reclassifying some early cancers may impact on patient compliance with screening programs and whether ultimately they might slip through the cracks and end up at risk.
So for now this remains an interesting conversation, but it definitely does highlight the need for patients to be fully informed about the condition they’re being diagnosed with, offered a realistic prognosis and given all the treatment options including if applicable “watch and see”. And patients should feel empowered to take the time to make the right decision for them. You need to be able to live with whatever decisions you make in the long-term, so ask your doctor for time if you need it.
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