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Taking Cancer Out Of The Conversation

OPB | Aug. 7, 2013 12:30 p.m. | Updated: Sept. 11, 2013 1:17 a.m.

An advisory panel to the National Cancer Institute has recommended changing the names of some precancerous tumors in an effort to lower overdiagnosis and overtreatment.  

The idea is that the word cancer can cause such trauma and fear that it leads to rash and unnecessary procedures. An example of a cancer the panel recommends downgrading is ductal carcinoma in situ (DCIS), what is sometimes called stage 0 breast cancer. Some women undergo mastectomies and chemotherapy to destroy tumors that likely would have never left the milk duct.

This sort of pulling back from cancer detection and treatment has been a hard sell for doctors, thanks in large part to their successes educating the public about cancer. For decades, the most persistent mantra about cancer was early detection. If cancers could be found at nascent stages, the reasoning went, more people could be saved. More and better screenings ensued.

Until a few years ago, this was considered great news. Now, though, there’s a growing belief among doctors and researchers that more detection hasn’t led to greater survival rates and it may even cause more harm than good with some cancers. The most famous example of this change in thinking came in 2009 when the guidelines for mammograms were changed, having women start screening later and less frequently.

Would hearing you had an indolent lesion be less frightening than cancer? Are you a doctor? Would a name change make it easier to assuage patients’ fears?

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