Definition of Cancer Should Be Tightened, Scientists Say

[onehandle]

Source: New York Times

A group of experts advising the nation’s premier cancer research institution has recommended sweeping changes in the approach to cancer detection and treatment, including changes in the very definition of cancer and eliminating the word entirely from some common diagnoses.

The recommendations, from a working group of the National Cancer Institute, were published on Monday in the Journal of the American Medical Association. They say, for instance, that some premalignant conditions, like one that affects the breast called ductal carcinoma in situ, which many doctors agree is not cancer, should be renamed to exclude the word carcinoma so that patients are less frightened and less likely to seek what may be unneeded and potentially harmful treatments that can include the surgical removal of the breast.

The group, which includes some of the top scientists in cancer research, also suggested that many lesions detected during breast, prostate, thyroid, lung and other cancer screenings should not be called cancer at all but should instead be reclassified as IDLE conditions, which stands for “indolent lesions of epithelial origin.”

While it is clear that some or all of the changes may not happen for years, if it all, and that some cancer experts will profoundly disagree with the group’s views, the report from such a prominent group of scientists who have the clear backing of the National Cancer Institute brings the discussion to a much higher level and will most likely change the national conversation about cancer, its definition, its treatment and future research.

Read more: http://well.blogs.nytimes.com/2013/07/29/report-suggests-sweeping-changes-to-cancer-detection-and-treatment

[sybylla]

1. Understandable that there is push-back. I mean without being able to use the c-word...

to scare people into unnecessary tests and surgeries, how on earth will the doctors and clinics be able to pay for all that equipment and earn a decent living?

[dbackjon]

2. That thought ran through my mind

[MotherPetrie]

3. K&R

[KT2000]

4. If they do this

there will be a drastic reduction in the number of cancer cases that will be used by corporations to paint a rosy picture of America's health. They changed survival from 7 years to 5 years, which really increased the numbers of those surviving cancer.
When Reagnut changed the numbers of those employed by counting the military, the media made note of the discrepancy for just a short time.

[Lonr]

5. Precisely

by artificially reducing the number of cancer diagnoses, they can skew the statistics so as to hide the expected increase in the number of cancers per capita as the result of contaminants which are released into our environment in the name of corporate profit.

[SheilaT]

6. When was the survival time changed from 7 to 5 years?

I've only really heard of it as a 5 year survival standard.

Actually, this kind of reduction would tend to reduce the apparent long term survival, since a great many things that aren't likely to turn into real cancer won't be named as cancer.

More to the point, the earlier cancer is detected, the better those long term survival numbers look.

Here's the example. Let's say a person has a condition of some kind that is simply going to kill her at age 60. Sad, yes. Now if she's diagnosed with cancer at age 58, she only has a two year survival. If that same cancer is detected at age 53, even though she still dies at age 60, she survived 7 years, thus beating the five year standard. No matter what she dies from.

I recently read a book describing all of this in great detail. Naturally, I can't recall the title or the author, but as I recall it was an M.D. He went into very careful analysis of various situations and conditions, pointing out there are times when it is reasonable to refuse tests and refuse treatment. He also emphasized very carefully that most of the time it should be a genuinely informed decision, and a joint one between patient and doctor.

[KT2000]

7. good question

I recall in the 90's that survival rate for breast cancer was marked at 7 and now is marked at 5. But as I looked around for an answer I did not find anything about that so I better take it back for now.
People, including media, do though mistakenly use the survival rate as meaning that after that benchmark they are cured.

I see your example but I believe the survival rate for cancer is based upon the stage at which the cancer is detected rather than age. The prognosis for stage 2 could be more than a 5 year survival rate whereas stage 4 is likely less, depending upon the type of cancer of course.

[SheilaT]

9. Probably something like that.

[undergroundpanther]

8. ahh those lazy irresponsible tumors

after all that IS what indolent means...lol

I dunno a tumor ,lesion,or 'growth' is something I don't want in my body.It takes energy and puts strain on the body,indolent or not.

Looking at the terrible pollution our bodies face everyday and the fact cancer is rampant and some chemicals are known to cause cancer end up being used way too much,..reminds me of tort reform that allegedly was about 'trivial lawsuits',remember the hot coffee in the lap stuff that was used to justify tort reform that ultimately benifieted corporations?...The law was redesigned to lessen the damages corporations have to pay to the people they hurt.If you have an indolent(lazy) lesion that's pre cancerous due to exposure to a toxic environment or accident..It saves the pig corporate thugs money if they can claim it';s JUST an indolent lesion,thus not be responsible for damage this lesion might do later as it could become cancer at any time.Also that gives insurance companies an excuse to use less costly interventions and if it's too late and suddenly and it's gone malignant well...

This "redefinition" serves corporate interests on many levels more that it does patients.

[yurbud]

10. to just Rahm Emanuel?

[leftyladyfrommo]

11. I'm glad they are doing this.

How many millions of women have gone thru absolutely awful treatments along with all the fear that is involved for nothing? It's great for the cancer treatment centers who make tons of money on unneccessary treatments.

I simply do not trust the medical people at all anymore. They never seem to be able to find what's wrong with people who really are having problems. Even after thousands and thousands of dollars worth of tests. And they treat people who would be way better off if they were just left alone.

If you do research on the tests that medicine says everyone should have done - mammograms, colonoscopy, etc. it begins to become very clear that many of those invasive tests are very dangerous and can have horrible side effects.

I go to the doctor if I am really sick - like with actual symptoms. The rest of the time I stay as far away from them as I possible can.

[sybylla]

12. Agreed.

Just about every encounter my family has had with doctors in the last 13 years has been purely for profit, not about the actual care. When my mom had breast cancer, we didn't trust the doctors and went straight to the CDC and NIH websites to investigate the best treatment options for her. That way when she went into the doctor's office to discuss her treatment, she already knew what was best for her. She would have been stuck with a slew of god-awful treatments otherwise.

My son's pediatrician used the C-word in front of him purely on speculation when he was 17. Scared the shit out of him for 4 weeks his senior year in high school before he could get back in for another chest xray - only to find that the first technician had the xray machine set up incorrectly and what appeared as some anomaly on the first xray was simply the backside of his ribs.

Last fall, I had a doctor who wanted to do a uterine biopsy on me purely because I was bleeding when I went in for my checkup. Her nurse even got bitchy with me when I called back a couple days later and cancelled the appointment. Turns out I was just experiencing some menopausal irregularity. But, of course, rather than wait a couple of months to see how everything played out, the doctor threw out the c-word and and her nurse tried to intimidate me into doing the test.

And those are just two of many examples of why I will never go to the doctor unless it's necessary.

[leftyladyfrommo]

13. The scary part

is that everyone you talk to has stories that are just horrific as yours.

My female ob/gyn tried to talk me into a hysterectomy when I was 32 so that I wouldn't have to worry about cervical or uterine cancer in the future. I had no symptoms of any kind and was perfectly healthy.

One woman I talked to had an x-ray done for back pain. They found a shadow on her kidney, went in and took her kidney out. The x-ray was in error and she lost a perfectly healthy kidney.

And how many women have suffered through hell itself from a wrong breast cancer diognosis. The numbers are in the millions.

It's horrible.

[sybylla]

14. I especially love the colonoscopy scam

Whether or not you have any family history of colon cancer, they want you to start having those things in your 40's and then every so many years. Puleeeze. Not one hint of colon cancer in my family in 5 generations. Why the hell would I follow their recommendations? If I am ever persuaded to do it without the least symptoms, it won't be before my 60th birthday.

The whole cholesterol thing drives me nuts too. Cholesterol is a factor, but no one seems to know with any certainty if it is a predictor or a cause. But let's test for it and prescribe ridiculous amounts of medications with god-awful side-effects just in case. My grandmother, still doing fine at 87, spent 25 years on cholesterol medicine, even though each of her three siblings, the youngest one 13 years older than her, lived into their 90's and died from old age. Not one heart problem amongst them. Thankfully, she tolerated it well with few side-effects. Finally, when she hit 85 her doctor told her she could quit worrying about it. You think?

I just get tired of hearing all the speculation coming out of doctors' mouths in what sounds instead like a tone of certainty. To a person, they've lost all credibility with me. Every time I think I might have found one who is better than that, it never lasts.

[wordpix]

15. Johns Hopkins killed my father, giving him operation after operation at age 82

Unfortunately, his (2nd) wife was the one approving all but the first operation. He wanted to be left alone after that and sign the do not take extraordinary measures papers in the hospital but she refused and said he was crazy, even though he was of perfectly sound mind - knew the month, year, president, etc. Johns Hopkins went along with his wife's wishes and not his wishes, although he answered all the "sound mind" questions perfectly.

I mostly despise doctors and medical institutions. My mother has Alzheimer's and there's nothing we can do to help her now at age 88 in the advanced stage, except give her daily care of washing, feeding her, encouraging her to walk, etc. Yet her doc suggested she go to J. Hopkins for a special program for a month. I responded that she would probably be so scared out of her mind the program would kill her.

[leftyladyfrommo]

17. That is so sad.

Our medical profession makes dying just awful.

[leftyladyfrommo]

16. I agree with the colonoscopy thing.

Forget that. I read a book written by the head of a big medical teaching hospital and he said he would never get one. People actually can die from those things. They hemorrhage and bleed to death.

The other huge scam out there was the meds for bone strength like Fosamax. The article I read on that said that the company that developed the drug actually paid to put the x-ray machines in the different facilities. Then they came out with this huge program to check your bones every year. That was another thing the head of the hospital talked about. I guess the drugs do make bones stronger but they haven't shown that it helps with fractures. He said the real cause of bone fracture is people being in a very feeble condition. If you are active your bones don't just break.

40,000 to 98,000 deaths per year due to medical error. (Per AMA) Total cost - 17 t0 30 billion.

Preventable Medical errors - 6th biggest killer in America.

Deaths from preventable medical mistakes & infection - 200,000 a year.

14 million colonoscopies are done each year on perfectly healthy people age 50 and up. 70,000 will be injured or killed.
That is 22% higher than annual deaths from colorectal cancer.

And these numbers are low because many deaths and injuries are unreported.