Terminal Terminology: Redefining CANCER

A recent news story about redefining cancer raises the issue of how powerful something becomes depending on what we call it.  In this case, I call it “terminal terminology.”  Cancer diagnosis and treatment is literally a growth industry.  About half of us will get a cancer diagnosis during our lifetime.  A cancer diagnosis raises the fear of death. Unfortunately, with increasingly detailed diagnostic technologies, many of the “cell abnormalities” detected have little, if any, clinical significance — except that it leads to patient stress and overtreatment, a major threat to well-being.

As CBS news reports it:

There has been a “dramatic increase in certain kinds of cancer like thyroid cancer [and] melanoma,” Dr. Agus said on “CBS This Morning,” “Almost a 200 percent increase over the last 35 years.”

The increase is due in part with new technology that is “allowing us diagnose many more cancers,” he explained. “The problem is many of these cancers are not ever going to cause a problem.”

“It’s like if you told a firefighter, ‘Go put out every fire, they’d be blowing water on tiki torches and candles when they don’t need to. It’s the same thing [with cancer]. Many of these cancers are so slow-growing, we need to redefine them.”

The risk of aggressive treatment of slow-growing cancers include unnecessarily undergoing “radical therapy” including surgery and radiation, treatments that could cause “lots of side effects when it’s not needed,” according to Agus.

“Lots of cancers…we don’t need to treat,” he said, citing certain types of thyroid and breast cancers among them, “The key is to treat the cancers we need to treat, so we need a new definition.”

Agus advises doctors to educate their patients about the range of treatment options available, so that patients fully understand potential side effects and ramifications and can weigh them against the risks of living with a slow-growing cancer.

Hopefully, reasonable clinical care will win the day over easy profits and hyperbolic reactions.  Of course, rationality often escapes the human experience.  Technically, the term for unexplained irrationality in the medical care system is “idiopathic idiopathy.”

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