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Finally, Some Good(ish) News on the Cancer Front


Hundreds of thousands of Americans are undergoing unnecessary and harmful cancer treatments every year because the medical establishment has been using outdated definitions. Fortunately, the National Cancer Institute has published a paper recommending changing the definition of the disease and renaming certain conditions. NYT:

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….

“We need a 21st-century definition of cancer instead of a 19th-century definition of cancer, which is what we’ve been using,” said Dr. Otis W. Brawley, the chief medical officer for the American Cancer Society, who was not directly involved in the report.

New technology is part of the problem driving cancer overdiagnosis. Innovative detection methods now allow doctors to pick up widely on “incidentalomas,” or ” premalignant and cancerous lesions that are so slow growing they are unlikely to ever cause harm.” But when these are found, patients alarmed by the word “cancer” may conclude that they have to get operated on. The costs of this across all dimensions—financial, physical, psychological—are enormous. If the NCI’s warning is heeded, a lot of wasteful spending and meaningless suffering could be avoided.

Med tech has huge potential to bring down costs and reduce quality, but all tech is a two-edged sword. As it improves our ability to treat all manner of illness, whether real or perceived, it can also exacerbate the problems of overdiagnosis and overtreatment. When you combine that with the fear of aging and death that can drive Americans to seek invasive life-extending measures, you have a dangerous combination. It will take a determined, well-coordinated movement by doctors, insurers, and patients to reduce medically unnecessary procedures. Reining in cancer treatments is just the beginning.

[Hospital technology image courtesy of Shutterstock]

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