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July 30th, 2013
The lead article in today’s New York Times, “Scientists Urge Narrower Rules to Define Cancer,” describes a natural evolution as our medical procedures become more precise and a whole series of conditions are found that may not be harmful for the patient in the long run.
The group issuing the report came from the National Cancer Institute, and they recommended eliminating the word “carcinoma” for the results of some sensitive screening tests. Many lesions now found are so slow growing that they may never pose any harm to the individual who has them. But since the word “carcinoma” is applied to them, a whole series of invasive and often harmful procedures are used to try to get rid of the lesions.
The problem is called “overdiagnosis,” and the scientists’ cure involves reclassification of these diseases. The problem, however, arises that many of the lesions referred to in the report are not totally understood, and the doctors often do not know whether they will be slow or fast growing. To start to rename them suggests a greater knowledge than modern medicine currently has.
There is no doubt that overdiagnosis is occurring; however, eliminating the use of the word “carcinoma” may be a little bit premature. I would rather know the potential for a disease’s progression than to be lulled into a false sense of security where only the doctor really understands the situation.
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