Thursday, March 13, 2014

DCIS - Who gets too much treatment?


 Redefining cancer to reduce unnecessary treatment

By Modern Healthcare 
Posted: March 8, 2014 

Modern Healthcare’s article this morning had an excerpt of an interview with Dr. Otis Bradley, CMO of the American Cancer Society.  I’m trying to pinpoint what's new there.   

  His definition, “Cancer is uncontrolled cell growth” leads to  “we believe that 10 % to 30% of all of our localized {breast} cancers are overdiagnosed cancers. These are women who will be treated needlessly.”  He discusses genetics of cells--which ones are likely to grow and kill, which not.  You may have seen some of those ideas on medpage “hot topics” video.

Like some other women after diagnosis, I looked on the web and  even bought the Mayo Clinic Cancer Book.  But I had to stop and realize that much information may not have been found by some patients, and may be rejected by many doctors.  

I was given a copy of my DCIS needle biopsy pathology report, and I read it carefully, because I wanted to be one of the women who may simply go home, watch, and wait.  I didn’t want to think about radiation.  

But when I saw the “levels” on the report,  where my tumor fell on those levels, and that mine was hormone dependent, I was sure radiation would be recommended along with other treatments.  In other words, I was not in Dr. Brawley’s ten percent of needlessly treated.  But what about other women?  

Are other doctors and other areas using less specific or accurate biopsy?  Or what?  Are other doctors using surgery and radiation for even the lowest levels of tiny tumors? 

Are women demanding more treatment for the lowest levels of tumors?  One thing I do know:  fear is an incredible motivator.  Get it out of me!  Kill it!  That all goes through our minds sometimes.

What doctor refuses demands like that?

Much of Dr. Brawley's information has been available for some of us, at least for women who had access to research on the Internet, knew where to look, who even bought the Mayo Clinic Cancer Book.  I remember trying a Sloan Kettering interactive questionnaire on my level and type of tumor, and the statistics were convincing.    But I have to stop and realize some findings may be rejected by doctors.

And, who really advises women to look up a famous hospital on line and take its interactive questionnaire?   Would all women do that?  Cancer strikes women who can’t even read English.  All they have is memories of breast cancer funerals, and doctors who will take them as patients. 


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