Drop the C-word to reduce anxiety and over-treatment, say experts
Time to stop telling people with low risk conditions that they have 鈥榗ancer鈥� if they are unlikely to be harmed it.
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The appeal in follows mounting evidence that patients who are told they have 鈥渃ancer鈥� for low risk conditions more often choose surgery than those whose condition is described with terms such as 鈥渓esions鈥� or 鈥渁bnormal cells鈥�.
鈥淭here is a growing body of evidence that describing a condition using more medicalised labels, including the use of the term 鈥榗ancer鈥�, can lead to an increased preference for more invasive treatments,鈥� says听听who co-authored the BMJ analysis with colleagues from听听and听.
鈥淭his supports calls to remove the cancer label, where it is appropriate.鈥�
鈥淎 prime example of this is low risk papillary thyroid cancer,鈥澨齭ays听听who led the analysis.
鈥淪tudies show that progression to clinical disease and tumour growth in patients with small papillary thyroid cancer who choose surgery are comparable to those who monitor their condition.鈥�
It's time to stop telling people with a very low risk condition that they have 鈥榗ancer鈥� if they are very unlikely to be harmed by it.
Similarly, in localised prostate cancer where听听has been a recommended management option for many years, studies show that internationally most men still prefer radical prostatectomy or radiation therapy.
Active surveillance involves closely watching a patient鈥檚 condition but avoiding treatment unless there are changes in test results that show the condition is getting worse.
鈥淲hile active surveillance is increasingly being recognised as a safe management option for some patients with cancer, there is still a strong belief that aggressive treatments are always needed,鈥� says Professor McCaffery.
There is still a strong belief that aggressive treatments are always needed.
The authors say cancer types that could be considered for re-naming include intrathyroidal papillary thyroid cancer (<1cm in size), low and intermediate grade听听(DCIS), also often known as stage 0 breast cancer, and听听(Gleason听鈮�6).
Moves to remove the cancer label aren鈥檛 new, write the authors:
鈥淎n early example of this was when the World Health Organisation and International Society of Urological Pathologists removed the cancer label from bladder tumours. In 1998, they agreed that a condition known to rarely progress to invasive cancer should not be called 鈥榗ancer鈥欌��.
In this change, 鈥榩apilloma and grade 1 carcinoma of the bladder鈥� were reclassified as 鈥榩apillary urothelial neoplasia of low malignant potential鈥�.
A similar change has been made in the labelling of cervical abnormalities detected during a Pap smear, which has supported more women to follow active surveillance in preference to invasive treatments.
鈥淭he evidence suggests to us that it's time to stop telling people with a very low risk condition that they have 鈥榗ancer鈥� if they are very unlikely to be harmed it,鈥� says听.
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