Was your PSA test slightly high, your Pap smear “not quite right”, your mammogram funny? Did your CT scan detect a teeny weenie nodule and your doctor schedule a biopsy? Cancer!! That’s what they say! You end up with the painful treatment and are proclaimed a “cancer survivor”. But was it cancer?
Since ages, doctors say, that early detection leads to treatment in time, as the cancer spread will be slowed with timely diagnosis. Whether it was the prostrate, lung, breast or thyroid , that’s what the theory stated. The question is- was the cancer actually life threatening in the first place?
Seeing the large number of “early” detected cancer cases Peter Carroll, the chairman of the department of urology at the University of California at San Francisco and a specialist in prostate cancer says “We’ll all be cancer survivors if we keep going at the rate that we’re going.”
The focus towards early detection and early traumatic cancer treatments may actually be pulling the doctors attention away from the fast growing fatal tumors.
Cancer over diagnosis
People do feel that by going through frequent tests and screening procedures they can hold death at bay. Laura J. Esserman (a surgeon and breast-cancer specialist), Ian M. Thompson Jr. (a urologist) and Brian Reid (a specialist in esophageal cancer) argue “Physicians, patients, and the general public must recognize that over diagnosis is common and occurs more frequently with cancer screening.”
They demand that “cancer should be attributed to only those situations that are actually life threatening if not treated in time.
Have you noticed that the rate of cancer survivors is rising because of the detection of the cancers that are non-threatening? So why is it done? The physicians feel that rather than ignore a case that can turn fatal it is better to treat it in time.
Misdirection in research
Esserman, director of the Carol Franc Buck Breast Care Center at UCSF issues a warning signal “the cancers that grow and spread very quickly are not the ones that you can catch in time with screening.”She states that early detection can lead to misdirection in research procedures and the funding allotted for it.
Talking about screening she insisted “We have to come up with better treatments, we have to figure out who’s really at risk for those and figure out how to prevent them,” she says. “We’re not going to fix it with screening.”
We have another example of ductal carcinoma, a type of breast cancer. In this case the walls of the milk ducts show a cell lining that is affected by cancer but this disease has not gone deep into the breast tissue. So may be the cancer survivors went through the painful and traumatic “breast removal” treatment in vain.
Colin Wells, a radiologist at the University of California at Los Angeles specializing in breast imaging gave his verdict regarding this “Since we really don’t know the true natural history of DCIS we do not know if DCIS always progresses to invasive cancer or not.”
As a large number of people are roped in “active surveillance,” through biopsies, regular PSA tests, and imaging . Experts point out that one in three actually needs treatment within 5-10 years.