Wednesday, August 30, 2023

Opinion Today: Not everything we call cancer should be called cancer

Why, in the wake of medical advancements, we should be especially careful with the label.

By Chris Conway

Senior Staff Editor, Opinion

Not all cancers are equal. Some grow fast, some slow. Some kill quickly, others may be so sluggish that you'll die of something else before those errant cells multiplying inside you prove fatal. And yet all those conditions are called cancer, a fearsome name that, as the writer Susan Sontag put it in 1978, conjures "an evil, invincible predator, not just a disease."

Treatments for cancer for the most part have vastly improved since then, and yet the connotation the word invokes is a death sentence. A friend was diagnosed a few years back with what he described as early-stage prostate cancer, and though his doctor suggested watching to see how it progressed, he wasn't interested in waiting. He wanted surgery, immediately. "I don't want that thing growing in my body," he told me.

This is the problem with the word "cancer," write two cancer surgeons in a guest essay today. Hearing that diagnosis, they write, "the patient's assumption is that, without treatment, their condition will rapidly or ultimately lead to metastases and death." That is not always the case. Yet it's no wonder patients often opt for aggressive treatment they don't need. And the problem with those treatments is that they can lead to other medical problems and psychological and financial difficulties.

The essay's authors are Laura Esserman, a surgeon and breast cancer oncologist, and Scott Eggener, a surgeon and urologic oncologist. Their focus is on the two most diagnosed cancers in the country.

They argue that for many early-stage, low-risk cancers, the term doesn't match how the disease behaves. Getting rid of that name and all its baggage would encourage clinical trials or other alternatives to unnecessary treatment and ease the stress on patients and their families.

"That's why," they write, "we need to rethink what we call cancer."

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