A rose is a rose, but is a cancer a cancer?
In a July 29, 2013 article Scientists Seek to Rein in Diagnosis of Cancer, NYTimes journalist Tara Parker-Pope discusses the recommendations of an NCI panel that some premalignant conditions should be renamed to remove the word "cancer" or "carcinoma." Instead, for example, they propose for appropriate abnormalities the acronym IDLE -- which stands for indolent lesions of epithelial origin (such as of the breast, prostate, thyroid and lung).
Why? So "patients are less frightened and less likely to seek what may be unneeded and potentially harmful treatments," such as surgery, radiation, hormone therapy.
That some prominent cancer experts disagree with these recommendations reflects the complexity of the issue. At the heart of the problem is uncertainty: Cutting-edge technology cannot predict with certainty which premalignant lesions will transform into life-threatening cancers.
In general, the approach has been to treat everyone aggressively in order to give the best survival advantage to the relatively few otherwise destined to develop cancer. The risk of not treating is obvious -- namely, developing cancer.
The panel feels the risks of treating premalignant lesions have been underemphasized. Today, "hundreds of thousands of men and women are undergoing needless and sometimes disfiguring and harmful treatments for premalignant and cancerous lesions that are so slow growing they are unlikely to ever cause harm."
Proponents of changing the name of precancerous lesions will serve patients by taking the fear out of the diagnosis.
Next: The real issue behind the issue of naming cancer.