What? Now You Are Telling Me that I DONʼT Have Cancer After Telling Me I DO?

1930 Manfred Hirzel (German artist, 1905-1932) MelittaOkay, how are you going to feel if I call you back into my office and tell you that you really donʼt have cancer after I told you that you did and treated you for it? Confused? Forlorn? Irate?

I would suppose your would slump in your seat and then call your lawyer. Hold your fire. It is not as it appears. Let me explain.

A blue ribbon panel of cancer experts organized by the National Institutes of Health came out with new suggestions regarding the biological definition of cancer. What the panel suggested is that maybe we shouldnʼt be calling some cancers…..cancer. Sounds strange, but it isnʼt. The panel concluded some entities that we have been calling cancer just arenʼt worthy of the name.

In the realm of breast cancer, the most prominent of these conditions that may not be so cancerous is Ductal Carcinoma In Situ. This is Stage O breast cancer. Theoretically, it has no potential to spread and lead to a fatal outcome. It has been treated in a standard fashion in the past with lumpectomy and radiation therapy or mastectomy. Mastectomy provides a 100% survival. Lumpectomy with radiation therapy and an anti estrogen regime has a survival rate that approaches 100%, but falls a few percentage points short. These are fantastic numbers. Some have suggested that perhaps even radiotherapy isnʼt necessary in a percentage of cases. We are now looking to see if we can better identify those cases.

So, should we call this Ductal Carcinoma In Situ condition cancer? The panel suggest otherwise and asserts that the term should be reserved for those cancers that have the potential to cause more damage. I canʼt argue with this conclusion.

Nonetheless, I suspect that not too many patients with Ductal Carcinoma In Situ will be calling their family and friends to apologize for having exaggerated their problem and offering to refund the sympathy and support they received. And, they shouldnʼt. But it is easy to understand why some may wonder what is going on with this. How can something be cancer one day and not the next? And if this wasnʼt cancer, why was I treated for it?

Good questions and we will take them up in time….