22 April 2022

Low grade tumours should not to be labelled as ‘cancer’ to reduce patient anxiety, says new paper

Is it time to remove “cancer” label from low risk prostate tumours? A multidisciplinary team of experts writing in the prestigious Journal of Clinical Oncology think that it is, to ease alarm among patients and families and reduce the risk of unnecessary treatment.

Physicians are increasingly recommending active surveillance approaches for low grade tumours which are unlikely to spread, judging the risks of treating with surgery or radiotherapy to be greater. Yet these lesions are still termed “cancer” – a word that many associate with an aggressive and potentially lethal disease. Use of the C-word may be encouraging patients to opt for treatments they don’t need, say the authors of the JCO paper.

Fewer than 1% of men with tumours that rate 6 on the Gleason Score (GS6) experience metastatic disease or die from cancer within 15 years of the initial diagnosis, says lead author Scott Eggener, MD, a urologic oncologist and professor of surgery at the University of Chicago.

"No matter how much time a physician may spend downplaying the significance of a GS6 diagnosis or emphasising the phrase low-risk, the words 'you have cancer' have a potent psychological effect on most men and their families,” says Eggener.

“We believe that a name change should be thoroughly discussed, vetted, and ultimately adopted. If ultimately deemed appropriate, there will be predictable and unforeseen obstacles, requisite educational campaigns, and large-scale implementation efforts. Nevertheless, we feel that rescinding the cancer label from GS6 would dramatically improve individual and public health. The data are compelling, the moral imperative is sound, and the time is overdue.”

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