Some oncologists are homing in on another cancer they want to see called by other labels: ductal carcinoma in situ, The New York Times reported Jan. 28.
DCIS is a common breast cancer diagnosis which describes cancer cells that are confined to the lining of the milk ducts. For most patients, the cells will not spread or cause problems; though for 25% of patients, it can transform into an invasive breast cancer. More than 50,000 patients receive the diagnosis each year.
Calling DCIS a cancer can make patients feel like they face a medical emergency that requires immediate surgery and radiation, but studies suggest these treatments are unnecessary and overused. Preliminary results from a trial of nearly 1,000 women found that after two years, women who actively monitored the disease did not experience higher rates of cancer than those treated with surgery.
Some oncologists argue that calling the condition something other than cancer can reduce patient anxiety and shift the treatment paradigm from invasive surgery to active monitoring. Some have suggested calling DCIS anything from a risk factor to abnormal cells to precancer to stage 0 cancer.
However, there are some downsides to renaming the disease.
"Like, we're going to call it this code word for cancer, but the patients won't be scared because they won't know what that means," Shelley Hwang, MD, a surgical oncologist at Duke University and lead author of the recent DCIS trial, told the Times. "It's a little disingenuous."
It can also hinder research by severing the link between diagnosis, data and the researchers trying to understand the natural history of the disease and its progression.
DCIS the newest cancer spotlighted in the debate around removing the "cancer" label for low-risk diseases. The goal si to encourage patients to participate in active monitoring when appropriate, which can be difficult to do once the word "cancer" is introduced.