Doctors advocate fewer cancer diagnoses
Cancer is a horror picture for most people. Friends or relatives who have already died of cancer show how quickly it can be ripped out of life. But not every cancer tumor has to end with a rapid death. So many women don't die of breast cancer but with it. Malignant prostate cancer is also diagnosed in many men. Often, however, this grows extremely slowly, so that life is hardly or not at all shortened.
A very interesting debate is currently taking place in conventional medicine. A renowned team of doctors from the US National Cancer Institute is calling for "radical rethinking in cancer therapy". Medical advances in cancer screening for breast, colon, skin, cervix, and prostate cancer can save more and more lives. On the other hand, the highly complex and sensitive equipment can also make minimal changes visible, which only degenerate at a much later time or not at all. Patients who can not or only barely distinguish between minimal changes and cancerous tumors are emotionally burdened by the supposed diagnoses. In addition, numerous unnecessary diagnostic procedures, operations, radiotherapy and chemotherapy are carried out, which damage the body of the person affected.
However, the critics do not come from the ranks of naturopathy, but from the inside of conventional medicine cancer therapy. The top-class doctors Laura Esserman, Ian Thompson and Brian Reid in the US science magazine "JAMA" are calling for far-reaching reform on the subject of cancer. "The term 'cancer' should only be used for changes that are unlikely to lead to death if left untreated," says the team of experts. Cancer precursors or harmless tumors should instead be reclassified and redefined.
The doctors have already made specific suggestions for the radical restructuring that could lead to a massive rethink in cancer treatment. In five points, they put together a package of measures so that patients could benefit from this in the future.
Five-point plan for a few cancer operations First of all, doctors and patients should learn that overdiagnoses are made relatively frequently. This also happens because the screening programs continue to improve and increase in scope. In the second step, the term "cancer should only be used with caution by doctors." Preliminary stages must be redefined. For this, new diagnostic methods have to be developed in order to distinguish aggressive from harmless tumor variants at the molecular biological level. A new registry could be created to differentiate between harmless and less dangerous cancer tumors. In the course of this, new insights can be gradually gained. In addition, the authors believe that overdiagnoses must be significantly reduced. For this purpose, it only makes sense to undertake targeted screening of high-risk groups and to increase the intervals between screening examinations. Researchers and doctors should develop a new understanding of how tumors develop. This enables preventive measures and alternatives to surgical therapy to be designed.
The authors also demand that communication between the doctor and the patient should be much more sensitive. Only if the “patients are properly informed can presumably unnecessary interventions be avoided”.
The topic has been swelling in medical circles for several years. Again and again, individual scientists warn against using the PSA value as a marker for prostate cancer. This would result in many unnecessary operations. The same thing happens through breast cancer screening. For example, it was shown that only one in ten women who had a suspicious finding in the course of mammography actually developed breast cancer. "The new CT screenings of the lungs provide up to one in four findings," says Rudolf Kaaks, head of epidemiology at the German Cancer Research Center, to Spiegel magazine. "We have not yet found the optimal balance between saving lives through early detection and wrong diagnoses."
Cancer is not just cancer However, knowledge does not reach people. Most would overestimate the benefits of early detection. For this reason, fear is decisive and most patients choose to have abnormalities examined further or removed. However, this is associated with many risks. Cancers and their precursors are very different. Decisive are, for example, age, diet, genetics, lifestyle and gender. In addition, cells are still developing in a variety of ways, so that even highly specialized doctors cannot always understand this. So it cannot be predicted whether a small tumor in the breast will grow very quickly or will never cause problems.
Criticism of the restructuring For this reason, other experts consider the reform to be a misconception. "I wish we knew which precursors would turn into an aggressive tumor and which would not," Larry Norton, director of the Evelyn Lauder Breast Center, told The New York Times. "But you can't rewrite centuries-old literature because you suddenly want to change the terminology." (sb)
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