For Low-Risk Thyroid Cancer, Doctors Shouldn’t Use the Word “Cancer”

According to The Guardian, some researchers believe that the term “cancer” should be omitted from some medical diagnoses. Among these diagnoses include those for small thyroid cancer, low and intermediate grade breast cancer, and localized prostate cancer.

Thyroid Cancer Explained

Thyroid cancer is a type of cancer that starts in the thyroid gland located at the base of the throat. Essentially thyroid cancer is a mass of accumulated abnormal cells found inside this organ that have grown out of control. Some symptoms of thyroid cancer include a lump in the neck, hoarseness, and/or other voice changes, difficulty swallowing or breathing, neck and throat pain/swelling, chronic cough, or swollen lymph nodes in the neck. There are a few different types of thyroid cancer that can be diagnosed in a plethora of ways. To read more on thyroid cancer, including treatments, diagnosis, and more, click here.

Banning the C-Word

Recently, a published analysis in the British Medical Journal explained that the word “cancer” should not be used in diagnosing certain thyroid cancers, breast cancers, and prostate cancers as the societal stigma around the word itself could influence patients to undergo unnecessary and intense treatment.

Because technology has become so advanced, doctors are now able to spot early abnormal cell changes and lesions, otherwise known as “pre-cancers.” Though these pre-cancers are detectable at extremely small sizes, they may not ever grow to a size big enough to pose a threat to a patient’s health. As a result, calling these small pre-cancers “cancer” could just put extra stress on patients.

The analysis in the Journal read, “The use of more medicalised labels can increase both concern about illness and desire for more invasive treatment.”

Which makes sense. After all, the word “cancer” is scary for any patient to hear, so there would be no purpose in over-using it when not necessary.

“For decades cancer has been associated with death. This association has been ingrained in society with public health messaging that “cancer screening saves lives.” This promotion has been used with the best of intentions, but is in part deployed to induce feelings of fear and vulnerability in the population and then offer hope through screening,” the analysis continued. “Although the label needs to be biologically accurate, it also needs to be something patients can understand and that will not induce disproportionate concern.”

Where Thyroid Cancer Comes into Play

The published analysis was spearheaded by a researcher from the University of Sydney in Australia, Brooke Nickel. In addition, some researchers from the Mayo Clinic in the United States also contributed as did researchers from Bond University in Queensland.

Nickel expressed that a perfect example of when doctors should not use the term “cancer” was when discussing low risk, papillary thyroid cancer.

“Studies show that progression to clinical disease and tumour growth in patients with small papillary thyroid cancer who choose surgery are comparable to those who monitor their condition,” Nickel said.

A similar situation happens in men diagnosed with localized prostate cancer. Though doctors and health professionals overwhelmingly recommend active surveillance of the condition, the majority of men still go through with radical prostatectomy or radiation therapy to deal with their “cancer.”

“While active surveillance is increasingly being recognized as a safe management option for some patients with cancer, there is still a strong belief that aggressive treatments are always needed,” said study co-author, Professor Kirsten McCaffery.

According to Cancer Council Australia’s CEO, Sanchia Aranda, the scary “cancer” label has effectively been removed from many other types of tumors that are essentially harmless. For example, in cervical abnormalities that are detected in pap smears, using vocabulary that doesn’t include the word “cancer” has already swayed more women into active surveillance of the condition over invasive procedures.

“We would support the authors’ call for a global round table to agree on the literature, and what the best term for some of these conditions should be,” said Aranda.

The Breast Cancer Issue

This notion has far-reaching consequences, not strictly limited to thyroid cancer. For example, Sanchia explained that low and intermediate grade breast cancer tumors (DCIS) were among “one of the biggest problems” in over-treatment and consequently over-diagnosis.

“It was assumed when these lesions were first able to be diagnosed that they would all become invasive cancers,” said Aranda. “It’s becoming clearer that they won’t. For every woman helped with prevention with a DCIS removal, more women will have had unnecessary surgery.”

Due to the improvement of mammography technology, more and more abnormalities are able to be found. That said, these abnormalities are not always something to worry about.

 


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