Doctors propose new names for low-grade prostate carcinoma

It's scary to be diagnosed with cancer. Doctors say that it is time to change the name of low-grade prostate cancer in order to get rid of the alarming C-word.

19 April 2022 Tuesday 13:38
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Doctors propose new names for low-grade prostate carcinoma

Nearly all prostate cancers develop as men age. Prostate cancer is the leading cause of death for about 34,000 Americans each year. However, treatment can cause incontinence and sexual dysfunction.

Changes in the name can help low-risk patients avoid unnecessary surgery and radiation.

Dr. Scott Eggener from the University of Chicago Medicine said that "this is the most aggressive and wimpiest type of prostate cancer that is literally incapable of causing symptoms or spreading into other parts of the body." He is trying to revive a debate on how to explain the threat for worried patients.

Eggener, Monday's Journal of Clinical Oncology contributor, wrote that the words "You have Cancer" can have a profound impact on patients. Eggener and co-authors said that fear can lead to patients choosing unnecessary surgery or radiation.

Others are in agreement. "If you decrease anxiety, you'll lower overtreatment," Dr. David Penson from Vanderbilt University said. "The term 'cancer' puts a mental image in the heads of people: 'I must have this treatment.'

Sometimes, diagnosis starts with a PSA test. This looks for elevated levels of a protein which could indicate cancer. However, it can also detect other causes such as a less severe prostate problem or vigorous exercise.

A biopsy is recommended when a patient receives a suspicious test result. This involves taking tissue from the prostate gland. The pathologist then examines the tissue and scores it for abnormalities.

Patients with low scores -- Gleason 6, are often offered by doctors as a way to avoid radiation and surgery: active surveillance. This involves close monitoring, but no immediate treatment.

About 60% of low-risk patients in the United States choose active surveillance. They might still be concerned.

Penson stated, "I would be overjoyed if people came up a new name to Gleason 6," It will help a lot more men sleep better at night.

Joel Nelson, University of Pittsburgh School of Medicine, stated that dropping the term "cancer" would misinform patients by telling them that there's nothing wrong. While there is nothing wrong with today's technology, that doesn't mean we shouldn't keep track of the discoveries we make.

Name changes have been made in the past for low-risk cancers such as those of the thyroid, bladder, and cervix. There is a debate over whether to drop "carcinoma", DCIS or ductal carcinoma.

The 1960s-era Gleason scoring system for prostate cancer has changed. 6 is now the lowest score. It may be assumed that it is a medium score on the scale of 1-10. It's actually the lowest score on a scale from 6 to 10.

It could be called cancer instead of indolent lesion of epithelial origin. There are two options: IDLE, which stands for indolent lesions of epithelial origin; and INERRT, which stands for indolent rare requiring treatment.

Eggener stated, "I don’t really care what it’s called so long as it’s not cancer."

Steve Rienks (72-year-old civil engineer from Naperville, Illinois) was diagnosed in 2014 with Gleason6 prostate cancer. Active surveillance was his choice. Follow-up biopsies in 2017 & 2021 showed no signs of cancer.

Rienks stated that calling it something else would help patients make informed decisions. However, this is not enough. Patients must continue to ask questions until they feel confident.

Rienks stated, "It's all about understanding risk." "I encourage my male friends to learn more and seek additional medical opinions."

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