Rethinking the benefits of cancer screening
With leaps of advancement in medical science and treatment options, one sometimes wonders what mankind did before these techniques were developed! A similar discussion is emanating among the oncologists with regards to cancer screening, especially cancer screening for breast cancer and prostate cancer.
For years, screening has been touted as a great method that can allow physicians to detect a cancer at an early stage. Early detection has been put forth as one of the key factors that determine whether the treatment options used shall be able to successfully remove the cancer completely or not.
Cancer screening has allowed a higher level of detection and it is known that the diagnosis of breast cancer and prostate cancer has more than doubled since 1980. With better screening methods, a higher number of men and women are being diagnosed with potentially dangerous tumours. The absence of a decrease in the mortality rates of breast cancer and prostate cancer, however, has raised alarms about the relevance and need for cancer screening.
Physicians from University of California and University of Texas published a report in the Journal of the American Medical Association elaborating on concerns that the medical fraternity was beginning to feel about cancer screening. It also detects tumours that are not life threatening. These are tumours that would have probably gone unnoticed had the cancer screening not been done. However, there is also a high probability that these non-life-threatening tumours would have not caused any trouble and even regressed without any treatment.
A DCIS (Ductal Carcinoma in Situ), a low grade breast cancer is a condition that was not detectable before the days of mammography but is found in about 30% of the breast cancer cases reported in the US. The PSA (Prostate Specific Antigen) test is another case in point. The PSA test that checks protein levels in blood sugar led a large number of men running to get a biopsy done. The national Cancer Institute reported that only 25% to 30% of these men are actually diagnosed of prostate cancer.
It is ironic that while cancer screening does pick up cases like DCIS, the more lethal forms of cancer that are fast growing can be missed out in such screening sessions. It has been seen that even when these critical cases are detected, the patients cannot be saved from an early death.
The medical researchers, therefore, wonder whether cancer screening is doing more harm than good. In most cases a low grade cancer patient is told to 'wait and watch'; something that is fairly unpalatable for the patient. Constant worry, in most cases, leads to a decision to go ahead with therapy. And we all know the side effects that cancer treatment can bring along in its wake. "We may be harming anyone with DCIS", Laura Esserman, MD, a professor of surgery and radiology states. Over treatment of non-life-threatening prostate cancer can also result in treatment options that cause urinary issues and lack of sexual function.
Advancements in the medical arena are great achievements that are being made possible by the contributions of many research and development personnel in this area. However, given that we still do not understand the human body completely, all new developments should be evaluated objectively and used judiciously.