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If it's cancer, we must operate - or not, according to study

A diagnosis of cancer is never easy. It is a scary word for a patient to hear, and it is a complicated diagnosis for a doctor to explain. Cancers differ depending on a number of factors, including how early the cancer is detected and where the cancer is. Over the years, researchers have discovered that some cancers grow quickly and others very slowly -- so slowly, in fact, that they will never pose a threat to the life of the patient.

Imagine, though, being a doctor sitting down with a patient who is waiting for test results. "The biopsy," you say, "has come back, and yes, you have cancer. But this type of cancer grows very slowly, so we take a different approach. This type of cancer is rarely malignant, so you won't have to go through chemo or radiation treatments!" You smile and clap your hands together, so pleased that you can give the patient some good news.

Now imagine you are the patient. Do you hear anything past "you have cancer?"

It is almost understandable, then, that the patient will insist on aggressive treatment. And it may make sense, too, that the doctor, afraid of a medical malpractice lawsuit, obliges. The patient goes through treatment that often includes surgery.

Researchers have found that some prostate, breast, lung and thyroid cancers fall into the "slow-progressing" category, and a study published recently in JAMA Otolaryngology supports the argument. This study found that the number of cases of thyroid cancer has nearly tripled over the past 40 years.

The increase can be attributed in part to advances in technology and a trend favoring early detection of cancer. The sense in the medical community has been that the earlier cancer is diagnosed, the better chance the patient has to survive. Unfortunately, according to one of the study's authors, "Our old strategy of looking as hard as possible to find cancer has some real side effects."

Just what those side effects are will be explained in our next post.

Source: TwinCities.com, "Thyroid cancer cases have soared," Lindsey Tanner (Associated Press), Feb. 20, 2014

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