Doctors Suggest New Names for Low-Malignant Prostate Cancer

The diagnosis of cancer is scary. Some doctors say it’s time to rename low-grade prostate cancer to eliminate the alarming C-word.

As men grow older, cancer cells develop in almost every prostate and most prostate cancers are harmless. Approximately 34,000 Americans die of prostate cancer each year, and treatment of this disease can lead to sexual dysfunction and incontinence.

Renaming can allow low-risk patients to skip unnecessary surgery and radiation.

“This is the least aggressive and most watery form of prostate cancer that can’t literally cause symptoms or spread to other parts of the body,” explains the threat, Dr. Scott Eggener of the University of Chicago School of Medicine. We are reviving the debate about how to do it. For patients who are worried.

The phrase “you have cancer” has a huge impact on patients, Eggener wrote in the Journal of Clinical Oncology on Monday. He and his co-authors state that fear of the disease may cause overreaction in some patients and may opt for unnecessary surgery or radiation therapy.

Others agree. “Reducing anxiety can reduce overtreatment,” said Dr. David Penson of Vanderbilt University. “The word” cancer “has an idea in their minds. “I have to treat this.”

Diagnosis may begin with a PSA blood test. This looks for high levels of protein that can mean cancer, but can also be caused by less serious prostate problems and strenuous exercise.

If the patient has suspicious test results, the doctor may recommend a biopsy that involves taking a sample of the tissue from the prostate. The pathologist then looks under a microscope and scores the sample for how the cells look abnormal.

Doctors often provide patients with the lowest scores (Gleason 6) with ways to avoid surgery and radiation. This is active monitoring with close monitoring but no immediate treatment.

In the United States, about 60% of low-risk patients choose active monitoring. But they may still be worried.

“If people came up with a new name for Gleason 6 disease, I would be over the moon,” Penson said. “It will allow many men to sleep better at night.”

But Dr. Joel Nelson of the University of Pittsburgh School of Medicine said that dropping the word “cancer” would “misunderstand patients by saying nothing is wrong.” There’s nothing wrong with it today, but that doesn’t mean you don’t have to keep track of what we’ve discovered. “

The name change previously occurred in low-risk cancers of the bladder, cervix, and thyroid gland. In breast cancer, there is ongoing debate about removing “cancer” from DCIS or ductal carcinoma in situ.

For prostate cancer, the Gleason ranking system of the 1960s evolved, with a score of 6 being the lowest. Patients may consider it to be a medium score on a scale of 1 to 10. In fact, it’s the worst on a scale of 6 to 10.

What do you call it instead of cancer? Suggestions include IDLE for epithelial-derived painless lesions, or INERRT for painless neoplasms that require little treatment.

“Unless it’s called cancer, I don’t really say what it’s called,” Eggener said.

Steve Rienks, a 72-year-old civil engineer in Naperville, Illinois, was diagnosed with Gleason 6 prostate cancer in 2014. He chose active surveillance and found no evidence of cancer on follow-up biopsies in 2017 and 2021.

Calling it something else would help patients make informed choices, Rienks said, but that’s not enough: patients need to ask questions until they feel confident.

“It’s about understanding the risks,” Rienks said. “I would like to encourage fellow men to educate themselves and get additional medical opinion.”

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