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Top Cancer Doctor Shifts From New Suggestion Against Using Diagnosis

"Our concern is that we wouldn't want patients to think that there's nothing to worry about."

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The severity of a cancer diagnosis has prompted conversations from doctors who wonder if using the word cancer incites an unnecessary fear in some milder cases. Other experts, however, are concerned that not using the word could curb treatments for patients. A new article published on Monday in the Journal of Clinical Oncology, titled, "Low-Grade Prostate Cancer: Time to Stop Calling It Cancer," argued that, for men who are diagnosed with low-grade prostate cancer, the word cancer should not be used. According to the Associated Press, Dr. Scott Eggener, co-author of the article and doctor with the University of Chicago Medicine, said that the lowest-grade prostate cancer, known to have a Gleason 6 rating, "is the least aggressive, wimpiest form of prostate cancer that is literally incapable of causing symptoms or spreading to other parts of the body." The article said that "a major contributing factor to overdiagnosis and overtreatment is the designation of a particular pattern of low-grade cellular changes in the prostate as cancer, which, in our view, should not be called cancer." However, prostate researcher and CEO of the American Cancer Society (ACS), Dr. Karen Knudsen, told Newsweek that evading the term cancer when diagnosing a patient could give them false hope. "Our concern is that we wouldn't want patients to think that there's nothing to worry about," Knudsen said. "That patient without question requires active surveillance." "Gleason 6 cancer is a low-risk cancer, but it is not a no-risk cancer," Knudsen added.
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According to the ACS, prostate cancer is the second leading cause of cancer death in American men, the first being lung cancer. About 1 in 41 men will die of prostate cancer in the U.S per year. "It is the case that we certainly welcome the discussion about terminology," Knudsen said, "But from our perspective, the more important component is having the important discussion about what needs to happen downstream. Not all patients with Gleason 6 cancers are alike." Knudsen said that someone diagnosed with Gleason 6 still risks the possibility of cancer mutating into a more aggressive form of prostate cancer. "So the Gleason 6 or low-risk cancer all on its own is not enough, from our perspective to call it something that's not cancer," she said.
Prostate Cancer
Some doctors are concerned that the treatments of prostate cancer may be curbed if doctors stop calling the lower-grade diagnoses "cancer." In this photo, this photomicrograph revealed histopathologic changes indicative of adenocarcinoma, of the prostate. Smith Collection/Gado/Getty Images
The Gleason 6 diagnosis offers doctors a way to avoid surgery and radiation and only treat a patient with close monitoring without the risk of unnecessary procedures, and some will continue to argue that it should not be coined cancer. Still, Knudsen told Newsweek that no matter what terminology is used, "empowering patients to understand what the diagnosis is, and to understand what should happen next, is an important concept in medicine, and that is what we should embrace full transparency with."