Page 12 - aruba-today-20220419

A12 HEALTH
Tuesday 19 april 2022
Doctors suggest new names for

low-grade prostate cancer

In the U.S., about 60% of
low-risk patients choose
active surveillance. But
they might still worry.
"I would be over the moon
if people came up with a
new name for Gleason 6
disease," Penson said. "It
will allow a lot of men to
sleep better at night."
But Dr. Joel Nelson of Uni-
versity of Pittsburgh School
of Medicine, said dropping
the word "cancer" would
"misinform patients by
This 1974 microscope image made available by the Centers telling them there's noth-
for Disease Control and Prevention shows changes in cells ing wrong. There's noth-
indicative of adenocarcinoma of the prostate. ing wrong today, but that
Associated Press doesn't mean we don't
By CARLA K. JOHNSON of the disease can cause have to keep track of what
AP Medical Writer some patients to overreact we've discovered."
A cancer diagnosis is scary. and opt for unneeded sur- Name changes have hap-
Some doctors say it's time gery or radiation. pened previously in low-risk
to rename low-grade pros- Others agree. "If you re- cancers of the bladder,
tate cancer to eliminate duce anxiety, you'll reduce cervix and thyroid. In breast
the alarming C-word. overtreatment," said Dr. cancer, there's an ongoing
Cancer cells develop David Penson of Vanderbilt debate about dropping
in nearly all prostates as University. "The word 'can- "carcinoma" from DCIS, or
men age, and most pros- cer,' it puts an idea in their ductal carcinoma in situ.
tate cancers are harmless. head: 'I have to have this In prostate cancer, the
About 34,000 Americans treated.'" 1960s-era Gleason rank-
die from prostate cancer Diagnosis sometimes starts ing system has evolved,
annually, but treating the with a PSA blood test, which is how 6 became
disease can lead to sexual which looks for high lev- the lowest score. Patients
dysfunction and inconti- els of a protein that may may assume it's a medium
nence. mean cancer but can also score on a scale of 1 to 10.
Changing the name could be caused by less serious In fact, it's the lowest on a
lead more low-risk patients prostate problems or even scale of 6 to 10.
to skip unnecessary surgery vigorous exercise. What to call it instead of
and radiation. When a patient has a sus- cancer? Proposals include
"This is the least aggressive, picious test result, a doc- IDLE for indolent lesion of
wimpiest form of prostate tor might recommend a epithelial origin, or INERRT
cancer that is literally inca- biopsy, which involves tak- for indolent neoplasm rare-
pable of causing symptoms ing samples of tissue from ly requiring treatment.
or spreading to other parts the prostate gland. Next, "I don't really give a hoot
of the body," said University a pathologist looks under a what it's called as long
of Chicago Medicine's Dr. microscope and scores the as it's not called cancer,"
Scott Eggener, who is reviv- samples for how abnormal Eggener said.
ing a debate about how to the cells look. Steve Rienks, a 72-year-old
explain the threat to wor- Often, doctors offer pa- civil engineer in Naperville,
ried patients. tients with the lowest score Illinois, was diagnosed with
The words "You have can- — Gleason 6 — a way to Gleason 6 prostate cancer
cer" have a profound ef- avoid surgery and radia- in 2014. He chose active
fect on patients, Eggener tion: active surveillance, surveillance, and follow-up
wrote Monday in Journal which involves close moni- biopsies in 2017 and 2021
of Clinical Oncology. He toring but no immediate found no evidence of can-
and his co-authors say fear treatment. cer.
Calling it something else
would help patients make
informed choices, Rienks
said, but that's not enough:
Patients need to ask ques-
tions until they feel confi-
dent.
"It's about understanding
risk," Rienks said. "I would
encourage my fellow
males to educate them-
selves and get additional
medical opinions."q