Video of the day

In honor of the Return of Breaking Bad tonight.  Even if you have no interest in the show, this is awesome.  Time to sue some Amish Elders.

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The c word

Interesting article in the NYT a couple weeks ago about how doctors are looking to redefine when we actually use the word “cancer.”  This sounds like a great idea to me.  I think it is fairly safe to say that once many people hear the word “cancer” all ability for rational weighing off possible health outcomes goes out the window (i.e., the huge over-treatment of Prostate cancer).  To wit:

A group of experts advising the nation’s premier cancer research institution has recommended changing the definition of cancer and eliminating the word from some common diagnoses as part of sweeping changes in the nation’s approach to cancer detection and treatment.

The recommendations, from a working group of the National Cancer Institutewere published on Monday in The Journal of the American Medical Association. They say, for instance, that some premalignant conditions, like one that affects the breast called ductal carcinoma in situ, which many doctors agree is not cancer, should be renamed to exclude the word carcinoma so that patients are less frightened and less likely to seek what may be unneeded and potentially harmful treatments that can include the surgical removal of the breast.

The group, which includes some of the top scientists in cancer research, also suggested that many lesions detected during breast, prostate, thyroid, lung and other cancer screenings should not be called cancer at all but should instead be reclassified as IDLE conditions, which stands for “indolent lesions of epithelial origin.” …

The concern, however, is that since doctors do not yet have a clear way to tell the difference between benign or slow-growing tumors and aggressive diseases with many of these conditions, they treat everything as if it might become aggressive. As a result, doctors are finding and treating scores of seemingly precancerous lesions and early-stage cancers — like ductal carcinoma in situ, a condition called Barrett’s esophagus, small thyroid tumors and early prostate cancer. But even after aggressively treating those conditions for years, there has not been a commensurate reduction in invasive cancer, suggesting that overdiagnosis and overtreatment are occurring on a large scale.

Now, nobody’s about to start calling lung cancer or brain cancer something else.   But it’s also pretty clear that “cancer” covers an array of vastly different diseases and that, in some cases, it probably does more harm than good to use the word cancer.

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