Originally published in July-August 2004 icon
Over diagnosis of Prostate cancer
The Guardian (May 26th 2004) reported an article by the Institute for Cancer Research which suggested thousands of men may be putting themselves at unnecessary risk of serious side effects - like impotence and incontinence - by opting for radical surgery and other treatments rather than a simple programme of ’active surveillance’.
As many as 50 per cent of all men diagnosed did not need invasive treatment
Apparently 11 years of ’active surveillance’ at centres like the Royal Marsden have suggested as many as 50 per cent of all men diagnosed did not need invasive treatment.
(Ed: Certainly this confirms earlier studies in the USA. The NCI has stated that up to 90 per cent of all cancers may be slow growing and can be left safely for 10 years or so. Anyone who has seen Chris Woollams on tour will know he covers over-diagnosis extensively in his speech. The problem lies with the PSA test which is anyway only 70 per cent accurate at best, and also fails to distinguish between the ’tigers’ and the ’pussycats’ as Colin Cooper of the Everyman Male Cancer Research Centre at the Institute confirms. Only 3-10 per cent may be ’tigers’ although you can get these at any age).
Overdiagnosis of breast cancer too
Meanwhile criticism on mammograms and their diagnosis rates came at the American Breast Cancer Congress.
Apparently half of all diagnosis by mammograms is DCIS. What is this? Answer: calciferous particles found in the ducts. It is neither cancer, nor pre-cancer. Indeed according to UCLA only 20 per cent of DCIS, at most, goes on to become breast cancer. Yet the diagnosis can produce fear and inaccurate diagnosis and treatment. (Ed: One woman reported to us that she had been given radiotherapy immediately for DCIS).
There is some suggestion that vitamin D can help remove such calciferous particles. Certainly UCLA and the Royal Marsden both recommend vitamin D for women with breast cancer.