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Reshaping the Definition of Cancer


SPRINGFIELD, Mass. (WGGB) — It’s a word that no one likes to hear. Yet when it comes to changing the definition of cancer, according to Dr. James Stewart, it’s actually something that’s been discussed for a number of years.

“We know there are a lot of things  that we find when we do screening tests, and we do biopsies that are somewhat abnormal, and sometimes the word carcinoma, or cancer is associated with them, which scares everybody, but they don’t really behave like cancer,” Stewart says.

As the head of hematology and oncology at Baystate Medical Center, Dr. Stewart says there have been several occasions where he’s seen the word cancer on a pathology report, but that it might not be the case.  

“You have to ask yourself, ‘Ok, is there a particular thing that was biopsied, whether it’s in the breast or prostate, or some other part of the body, is it ever going to cause them problems? Does it need to be surgically removed? Given radiation? Treated like cancer?’” Stewart adds.

Which Dr. Stewart says leads to over diagnosis and overtreatment.

In some cases, things that may initially appear to be cancerous may either progress very slowly, or even not at all.

“Instead of calling things labeled with the word carcinoma in situ. They might want to call them indolent legions of epithelial origin a long phrase, kind of implying that they’re not going to do much,” Dr. Stewart explains.

In terms of early diagnosis, Stewart says they are still looking to find cancer at an early stage and observe it.

Results of the National Lung Screening Trial find that ct scans might be an early way to detect lung cancer in smokers and people over the age of 55.

The Journal of the American Medical Association also suggests diagnosing a patient with cancer only when lesions are life threatening and require treatment. They also suggest creating ways to recognize and monitor lesser lesions.

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