Many of us have been raised with the idea that being cautious is always better when it comes to cancer. But, new evidence is actually showing that the opposite may be true, particularly for cancers of the breast and prostate. A new study recently found that many women who are treated for early-stage breast cancer actually may not have needed treatment in the first place. And furthermore, although the study is new, it reflects research that’s been conducted for a number of years on prostate cancer.
Breast Cancer Screenings and Success Rates
A study by scientists at Yale University and published in the New England Journal of Medicine last Wednesday examined cases of breast cancer between 2002 and 2013. The scientists found that rather than catching breast cancers early, too-frequent cancer screenings may be picking up on cancers that, if left untreated, might not pose much of a risk anyway.
For more than 100 years, we’ve known that small breast cancers have a much better prognosis than large breast cancers,” Donald Lannin, who led the study, told NPR. “We always assumed that it was because we were catching the small cancers early and then that’s why the cure rate was much better.”
Lannin explains that scientists now believe that some cancers are simply slow-growing, while others are fast-growing.
“It takes 15 or 20 years for [these small tumors] to cause any problems. And you can kind of imagine that a lot of patients will die of something else over that 15 or 20 years.”
So, if a patient might otherwise die from advanced age or other less intrusive factors within those two decades, it would seem that invasive cancer treatments like chemotherapy and radiation would be unnecessary, not to mention expensive.
The Prostate Cancer Story
For the past few years, doctors have been saying something similar about prostate cancer.
“Evidence is growing that early treatment with surgery or radiation prevents relatively few men from ultimately dying from prostate cancer, while leaving many with urinary or erectile problems and other side effects,” writes Daniel Pendick for Harvard Men’s Health Watch.
To combat the issue, prostate cancers are rated on an index called the Gleason Scale, which is generally determined by examining the cancer for its growth rate. Men with low-grade cancers are often put on a system called active surveillance, in which their doctors closely monitor their cancer to determine whether or not it warrants aggressive treatment.
Now that incidences of breast cancer are expected to be a similar situation, active surveillance may be an option for people with small cancer of the breast.
“What we need to do is go from a mid-19th century definition of cancer that involved a biopsy to a 21st century definition of cancer that involves both [biological] and genomic testing,” Otis Brawley, chief medical officer at the American Cancer Association, tells NPR. “That kind of test would allow doctors to say, ‘Mrs. Jones, you have a breast cancer that we should watch’ or ‘Mrs. Smith, you have a breast cancer that we should treat,’” Brawley says.
Current Recommendations for Breast Cancer Screenings
The American Cancer Society currently recommends breast self-checks for all women with regularity. Once a woman hits 45, the AC recommends that she get yearly mammograms until she turns 55, at which point she can switch to one screening every two years.