Using the word cancer with low-risk patients can scare them into having invasive treatment.
Using the word cancer with low-risk patients can scare them into having invasive treatment.

Doctors asked to drop the C-word

DOCTORS need to drop the word cancer when talking to some patients and use phrases such as lesions and abnormal cells instead because the c-word sparks harm from over treatment and high anxiety.

Queenslanders are among medical researchers making this appeal in today's British Medical Journal as evidence grows that the use of the word cancer can scare patients into choosing invasive treatments.

The paper was authored by researchers from the University of Sydney, who worked with researchers from Bond University on the Gold Coast and the Mayo Clinic in the US.

"The evidence suggests to us that it's time to stop telling people with a very low risk condition that they have 'cancer' if they're very unlikely to be harmed by it," Bond University senior research fellow Dr Ray Moynihan said.

Cancer Council Australia chief executive Sanchia Aranda yesterday said it was time for a global roundtable on whether the word cancer should be used when communicating with low-risk patients.

"The potential upside is helping to avoid overdiagnosis and treatment, and helping reduce anxiety for some of those diagnosed with low-risk conditions. However, the difficulty is that it's hard to predict which pre-malignancies will progress into invasive disease," she said.

"Not using the word 'cancer' when describing these conditions may offer false reassurance to those diagnosed, which could lead to complacency and, ultimately, later diagnosis.

"Understanding these types of conditions is more complex than just the word cancer, and we encourage anyone who receives a diagnosis to ask their doctor lots of questions about monitoring their condition, different treatment options, likely outcomes and risks"

A prime example is low risk papillary thyroid cancer, according to Brooke Nickel of the University of Sydney.

"Studies show that progression to clinical disease and tumour growth in patients with small papillary thyroid cancer who choose surgery are comparable to those who monitor their condition," she said.

Another example is in localised prostate cancer, where "active surveillance" is a recommended management option, despite studies showing men still prefer radical prostatectomy or radiation therapy.

Active surveillance involves closely watching a patient's condition but avoiding treatment unless there are changes in test results that show the condition is getting worse.

The authors said cancer types that could be considered for renaming include intrathyroidal papillary thyroid cancer (tumour less than 1cm in size), low and intermediate grade ductal carcinoma in situ (DCIS), also often known as stage 0 breast cancer, and localised prostate cancer.


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