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Susan G. Komen 3-Day Walk in Washington, D.C. and the Race to Know When Not to Treat

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Washington, D.C. was abuzz this weekend with the Susan G. Komen three-day, 60-mile walk for breast cancer. Pink ribbons and high spirits brightened the drizzly gray city.

Stories were shared of mothers, aunts, grandmothers, daughters and sisters who are alive because of early detection and treatment. Other stories of lost loved ones, like my sister, were common, too.

There's another side to the story that no one talked about, probably because few people know about it.

Two months ago, The Journal of the American Medical Association (JAMA) published the recommendations of a National Cancer Institute panel that was established to evaluate the problem of overdiagnosis and overtreatment of cancer. Appropriately, the title of the article is, "Overdiagnosis and Overtreatment in Cancer."

Overdiagnosis is when lesions are found that if left alone, would never progress to cause harm if untreated. This phenomenon is common and occurs more frequently with breast, lung, prostate and thyroid cancer, the authors reported.

Anxiety-provoking, unnecessary treatments occur with overdiagnosis, a phenomenon I wrote about in The Treatment Trap. Medical mistakes can happen during unnecessary treatment, a reality of modern-day medicine reported in my book Wall of Silence, from the perspective of people who have been harmed.

Why are more cancers being diagnosed that will never amount to anything?

Better screening tools are detecting more cancers. Women's lives have been saved. These same tools are identifying more cancers that won't result in any harm.

Without knowing which lesions will result in potentially lethal cancer and those that won't, women are flying blind. Little wonder that many choose to aggressively treat rather than "wait and see."

Typically, the health care industry is slow to provide the public with information that would help them make informed treatment decisions. A patient-centered health care system would do just that.

Along those lines, the National Cancer Institute panel recommended the creation of an information bank, called a registry, to track lesions in women who choose to "wait and see." It couldn't happen soon enough. It's the best way for women to have confidence that it's okay to wait and see.

We need a race to know when not to treat.

In the meantime, the National Cancer Institute panel also recommended that the hair-raising word "cancer" be "reserved for describing lesions with a reasonable likelihood of lethal progression if left untreated." Other growths would be classified in a lesser category.

Anytime the "c" word can be avoided, mountains of needless anxiety can be avoided. This would really brighten the day for thousands of women.

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