About one in six men can be diagnosed with prostate cancer sooner or later of their lives, but these cancers are often not life-threatening. Most newly diagnosed men have grade group 1 (GG1) prostate cancer, which might live for years without causing significant damage.
Prostate cancer is graded based on how far it has spread and the way aggressive it looks under a microscope. Pure GG1 prostate cancer is the least dangerous type of the disease. It occurs more continuously with age, doesn’t metastasize to other parts of the body, and doesn’t require immediate treatment.
So should we even call it cancer? Many experts say no.
Dr. Matthew Koperberg, head of the department of urology on the University of California, San Francisco, says that if his doctors stopped referring to low-grade changes, men wouldn't need to worry as much — and unnecessarily. Will be less inclined to hunt treatment. As cancer within the prostate. He recently co-chairman A Symposium Where experts from world wide gathered to debate the professionals and cons of renaming GG1 cancer.
Contraindications in treatment
GG1 cancer will likely be detected by PSA screening. Screening goals to seek out more aggressive prostate cancer while it continues to be curable, but these efforts often detect GG1 cancer by probability. Symposium participants agreed that GG1 disease ought to be managed with lively surveillance. With this standard practice, doctors monitor the disease with periodic PSA checks, biopsies, and imaging, and treat the disease provided that it shows signs of progression.
But at the same time as medical groups work to advertise lively surveillance, 40% of men with low-risk prostate cancer within the United States are treated promptly. According to Dr. Koperberg, that is partly since the word “cancer” has such a robust emotional impact. “It resonates with people as something that spreads and kills,” he says. “No matter how much we try to get the message out there that GG1 cancer is not an immediate concern, there is a lot of anxiety associated with the 'C-word' diagnosis.”
The result is huge overtreatment, with tens of hundreds of men suffering unnecessary surgery or radiation unintended effects every year. A cancer diagnosis has other detrimental consequences: studies show negative effects on relationships and employment, in addition to “one's ability to obtain life insurance,” says Dr. Koperberg. “It could affect health insurance rates.”
Discussion about name change
Symposium experts suggested that GG1 cancer could possibly be known as an acinar neoplasm, an unusual but non-malignant growth in tissue. Skeptics worry that patients may not adhere to lively surveillance in the event that they aren’t told they’ve cancer. But should men be afraid to comply with proper supervision? Dr. Koperberg argues that patients with pure GG1 “should not be burdened with a diagnosis of a cancer that has zero potential to harm them.”
Dr. Koperberg cautions that because a biopsy can potentially miss advanced cancer elsewhere within the prostate, monitoring the condition with lively surveillance is critical. In addition, men with a robust family history of cancer, or genetic mutations akin to BRCA1 and BRCA2 that put them at higher risk of aggressive disease, ought to be followed more closely.
Meanwhile, support for the name change is gaining momentum. “Younger pathologists and urologists in particular think it's a good idea,” says Dr. Koperberg. “I think it's only a matter of time before the name change — in my view, we'll get there eventually.”
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