Chesney: New cancer recommendations need further review

Chesney: New cancer recommendations need further review

Others also voice concerns over new policies
Chesney: New cancer recommendations need further review

Dr. Jason Chesney of the James Graham Brown Cancer Center

New guidelines recommended by a National Cancer Institute working group are a call for additional study and should not cause physicians to radically change how they diagnose, treat and communicate with patients, say two experienced cancer doctors at the James Graham Brown Cancer Center at the University of Louisville.

The working group's report, "Overdiagnosis and Overtreatment: An Opportunity for Improvement," was published Monday in The Journal of the American Medical Association.

Jason A. Chesney, M.D., Ph.D., a member of the University of Louisville Division of Medical Oncology & Hematology, deputy director of the cancer center and medical director of its clinical research trials office, and Anthony E. Dragun, M.D., Associate Professor and vice chair of the U of L Department of Radiation Oncology, both say the NCI working group report requires additional study before being implemented because it does not take into account all factors leading to a definition and diagnosis of cancer.

The report recommends changing the definition of cancer and even removing the word from some common diagnoses because it creates fear in patients, causing them to seek what may be potentially harmful or unneeded treatments such as surgery.

"The problem with reclassifying pre-cancerous lesions as non-cancer is that we are confident that a certain percentage will, in fact, develop into full-blown cancer even with definitive therapy," Chesney said. "For example, 19 percent of DCIS treated with surgery and radiation will nevertheless recur. We do not yet have the technology to determine which of these pre-cancerous lesions will develop into cancers and which will stay small and not cause health problems."