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Should we rename low risk cancers?

BMJ 2019; 364 doi: (Published 23 January 2019) Cite this as: BMJ 2019;364:k4699

Rapid Response:

Re: Should we rename low risk cancers?

Certainly words will not solve our problems, but they may help. Cancer has been properly defined as "the emperor of all maladies" and its name raises panic which is by definition irrational and, as stated in dictionaries "often causing wildly unthinking behaviour", This certainly happens in patients, but the same holds true for medical doctors and (sadly) for medical oncologists.
Medical oncologists tend to implement "guidelines" in a rigid way and seem to have no consideration for disease characteristics and for extension. Young colleagues know by heart all possible mutations in EGF receptor in lung cancer, but ignore the difference between a microscopic infiltrating breast tumour (less than 1 mm in size) and a 3 cm mass: they tend to treat both conditions in the same way, because the oncological community, and the guidelines it issues, promote treatment (and overtreatment).
I agree that education (both of patients and of specialists) is the true "cure" of panic, but limiting the use of this frightening word may reduce anxiety in patients and stubborn adherence to guidelines in oncologists: both to the benefit of all parts. This has already been implemented for breast "lobular carcinoma in situ": widening this attitude will be of benefit.

Competing interests: No competing interests

25 January 2019
Giovanni Codacci-Pisanelli
Medical Oncologist
University of Rome "la Sapienza"
Corso della Repubblica, 79 Latina, Italy