A panel convened by the U.S. National Cancer Institute posted recommendations in the July 2013 Journal of the American Medical Association calling for an independent, broad group under the auspice of an organization such as the Institute of Medicine of the National Academies to review and rename less-risky lesions and growths currently identified as cancer. “The goal going forward is to personalize screening strategies, and focus screening policies on the conditions that are most likely to result in aggressive illness and death,” said Laura Esserman, director of breast care at the University of California, San Francisco’s cancer center.
My DCIS was caught before it became invasive. But the same data causing doctors to doubt whether we as patients understand our risks is now prompting them for similar reasons to reclassify my (fill in new description of the abnormal cells in my ducts that could break through and kill me) as a pre-cancerous condition, abnormality, what? That’s well and good if the science exists to quantify my risk of invasive cancer. However, my first surgeon (assigned by my health group) said if it was his wife, he’d recommend a double mastectomy with reconstruction and that additional imaging wouldn’t tell us anything of value. Then, without explanation, he quit. I got assigned a new surgeon. This surgeon listened and explained. He ordered more imaging that did give us information on the extent of my DCIS. He said I could choose mastectomy (single or double) but that the data also would support me if I prefered a partial mastectomy, radiation and Tamoxifen. I wanted to keep as much of my original parts as reasonable. I chose the lesser surgery. Three and a half years later there are more side effects than I expected but no cancer. So far, so good. I have mammograms twice a year, I see my oncologist twice a year, I see my radiologist every year, I see my GP every year, I see my dermatologist every year (don’t want skin cancer to join the party), I see my opthalmologist every year (Tamoxifen has a small % of vision side effects). Throw in the dentist and an occasional visit to my surgeon and I’ve pretty much got a monthly visit to a health care professional.
So, check back with me next year. By then I’ll still have scars, side-effects, medical copays for my monthly visits, debts from my procedures, but if one panel of doctors prevails…I might never had had cancer at all!