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m {COLUMN BY CHRISTIE ASCHWANDEW here's long:held assumption that cancer is a universally progressive disease that will metastasize and kill its victims unless its stopped early. ‘Since the is, “Early detection is your best protec ‘ton’ has been a mantra of the cancer-awareness com- ‘munity, spurring an insistence on frequent screenings ‘to.catch ever smaller abnormalities. But finding cancer in the body doosrit imply a death sentence. In fact new research shows that its cell behavior is actually quite diverse. To oversimplify: ‘Cancer is born when acell harboring damaged DNA rakes new cells instead of repairing itself or dying. At that stage, some cancers rapidly invade tissues even before they're discernible, But others grow so slowly ‘that they wont spread to different parts ofthe body inalifetime. Some even regress on their own. "The glands of the breast. the prostate, and the thyroid ean allharbor alot of small cancers that are detectable atautopsy but were not the cause of death’ says Gilbert Welch, a cancer researcher at the Geise! School of Medicine at Dartmouth, ‘The problem is, wee discovering too many cancers that don't raquire action. Studies suggest that 22 to ‘54 percent of breast cancers found through routine ‘mammography (and 23 to “2 percent of prostate cancers detected via prostate-specifc antigen, or PSA, test) were not fated to become life-threatening. Because its extremely dificult to distinguish between aggressive cancers and harmless ones during thelr early stages, we treat too many indolent cancers with surgery radiation, or chemotherapy. Thats no trivial ‘matter when these procedures can cost women their breasts or men thei sexual function, not to mention. the psychological toll ofa diagnosis. And with the cost of treating cancer in the US. projected to grow as, Cancer screeningcando _ ore harm than good | ausust 2014] NEXT ‘Subjective Measures Christie Aschwan fen so ectth relent ofa 2013 Nasional asc ttonof Sense Writers word OQ Nw “IN THE SCREENING PROCESS, NONAGGRESSIVE CANCERS WILL INEVITABLY TURN UP. THE KEY IS NOT TO TREAT THOSE.” such a8 29 percent from 2010 to2020, that’s potentially billions of dollar for unnecessary action. Let's drop the goal of finding more cancers and realign the purpose of screening with its origina ob- Jective:to save lives and reduce suffering, We should aim instead to fin the right cancers—the potentially | |

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