Scientists: Tighten definition of cancer.

• Author: Parker-Pope, Tara
• Position: News

Byline: Tara Parker-Pope

Changing the rules

5The situation: A group of experts advising the nation's premier cancer research institution has recommended sweeping changes in the approach to cancer detection and treatment.

5The reactions: It is clear that some or all of the changes may not happen for years, and that some cancer experts will profoundly disagree.

5The suggestion: The group also suggested that many lesions detected during breast, prostate, thyroid, lung and other cancer screenings should not be called cancer at all but should instead be reclassified as IDLE conditions, which stands for "indolent lesions of epithelial origin.''

A group of experts advising the nation's premier cancer research institution has recommended sweeping changes in the approach to cancer detection and treatment, including changes in the very definition of cancer and eliminating the word entirely from some common diagnoses.

The recommendations, from a working group of the National Cancer Institute, were published Monday in the Journal of the American Medical Association.

In one example, they say that some premalignant conditions, like one that affects the breast called ductal carcinoma in situ -- which many doctors agree is not cancer -- should be renamed to exclude the word carcinoma. That way, patients are less frightened and less likely to seek what may be unneeded and potentially harmful treatments that can include the surgical removal of the breast.

The group, which includes some of the top scientists in cancer research, also suggested that many lesions detected during breast, prostate, thyroid, lung and other cancer screenings should not be called cancer at all but should instead be reclassified as IDLE conditions, which stands for "indolent lesions of epithelial origin.''

While it is clear that some or all of the changes may not happen for years, and that some cancer experts will profoundly disagree, the report from such a prominent group of scientists with the clear backing of the National Cancer Institute brings the discussion to a much higher level and will most likely change the national conversation about cancer, its definition, its treatment and future research.

"We need a 21st-century definition of cancer instead of a 19th-century definition of cancer, which is what we've been using,'' said Dr. Otis W. Brawley, the chief medical officer for the American Cancer Society, who was not directly involved in the report.

The impetus behind the call...