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Globe Story About DCIS

Posted 1/21/2014

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  If you live in the Boston area and/or read the Boston Globe, you likely saw the cover story of yesterday's G section. Called "When the Writer Becomes the Patient", it details the journalist's experience of being diagnosed with and treated for DCIS. Well written and thoughtful, surely, but it does seem to again fan the anxieties about this diagnosis.

  Many studies have suggested that women who are diagnosed with DCIS (ductal carcinoma in situ, not an invasive cancer) are just as anxious as those of us who have "real" cancer. There has been a growing conversation about the wisdom of changing the name of this diagnosis, taking our "carcinoma" and replacing it with something else that describes atypical cells. By definition, "real" cancer is invasive and can potentially spread and kill you. That is why we endure such aggressive treatments. By definition, DCIS is contained within the ducts and does not yet have the ability to metastasize.

  The difficulty is distinguishing between DCIS that will eventually become invasive cancer with all its risks and DCIS that will just sit there forever. Upon autopsy, something like 70% of women are found to have DCIS in the breast that has caused them absolutely no trouble in their lives. The reporter does state this reality, but her vivid descriptions of her own natural anxiety and wish to do everything possible are troubling.

  Please understand: In absolutely no way am I minimizing the trauma of a DCIS diagnosis and likely treatment (although watchful waiting is sometimes a reasonable option, most women opt for surgery and often radiation therapy). It is confusing that something that isn't cancer gets treated like something that is, but that seems to be the current state of the art. What I do wish, for them especially but for the rest of us, too, that women who are diagnosed with DCIS can clearly understand that this is a problem that needs to be addressed, but that they don't need to fear for their lives. That detail belongs to the rest of us.

  Here is a link to the story:

http://www.bostonglobe.com/lifestyle/health-wellness/2014/01/20/health-journalist-with-breast-cancer-finds-herself-caught-between-statistics-and-personal-decisions/ExNLbyqiMTnk9tGZjv2LoM/story.html

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Comments

  • Margaret Fleming said:
    1/23/2014 1:49 PM

    There is DCIS and there is DCIS. And there is a gray area in mammography that can lead to a biopsy. Or to surgery.

    I had the lumpectomy. My doctor suggested I talk to a radiation oncologist and a medical oncologist. One look at my pathology report and I could guess who are the women who just have a lumpectomy and go home. And I guessed I wouldn't be one.

    I was too overwhelmed to insist that each study the radiation oncologist read was for women with a path report like mine or worse. I just heard the statistics. I had the radiation.

    I noticed that in many reports I read on line, life expectancy was mentioned. That phrase life expectancy gets your attention.

    I already knew before the lumpectomy one statistic I didn't want to know about adjuvant therapy, i.e., the pills. I'm waiting to hear more from a medical oncologist.

    It's not a question of do I fear for my life right now. It's a question of can I deal with the side effects of the pills. It's a question of do I fear my life ending painfully, too early.

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