There have been several interesting media reports about cancer lately. First, there was the study that showed that women who participated in a psychological intervention at the time of their breast cancer diagnosis did significantly better (a statistical term) than those who did not. Then there was the study that showed that intraoperative radiation was as good as six weeks of radiation in selected patients.

Both of these well-designed studies provoked incredulity from the medical world: “intraoperative radiation therapy termed experimental!” screamed one headline. “Oncologists skeptical regarding psychological interventions” blurted another. Yet, these are the same people who tout a two-month increase in survival from a new drug as earth shattering news.

Why are studies that decrease treatment less acknowledged than studies that increase it? Part of it has to do with our health care system, which rewards more treatment but not less. Another part may be the doctors who tend to be conservative and not eager to change or to accept new data.

Importantly, both of these new studies do more than suggest an alteration in therapy. They suggest a new thinking about cancer, which was echoed in the recent New York Times series about genetics and cancer.

There is growing data suggesting that for cancer to develop you need not only the mutated genes but an environment or neighborhood of cells surrounding these genes that are egging them on. It all depends on the peer group! What can change the neighborhood? Stress—or lack thereof, exercise, radiation therapy, and hormones, for example.

The reason the medical profession doesn’t like studies that show less therapy is as good if not better is because they still think that killing every cell is the goal. But what we are learning is that we can rehabilitate the cells if we change the neighborhood! Just like taking a kid out of a bad neighborhood with drive by shootings, drug pushers, and gangs can well salvage him or her. The same is true of cancer cells. This new thinking starts to explain why stress seems to increase cancer or its recurrence while psychological interventions or exercise can decrease it. We need to focus on more than mapping the genes if we are going to eradicate cancer.  We need to understand the local environment around the cancer if we are going to find ways to control it.

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4 Responses to Beyond the Headlines

  1. Luna says:

    From the link: “Andersen said most women with breast cancer would not be able to take part in such a support group at the moment, but she hopes the findings will encourage insurance companies to pay for them, and for hospitals to begin offering such services.”

  2. Heather says:

    Thanks for the reminder that my goal should not be for my “new normal” to look so much like my “old normal”. Taking care of ourselves, exercising, eating right, getting adequate rest and reducing stress is not just for the months of treatment…it is our prescription for life!

  3. Suembala says:

    Two interesting points: 1) the statement: “Yet, these are the same people who tout a two-month increase in survival from a new drug as earth shattering news.” Might this be a result of a pharmaceutical industry that has much to lose if treatment options are found that limit the need for drug therapy?

    2) “The reason the medical profession doesn’t like studies that show less therapy is as good if not better is because they still think that killing every cell is the goal.” Might this be the result of a litigious society that motivates doctors to treat cancer as aggressively as possible regardless of the stage, grade or size?

    Societal issues influence cancer treatment. Dis-ease isn’t simple and it shouldn’t be treated with a one size fits all prescription. I don’t have a solution, but I’m thankful for Dr. Susan Love, and others like her, who bravely question the status quo and advocate for changes in the current thinking about breast cancer and its treatments.

  4. Christine says:

    I was diagnosed in May 2010 and also had surgery that month. I of course read anything I could get my hands on from international breast cancer conferences and mainstream scientific journals. Believe it or not when I asked about TARGIT intraoperative radiation device, the Radiation Oncologist sniffed haughtily and dimissed it as “merely experimmental.”I did remind him it was up to Level 1V trials in a number of countries and the results to date over 10 years were equal or better than traditional full blast 6 weeks RT with boost. I also reminded him he had not yet bothered mentioning to me that his traditional RT regime appeared to have zero effect on overall survival. What was that? A mere research glitch over the past 30 years? I too am appalled at the double standard being applied depending on whether someone approves of a treatment [kid gloves] or disapproves.

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