The Confusion Over DCIS: What to Do About 'Stage Zero' Breast Cancer?

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Tony P of CA 4:32PM October 26, 2009

I was treated for a stage 0 in 2002. The biggest problem facing individuals is the pressure from doctors to make a committment to a course of treatment before getting all of the facts. Before I had a chance to digest my dianosis the doctors were in my face trying to get me to commit to anything/everything they were potentially going to make money over. Facts? I heard opinions all over the place. I got conflicting information/opionion from my surgeon, oncologist, and radiation oncologist. Fortunately I got a second opinion and dumped the hospital that was trying to work my insurance. Nightmare. ALWAYS, ALWAYS, ALWAYS get a second opinion and do your homework. It saved me a lot of grief. 20% of cancer is misdianosed.

Gwen Young of MI 3:28PM October 26, 2009

There are two issues here: whether to screen everyone over 40, and how aggressively to treat non-invasive cancer. The decision about aggressive treatment can be aided by genetic testing, but it's too expensive to be used routinely at present. Also, there's a difference between statistics based on large groups and predictions for an individual woman. How can any doctor answer the question: will this cancer kill me?
Here's what scares me: Medicare and the health insurance industry will take the ambiguities of DCIS and use them as an excuse not to pay for mammograms for women over 70 or those deemed to be low-risk. If we go back to the days when almost all tumors were discovered by women themselves, fear will once again dominate the discussion. It seems to me that we should continue to screen, learn as much as we can about the natural history of DCIS, and give women information and choices, even if we are not lowering the death rates. Let's just quit pretending that early detection produces early cures

Janet B. Thiessen of CA 8:07PM October 24, 2009

Cancer treatment has not changed in the last 60 years. The medieval treatment of cancer is not pretty, receives some results, and is more barbaric than medical. The pharmaceuticals spend their time and millions on cancer research and are better equipped, staffed, and experienced then funded cancer research centers that also spend millions but neither have resulted in a magic pill or cure. The researchers and centers receive large sums of money, drive expensive cars, and live in big homes while the number of cases increase and the 60 year old process continues. Mental disease: “doing the same thing over and over expecting different results.” The multi-billion dollar a year business for "cancer treatment" and "cancer research" would be in jeopardy if a cure were found. The money spent on “Pink” merchandise and products are not used for cancer treatment, survivor support, or research so it must be a feel good about yourself expense. The chemo drugs change but the conclusion, "some results" or "longer expectancies" are not a cure. The sad fact, cancer victims live a short and horrible life as a direct result of “Cancer Treatment”. Statistics are the true bleak black and white picture, not a “pink” bumper sticker, pink hair band, or pink shoes. "False hope" becomes reality when it happens to a loved one or someone in the spot light.

Serious of TX 11:40PM October 23, 2009

If you have a family history of breast cancer - then at the first sign of trouble,
stage 0 or 1, a preventative double mastectomy is a viable option.
I am much less worried about overtreatment than I am about having to go through
chemo and radiation - which I have had family and friends go through and it
is no something I want to experience.
I had stage 1 infiltrating ductal carcinoma and opted for a double mastectomy and
oophorectomy (ovary removal) and I am not sorry I did as I avoided chemo, radiation
and there is very little left to screen so I don't have to worry about getting
a mammogram once a year on my unaffected breast.
When they removed my cancerous breast they also found lobular carcinoma in situ -
which predicts breast cancer in the other breast.
Women should have the option of aggressive preventative treatment if they choose it.
If someone wants to try conservative treatment - they are welcome to gamble with their
lives but not mine.

C. Bethel of OR 12:58PM October 23, 2009

As someone furious about the complete lack of change regarding the number of breast cancer victims, I must look to other solutions for screening and treatment. We will suffer similar issues for an eternity because the basic roots of all of this is a lack of science & gross profiteering. Honest, indepedent researchers have a much different approach than the medical community when it comes to bonafide proof and solutions. A researcher follows the drilled-into-the-head rule: define the problem (which has yet to be done with cancer), research it, and then come up with a solution. If you can't define a problem, you cannot provide a solution. First, for profit companies will never have incentives to cure anything. The fact that we have all of these mini debates surrounding breast cancer is because the same people control this issue day in and day out. Profit is the only reason there is not a cure and will never be a cure. When mammography, sonograms, and diagnostic tools failed to identify a lump I found in my own breast, I searched for an alternative way to monitor. I found thermography. I spoke to manufacturers of thermography equipment, healthcare providers who use it for patients, and patients who used it. I felt 100% satisfied it was more accurate and was only more so when I received a 3 page summation of what I should look for, expect, etc. (not to mention it was cheaper). We will never find the answers until we acknowledge what is really responsible for cancer, remove bodycount profiteering, and make healthcare affordable. If one insurer negotiates a rate of $1500 for an MRI, why make another pay $4000? This whole thing is nuts and it is absolutely no surprise that we are ranked #39 worldwide for quality of healthcare. Look to thermography people!

Tracey Vickery of TX 9:20AM October 23, 2009

Further studies need to be done with matched controls of women with DCIS separated into a treatment group and a nontreatment group. If there is no surviror difference, then maybe one day, the standard of care will change, but a change must be based on evidence balanced with risk/benefit. The question is, who is going to volunteer to withhold treatment?
As we all are aware, estrogen reduced symptoms of menopause but fell quickly out of favor for increased risk of cardiovascular disease. Celebrex works for certain inflammatory arthritidies that other medications don't but not without risks of cardiovascular disease. Even acetominophen (tylenol) and aspirin can cause liver and kidney damage in unrestricted quantities. Do not fool yourself, everything has a risk, but we have to be responsible. This takes time and we need to be patient. Remember, your doctor gives you a recommendation based on current evidence, but it is you who ultimately have to choose and perform due diligence. And if you are still uncertain, get a 2nd, 3rd, 4th or 5th opinion.
Mecial malpractice? If doctors were wrong to treat DICS, should those 10% who developed leukemia litigate? If that's the case and doctors no longer treated DCIS knowing a small percentage progressed to invasive cancer, do those women that develop cancer litigate? Sounds like a catch 22 for the doctor.

Gil of PA 1:11AM October 23, 2009

Somehow I think many do not take dangerous drugs and surgery serious. Why would anyone, in their right mind do this to their body without even having a cancer diagnosis? The better scenario here would obviously be nutrition / prevention therapies, supplementing healthy foods with herbs that assist in reversal of unfavorable symptoms, yet be real. There is not as big of profit margin using natural, holistic remedies that often work better than the conventional "invasive" variety. BreastHealing.info

HealingNews of NM 12:27AM October 23, 2009

The treatment recommended by WESTERN doctors is surgery. It is totally possible to reverse cancer, ESPECIALLY stage 0, without surgery, radiation, or chemo. Surgery should be avoided if possible. And chemo causes leukemia in 10% of the patients.

Kaiulani Schuler of CO 9:47PM October 22, 2009