About that word: "cancer"...

[dentaltwin]

Does the name help? Can it be part of the problem?

medpagetoday.com/hematology...

[Tall_Allen]

No doubt that the word "cancer" carries a lot of baggage for all of us. The baggage weighs us down and influences our decision making. A few years ago, some doctors proposed the term "indolent lesion of epithelial origin," or IDLE to describe any cancer that will never do anything malignant:

ncbi.nlm.nih.gov/pmc/articl...

Ahmed/Emberton point out how different prostate cancer is from other kinds of cancer, and how a line is crossed between Gleason pattern 3 and pattern 4. Pattern 4 bears the hallmarks of cancer, but pattern 3 often doesn't.

thelancet.com/journals/lano...

Epstein argues that even Gleason 6 is invasive:

ascopubs.org/doi/full/10.12...

In this article I point out that about half of GS 6 cancers do progress:

pcnrv.blogspot.com/2017/11/...

With the growing acceptance of active surveillance for low risk PC, it is less of a pressing issue than it used to be. But the word is frightening and we've all been through the shock. I think that physicians who give a diagnosis of localized PC can help by slowing things down. In fact, I fantasize about the AUA having a guideline that treatment decisions for localized PC are not acted upon within a month of diagnosis. That would give at least some time for the emotional temperature to come down.

[dentaltwin in reply to Tall_Allen]

From Epstein et al: the Will Rogers phenomenon--LOL!

[Tall_Allen in reply to dentaltwin]

That's an actual thing in statistics. For those who haven't heard of it, it can occur when there is a change in the components of categories. So, for example, when they took cribriform pattern out of Gleason pattern 3 and put it into Gleason pattern 4, it lowered the risk level associated with BOTH patterns (its risk was at the high end of pattern 3, but the low end of pattern 4). The term comes from a joke told by Will Rogers: "When Okies from Oklahoma came to California, they raised the average IQ of both states" (i.e., they were at the low end of IQ in Oklahoma, but the high end of IQ for California).

[dentaltwin in reply to Tall_Allen]

That's a lot more comprehensible to me than the Monte Hall paradox.

[Tall_Allen in reply to dentaltwin]

Bayesian statistics give me a headache too. Conditional probabilities are often counter-intuitive. I can show the math, but putting it into comprehensible language is difficult.

[speedyhaddock]

lancaster.ac.uk/news/blogs/...

[dentaltwin in reply to speedyhaddock]

Isn't this tied in to issues of stigma and moralizing? The basis is more obvious with (for example) lung cancer, tied in as it is with personal choices, but it's true more or less for all cancers. When I was a kid there was a fear of contagion for many.

[Hidden]

The word has baggage as Tall_Allen points out. Maybe even more so with prostate because men traditionally avoid talking about health and especially health "down there" (as we say in Rhode Island, USA). At least now the word is actually spoken. In the 70s people would actually whisper the word: "well she has [whispered] cancer, you know" almost with a sign to ward off the evil eye. The more we talk out loud, the less power the word has.

[CalBear74]

Brings to mind Don Hayakawa's excellent book (yes the US Senator who went from college president to the US Senate back in the day) "Language in Thought and Action". Dadzone is right about avoidance of this word. As a child of the 40s-50's in NY, you could no more speak of this disease than you would "venereal disease".