When it comes to cancer, I’m neither physician nor patient, nor even a policy expert. But being both a critical thinker and a feminist, I’m struck by what the juxtaposition of two seemingly unrelated new oncology studies, published in highly respected medical journals a month apart, can tell us about how gender shapes the way we perceive (or misperceive) illness, and the impact that has on patients’ well-being.
On April 14, JAMA Oncology published “Nomenclature Revision for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma.” Although the title may be nearly impenetrable to the non-specialist, the study conveys good news: A condition previously categorized as thyroid cancer has been found to not be cancer after all. No longer labeled cancer, it will also no longer be treated the same way. Previously, approximately ten thousand patients a year in the U.S. with this condition have undergone thyroidectomy, followed by treatment with radioactive iodine and follow-up checkups for the rest of their lives. The recognition that these particular tumors are not actually cancer means physicians can follow a more appropriate and less harmful treatment protocol, leaving the thyroid in place and no longer subjecting patients to radiation, or to the lifelong stress and expense of unnecessary follow-up exams.
It’s hard to imagine any physician refusing to follow this new protocol, continuing to subject patients to unnecessary and harmful treatment, and then justifying such actions as being more sensitive to the needs of the patient. Yet “Growing Use of Contralateral Prophylactic Mastectomy Despite no Improvement in Long-term Survival for Invasive Breast Cancer,” published online by Annals of Surgery on March 11, found that the number of women undergoing double mastectomies (technically referred to as contralateral prophylactic mastectomy or CPM) tripled in the course of a decade — even though for the overwhelming majority of the patients, such surgery was medically unnecessary. These women, who were diagnosed with stage 1, 2, or 3 cancer in one breast, were having their other breasts removed even though those breasts were entirely healthy, and — because the women lacked other risk factors (the BRCA gene mutation, or family history of breast cancer, or chest radiation during childhood) — not at risk for developing cancer.
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
No comments:
Post a Comment