| June 6, 2006
The Cheerful Oncologist gives his take.
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Renal cell carcinoma took out my dad at age 62. Back then, it was a lucky incidentaloma discovery or death…
Any time anyone bitches about executive full body scans I can only think, I wish my executive dad had gotten one.
no dad, early detection doesn’t always make a difference. We’ve been lead to believe that any cancer can be cured if detected early enough, but this is not the case. It depends on the type of cancer, how aggressive it is, how effective the treatment is etc. With some types of cancer it can make a difference if the cancer that is destined to spread is detected at the right time, in others – it makes no difference. Sometimes, early detection picks up leisions that look cancerous but would never spread if left alone, yet since there are now no way to say which will spread and which will not, people undergo potentially dangerous treatment for something that would’ve never threatened their lives. In general, screening tends to pick up more slowly growing and indolent cancers than really aggressive ones.
You don’t know what would’ve happened if your dad’s cancer had been detected earlier. Some cancers are so aggressive, they’ll kill you even if detected early. If this happens all would early detection buy you is extra few years being sick. For example, your dad could’ve been diagnosed at 58, went through all the treatment, had a hellish 4 years and still died at 62. You wouldn’t consider it much of a benefit, would you?
This is called lead-time bias by the way and this is why you should always take the claims that “the 5-year survival rate is better if so-and-so is detected early”. Only decrease in mortality from this cancer is an indicator that a test works.
I don’t know much about renal cancer, but there is no evidence that any kind of screening for renal cancer reduces mortality, is there? So why do you think it would’ve helped your dad? For all you know it would’ve simply ruined last few good years of his life.
Renal cell cancer is completely curable if the kidney is removed before the the cancer has spread. There are no symptoms at all when the cancer in in the curable stage. The only people who survive renal cell cancer have their tumors discovered by accident.
So no, Diora, you don’t know much about renal cell cancer. If he had gotten a scan and the tumor discovered when it was localized, there it is highly likely he would be alive today. Or at least he would be dead from something else.
Oh, and yes, there is evidence that screening for renal cell cancer reduces mortality from renal cell cancer. In fact, it is not even very controversial that some patients really should be screened specifically for renal cancer…if they are males of a certain age with a family history of renal cell cancer…
Because not finding the tumor has equalled death, and early dectection equals surgical cure.
My Mum has just been diagnosed with early renal cell carcinoma at the age of 54. My Grandad died from metastic renall cell carcinoma at the age of 48. Mum’s cancer was found by accident, but one has to think would screening be of benefit for her twin and myself and my sister.
early detection does make the difference between life and death in these cases, my son was diagnosed with renal cell carcinoma when he was just 12, after discovering a mesenteric cyst, by the time all his scans were completed, some three weeks later, the cancer had already spread aggressivly to his lungs and abdomen, he then had some response to alpha interferon and 5 moths later had his kidney removed (all too late of course) its still very hard to deal with, he passed away 18th june 2004 after just 11 months. i am going to be writing my own blog on this subject and others.
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