Despite clear evidence from the most extensive study to date on DCIS — that there is no benefit to surgery, radiation and drugs (“standard of care” treatment for DCIS) — and despite significant harms of these treatments — doctors will most likely not be making any protocol changes.
During a KPBS interview, Dr Reema Batra, stated the “standard of care” will not change. Women will still be offered lumpectomy plus weeks of radiation or mastectomy when diagnosed with DCIS.
Whatever Happened to Doctors Following the Hippocratic Oath — “First do no harm?”
A NY Times article asks, “is there any reason for most patients with the diagnosis of DCIS to receive brutal therapies?”
ABC’s Good Morning America stated, “The study which followed 100,000 women for 20 years showed that these painful and risky procedures may be UNNECESSARY.”
DCIS is Not Cancer and Should Not Be Treated as Cancer
Dr. Esserman is one of a growing number of experts calling for change regarding the standard treatments for DCIS. She says, “DCIS is not a lethal condition. You are not going to die of it. So it’s important to know that you don’t have to do more than you need.” In an editorial regarding the latest study, Dr. Esserman states: “Given the low breast cancer mortality risk, we should stop telling women that DCIS is an emergency and that they should schedule definitive surgery within 2 weeks of diagnosis. The sum total of the data on DCIS to date now suggest that:
Much of DCIS should be considered a “risk factor” for invasive breast cancer and an opportunity for targeted prevention.
Radiation therapy should not be routinely offered after lumpectomy for DCIS lesions that are not high risk because it does not affect mortality.
Low- and intermediate-grade DCIS does not need to be a target for screening or early detection.
We should continue to better understand the biological characteristics of the highest-risk DCIS (large, high grade, hormone receptor negative, HER2 positive, especially in very young and African American women) and test targeted approaches to reduce death from breast cancer.”
In a previous CNN article, Dr. Esserman stated, “DCIS is not cancer, yet because the word “carcinoma” is used in the label, it often creates panic. To sit across from my patient and see her in a state of complete misery and anxiety once again brought into focus so clearly why it is important to be able to distinguish the variation in this disease. Why should she have to suffer the emotional trauma of thinking she has a fatal disease if that is most likely not the case? Why should she be subjected to invasive procedures unnecessarily? It is heartbreaking to see a woman — and I have seen it many times — go through this turmoil when the ability to ease her worries, without compromising her health, could be in our grasp.”
Need for More Studies
Dr. Shelley Hwang of Duke University is working on creating an “Active Surveillance” study. In a recent Elle Magazine article, she states how previous thinking about DCIS is “wrong” and why she has been working hard for more than a decade to “stop the freight train of overtreatment for DCIS.”
Surgeons and oncologists interviewed in recent news reports such as this San Diego Union Tribune article say this kind of study — one that randomly assigns women surgical treatment or active surveillance — is the key to understanding more about DCIS.
But until such a study is completed, standard protocol will not change. Doctors will use this “need for more studies” as the excuse to continue their over-treatment protocols.
What Women Today Need to Know if Diagnosed with DCIS
DCIS is massively over-treated. Over-treatment equals extreme harm physically, emotionally, spiritually and financially. Today, women must decide for themselves if they will go along with the “standard of care” because it is “policy” or if they will educate themselves, get more precise information on their individual case and make treatment and lifestyle decisions based on facts not fear.
Support and Resources
Please take the time to investigate options and learn as much as you can before rushing into aggressive treatments. There is great wisdom and support for you here:
DCIS Redefined: Dilemmas, Choices & Integrative Solutions
Donna’s Choice: Global Healing From The Inside Out (Facebook Group)