GIVEN THAT WE ALL HAVE THEM, IN WHAT SENSE ARE THEY ABNORMAL?:

'Cancer' or 'Weird Cells': Which Sounds Deadlier? (GINA KOLATA, 11/22/11, NY Times)

The idea of cancer as a progressive disease that will kill if the cells are not destroyed dates to the 19th century, said Dr. Otis Brawley, chief scientific and medical officer at the American Cancer Society. A German pathologist, Rudolph Virchow, examined tissue taken at autopsy from people who had died of their cancers, looking at the cells under a light microscope and drawing pictures of what he saw.

Virchow was a spectacular artist, and he ended up being the first to describe a variety of cancers -- leukemia, breast cancer, colon cancer, lung cancer.

Of course, his patients were dead. So when he noted that aberrant-looking cells will kill, it made sense. The deranged cells were cancers, and cancers were fatal.

Now, Dr. Brawley said, the situation is very different. Instead of taking tissue from someone who died, a doctor takes tissue from a living patient, threading a thin needle into a woman's breast or a man's prostate, for example. Then a pathologist looks for abnormal cells.

Yet "how it looks under a microscope," Dr. Brawley said, "does not always predict." That is especially true for things like Stage 0 breast cancer or similar conditions in other areas of the body -- conditions detected by screening and not by symptoms or by feel. [...]

Many medical investigators now speak in terms of the probability that a tumor is deadly. And they talk of a newly recognized risk of cancer screening -- overdiagnosis. Screening can find what are actually harmless, if abnormal-looking, clusters of cells. 

Posted by oj at November 23, 2011 6:20 AM
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