Would You Choose “Watchful Waiting” – Hoping for Spontaneous Remission??

Amy Hendel Health Guide
  • A new breast cancer study out of Norway is turning the world of breast cancer on its head.  Researchers claim that their new study suggests that some breast cancers- even invasive ones - might spontaneously resolve if left alone.  This has left some cancers experts outraged, while others are speculative - willing to entertain the possibility of spontaneous resolution.  And I wonder just how the average female patient will entertain this news.

     

    On the one hand you have the mammogram screening guidelines, which recommend all women at age 40 obtain a baseline mammogram, and those with strong risk factors, get the baseline started earlier, at age 30-35.  You then have the situation of finding a suspicious area(s) on mammogram, doing follow up ultrasound and a subsequent biopsy,  if cancer is strongly suspected.  So I wonder if women who are then given the "big C" diagnosis will even remotely entertain a "wait and see" approach as their treatment of choice.  It is certainly done in prostate surgery - though the expectation is not spontaneous remission.  It's done more to follow slow growing prostate cancer so that surgical intervention, which has some pretty negative side effects (ED,) can be delayed or possibly avoided. 

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    Certainly in the case of breast cancer, typical patient attitudes include - "get it all, please, remove the other breast too - just incase, take both breasts to reduce my risk OR utter denial."  A big problem with wait and see approach to diagnosed breast cancer is that no statistics solidly exist - so how do you know if YOUR cancer will sit tight - progress slowly - or quickly metastasize and kill you??  And experts who have reviewed this study feel it was a very flawed study because of the way it dealt with the 2 groups of women who participated and because of the way the researchers ultimately extrapolated their final results and assumptions.  One group of women had only one mammogram, the other had several screenings (both over a six year period.  Results of diagnosed cancers from these screenings and state of health at the end of the six year period were compared.  The researchers believed that some of the cancers that might have been aggressively treated, spontaneously disappeared.

     

    Experts who criticize the study say that the whole point of the screenings is that if you miss something on one particular mammogram one year, the follow up screening (because images from year to year are compared) would more than likely pick up the missed finding.  So even if a year was lost - you would still be on top of the cancer at an earlier stage then if you had no screenings or screenings done many years apart.  But some surgeons feel that a breast cancer diagnosis and treatment is so devastating to women - that having the opportunity - even in some cases - to watch and wait and see if the tumor(s) go away would be an incredible option.  Having had a mother whose very aggressive cancer was diagnosed quite late, and who never had a chance with any of the available treatments to successfully treat her inevitably deadly cancer - you would never convince me to "wait and see." 

     

Published On: November 30, 2008