Debate over early-stage cancer: To treat or not to treat?

A patient receives chemotherapy treatment for breast cancer. (REUTERS/Eric Gaillard)

To treat or not to treat is becoming a hot question.

After years of aggressive treatment of even the smallest thyroid cancers, prominent researchers in the U.S. and Japan are urging a rethinking of old practices and saying simply to watch and wait may be effective for many patients with early-stage disease.

“Active surveillance,” as some call it, where doctors carefully monitor patients with small thyroid malignancies via tests and checkups, could be an acceptable alternative to surgery to remove a cancer that isn’t likely to grow or spread, according to two recent articles that are set for publication in the American Thyroid Association journal Thyroid and available online now.

“We have always been taught to fear cancer, that all cancer is bad, and all cancer should be operated on,” says Otis Brawley, chief medical officer of the American Cancer Society. But now as never before, he says, treatment regimens for several early forms of cancer, including prostate, breast and now thyroid, are being challenged.

R. Michael Tuttle, an endocrinologist at Memorial Sloan Kettering Cancer Center, says numbers of Americans diagnosed with thyroid cancer “are going through the roof.”