Larry Norton Discusses Proposal to Redefine Cancer on PBS NewsHour

Pictured: Larry Norton

Deputy Physician-in-Chief for Breast Cancer Programs Larry Norton

In recommendations published in the Journal of the American Medical Association on July 29, a working group of the National Cancer Institute suggests changing the definition of cancer. The authors argue that early-stage, noninvasive forms of cancer such as ductal carcinoma in situ (DCIS), a premalignant form of breast cancer, should be reclassified and renamed so patients are less likely to seek aggressive treatment that may be unnecessary.

Larry Norton, Deputy Physician-in-Chief for Breast Cancer Programs at Memorial Sloan Kettering, commented on this topic last night on PBS NewsHour, along with medical oncologist Barnett Kramer of the National Cancer Institute. Dr. Norton stated that he is in favor of changing the terminology of some early-stage cancers, but only when the medical community has a better understanding of these diseases and doctors can be absolutely sure which cancers will progress and which will not.

“We’re not quite there yet,” he said. “There’s no definitive test that we can do now to DCIS that is going to tell us with certainty that it is not going to turn into a dangerous disease that could be life threatening.”

“We’re moving in that direction,” Dr. Norton added. “It’s a very, very important area of research. And I would applaud the day when we could actually say these are early changes and they’re never going to cause a problem. That is going to be wonderful.”

Watch the PBS NewsHour segment and read Dr. Norton’s comments in a New York Times article published on July 29.


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Dr Larry Norton is the most well respected physician in breast cancer.
His comments/suggestions should be WELL NOTED and respected by all!!

I wish you had let us know before the airing on PBS, not a month after the fact, so we could have watched it then. This is esepcially true for survivors as well as those of us who work with women who are currently diagnosed.

After a biopsy which removed all the DCIS found on Mammo, I had a lumpectomy. I asked the surgeon to take a big lump so the margins would be clean and I wouldn't need radiation. Invasive cancer was found on the edge of the margin, some distance from the original DCIS. There was also 3.5 cm of pleomorphic (aggressive) LCIS, giving a 40% chance of having it in the other breast. So I had bilateral partial mastectomies with a lift, to check lots of tissue pathologically. Found 4 more mm of invasive. Had 33 radiation treatments. Node neg. In my case nothing but the DCIS showed on mammo, there were no palpable lumps, but I went from a Stage 0 to stage 1. I am very glad that the DCIS was treated like cancer because invasive cancer was found. If we had left the DCIS as precancer and just watched and waited, I might have ended up with stage 2 or 3, necessitating chemo. I love my smaller breasts and feel reassured that my treatment was successful. In my case DCIS was a sentinel of a worse problem. All people with breast cancer should be given a choice about watching, waiting and getting squeezed every 6 months and worrying, or taking the problem out and getting rid of it, and perhaps getting rid of something else nearby that is worse. Please lets not treat DCIS as a non-cancer, but give individuals a choice of what to do for treatment.

Bill Giacolone, have you had breast cancer? My fear is that if DCIS and pleomorphic LCIS are treated as precancers, insurance companies will stop paying for surgical removal until something worse is found. This might mean more expense for the patient in terms of suffering, or for the insurance company or taxpayers (Medicare, Medicaid) in terms of higher costs of treatment.