Jill Feldman, Lung Cancer Patient and Advocate, shared on LinkedIn:
“As Raja Flores points out in this article, Oncology has a language problem. And I think it goes well beyond how we define ‘early stage’.
What concerns me most is what patients and families hear when these terms are used. For most people, early stage sounds reassuring. It suggests the cancer was found early and treatment will cure them.
But in lung cancer, even early stage (stage I and stage II) has a significant risk of recurrence. And now some Stage III lung cancers are considered early stage. What are patients and families supposed to take away from that?
I can tell you firsthand how devastating it is to be diagnosed with Stage IA lung cancer, believe you’re cured, experience recurrence, and then learn that you have advanced-stage disease.
Of course staging matters. It describes the extent of the cancer and helps guide treatment. But stage is not prognosis, and patients aren’t statistics.
What patients and families really want to know is:
- What does this mean for me?
- What is the goal of treatment?
- What are my options?
- What are the chances the cancer will come back?
- What will my life look like?
Staging is how clinicians talk about cancer and communicate with each other. But for patients and families, the real question is ‘What does that stage mean for me, my family, my life?’
Because understanding your stage is NOT the same as understanding your cancer.”
Oncology has a semantics problem: How do we define ‘early stage’?
I recently found myself asking a question that I thought had an obvious answer:
What is early-stage cancer?
The question came to me while watch- ing a television commercial for Merck’s Keytruda. The commercial repeatedly referred to ‘early-stage’ lung cancer. I knew the clinical trial behind the com- mercial. KEYNOTE-671 did not enroll pa- tients with stage 1 lung cancer. It includ- ed patients with stage 2 and 3 disease, including patients with mediastinal lymph-node metastases. As a thorac- ic surgeon, these were not patients I would intuitively describe as having early-stage lung cancer.
That disconnect made me wonder whether this was simply a lung cancer problem or whether the meaning of “early stage” had become similarly difficult to define across oncology. So, I went looking for a definition. The National Cancer Institute’s Dictionary of Cancer.
Terms defines:
- Late-stage cancer – A term used to describe cancer that is far along in its growth, and has spread to the lymph nodes or other places in the body.
- Early-stage cancer -A term used to describe cancer that is early in its growth, and may not have spread to other parts of the body. What is called early stage may differ between cancer types.
And then there is only one cancer-specific definition:
Early-stage breast cancer – Breast cancer that has not spread beyond the breast or the axillary lymph nodes. This includes duc- tal carcinoma in situ and stage 1, stage 2A, stage 2B, and stage 3A breast cancers.
You can also read: Early-Stage Lung Cancer Diagnoses Rise Across the United States
