In the Pipeline:
Better Cancer Screening

Researchers are working to come up with smarter tests to distinguish aggressive cancers from ones that can safely be left alone. Learn how.

Cancer screening: Doing more harm than good?
How to decide: Is screening right for you?
Beyond cancer: 3 other ways you could be overtreated
Ask Shannon Brownlee your questions about cancer screening tests

Many current cancer screening tests are like a dumb but eager bloodhound that sometimes nabs a lethal cancer and sometimes the cancer equivalent of a neighbor kid who stepped on your daisies. Right now doctors often can't tell which is which, but researchers around the country are working to come up with smarter tests to distinguish aggressive cancers from ones that can safely be left alone. Some of the most promising approaches are looking at different genes on tumors (genomics) and the proteins produced by them (proteomics) to find the signs of sinister cancers.

How might smarter tests work? A new tool used in some breast cancer patients gives a clue. The Oncotype DX test measures the activity of 21 genes in a woman's tumor cells and uses the results to calculate the likelihood of the cancer recurring within ten years. It's used for women with early-stage breast cancer to help them decide if they need treatments like chemotherapy after surgery; those with a low score can opt out of harsh extras. Researchers are following women who decide against the add-on treatments to make sure they do as well as those who throw everything at their cancer.

Scientists are also hopeful about tests in the works for men diagnosed with prostate cancer. Doctors have long used something called the Gleason score to determine whether to treat this cancer or leave it alone: The higher the score, the harder doctors want to hit it. But a score of 6, smack in the middle of the scale, leaves physicians in the dark. Less than half of the cancers with a Gleason 6 will become aggressive, but most men with this score end up being intensively treated. Now researchers say that examining a man's tumor cells for two genes may help determine if that's necessary. One test looks for a mutation in a gene known as ERG; the other looks at one called PCA3. If both genes are relatively inactive in a man's cancer cells, he might be able to safely avoid aggressive therapy -- and its side effects.

Screening tests can find cancer early -- so why do some experts say they can do more harm than good? Read the special report and ask your questions to expert Shannon Brownlee, author of Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer.

From Reader's Digest - April 2009

 

• • Colon Cancer
• • Breakthroughs
• Breast Cancer
• Cancer

• Cancer Screening: Doing More Harm than Good?
• Screening tests can find cancer early -- so why do some experts say they can do more harm than good? Read this before your next mammogram, PSA test, or colonoscopy.
• 
• Screening Tests:
  Are They Right for You?
• Factors to consider before you schedule a cancer screening test.
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