Getting tough on cancer

Re: Why we need a new war on cancer, Sharon Kirkey, May 6.

The article on re- evaluating cancer treatment has omitted an important issue — the morbidity of cancer as opposed to simply survival and mortality rates. Survival rates are meaningless unless they are differentiated by survival disease- free versus survival with disease.

While there is a place for active surveillance/monitoring of what are understood to be “low risk” pathological abnormalities ( for example, DCIS) as opposed to more aggressive therapies, nothing in this article has been said about the morbidity of cancers that are either “watched” or minimally treated which then go on to spread or otherwise metastasize. Once that occurs, it is generally downhill from there, regardless of treatment.

That is why, over my 50 years as a surgeon, and including dealing with my own and my wife’s cancers 15 years ago, I have generally advocated the principle that “the first chance at treating the cancer is the best chance” at eradicating it, being more aggressive is generally better than being passive, especially when dealing with younger and generally more healthy patients.

Notwithstanding the side effects of some of the therapies, these usually pale in comparison with the miserable consequences of a cancer which has gotten out of control. Morton Doran, Fairmont B. C.

Great article about cancer. Hopefully you’ l l address the question “What is being done to find the triggering mechanism of c ancer?” Treatment research is fine but root- cause research is needed and one never hears about research into the root triggering mechanism(s). Paul Larocque, Markham, ON.

The article notes that contralateral prophylactic mastectomy ( CPM) is requested by women out of fear that the disease free breast will also develop cancer.

In my experience, as a breast health navigator, the treatment team needs to be mindful that many women who have a mastectomy without reconstruction, opt for the CPM, not out of fear, but out of a desire for their bodies to be symmetrical. Miriam Sweet Goldstein, Toronto