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Active Surveillance in DCIS

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Active surveillance in DCIS is finally here. I say finally because “deintensifying treatment” has come to many other forms of cancer including prostate cancer. Years ago.

When I first wrote about DCIS, dyintensifying treatment was for the patient to have a lumpectomy and nothing more. And a lumpectomy only,  is still a valid therapy plan for the newly diagnosed DCIS patient. But another possible therapy plan, according to the article linked below, is active surveillance in DCIS.

Let me be fully transparent. Active surveillance or watch and wait is for DCIS, not breast cancer. While not all oncologists agree, I don’t consider DCIS to be cancer.

“Watch and wait” is somewhat of a misnomer in my experience. While the patient may want to wait before undergoing any conventional therapies, they should “pre-habilitate” with evidence-based non-conventional therapies including:

  • Anti-angiogenic nutrition
  • Anti-angiogenic supplementation
  • Lifestyle therapies such as exercise. 

According to research, prehabilitation before any/all cancer therapies will enhance your response to therapy if you ever do choose to treat your NHL. Prehabiitation is tailor-made for watch and wait in DCIS.

What are the pros and cons of active surveillance in DCIS?

Pros of Active Surveillance in DCIS

  1. Avoidance of Overtreatment:
    • Many cases of DCIS may not progress to invasive cancer. Active surveillance can prevent unnecessary treatments, which can have significant side effects and impact quality of life.
  2. Quality of Life:
    • Patients can avoid the physical and psychological stress associated with surgery, radiation, and other treatments. This can lead to a better overall quality of life.
  3. Lower Risk of Complications:
    • By avoiding surgery and radiation, patients reduce the risk of complications such as infections, scarring, and other surgical risks.
  4. Cost-Effective:
    • Active surveillance can be less expensive compared to immediate treatment, which involves costly procedures and follow-up care.
  5. Preservation of Breast Tissue:
    • Avoiding or delaying surgery preserves the breast’s appearance and function, which can be important for a patient’s self-esteem and body image.

Cons of Active Surveillance in DCIS

  1. Psychological Stress:
    • Some patients may experience anxiety and stress knowing they have a cancer diagnosis and are not actively treating it.
  2. Risk of Progression:
    • While many DCIS cases do not progress to invasive cancer, some do. Active surveillance carries the risk that the disease might advance and require more aggressive treatment later.
  3. Frequent Monitoring:
    • Active surveillance requires regular check-ups, mammograms, and possibly other imaging tests. This can be time-consuming and stressful for some patients.
  4. Uncertainty:
    • There is currently no definitive way to predict which cases of DCIS will become invasive. This uncertainty can make decision-making challenging for patients and healthcare providers.
  5. Potential for Delayed Treatment:
    • If DCIS progresses to invasive cancer, the delay in treatment might result in a more complicated and aggressive treatment plan than if the DCIS had been treated immediately.

I was diagnosed with a pre-cancer stage of cancer. My cancer, multiple myeloma- a blood cancer.  My point is that my oncologist told me that there was nothing that I could do. I now know that my onc. was wrong.

While I probably would have progressed to full myeloma, I would have responded to therapy better when I underwent induction therapy and may have avoided many of the side effects that I now live with.

Have you been diagnosed with DCIS? If you would like to learn more about taking a watch and wait therapy plan, email me at David.PeopleBeatingCancer@gmail.com

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

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