@handera “relabeling GGI reduces overdiagnosis and overtreatment”…
…BY WHOM??
Urologists are specialists who should ALL be adhering to the current norms, which state that G3+3 and select 3+4 should be addressed by Active Surveillance. They already KNOW this.
However, if a doctor decides to go rogue and attempt to coerce patients into treatment, no change in wording is going to change that.
Case in point: I practiced dentistry for 42 years. Many, many patients have cheek biting issues - including myself. It stems from either a slight malpositioning of the teeth or an exaggerated chewing motion.
This causes a low-grade chronic injury, very similar to a callus forming on your hands; the tissue thickens from over usage. In time, some patients develop a whitish line that runs from the back of their inside cheek forward toward their mouth opening. This is called a Linea Alba.
It is totally innocuous and should be left alone – similar to a Gleason 3+3. Watch it, look for changes, but don’t do anything.
However, I had one particular oral surgeon to whom I referred patients, constantly frightening patients with the idea that this innocuous line in their mouths was going to turn into oral cancer. She would then get them in for ‘treatment’ which would consist of her scraping away the white line with the edge of a scalpel or using electrical cautery to remove it.
The patient would then return to my office and relate this harrowing tale. As diplomatically as I could, I would tell them that it was probably unnecessary and not to worry about it. Unbeknownst to me, the oral surgeon had already rescheduled the patient to return in six months to once again remove this harmless white line which by that time would have returned from constant chewing. She also sent the tissue out for a biopsy, which was another charge the patient incurred.
Finally, I spoke to the oral surgeon about this and she tried to bullshit me as well!
Needless to say, I stopped referring to her and found someone else. Yet, I am sure other unethical, rogue surgeons were doing similar things.
All I am trying to say here is that you can change the words all you want, but getting doctors to follow those words and allaying patients’ fears is quite something else. Best,
Phil