BREAST CANCER: How Critical is Treatment Timing?

      Weighing in on a decades-long controversy, two studies in today's Lancet offer conflicting views on how soon women should seek treatment for breast cancer. In a review of 87 previous international studies involving a total of 100,000 women, researchers at the London-based Imperial Cancer Research Fund found that a three- to six-month delay between the onset of symptoms and treatment could "cost lives" for some women. By contrast, researchers at the UK-based Huddersfield Royal Infirmary studied 32,000 women and concluded that the speed of treatment is not critical. In the first study, Dr. Mike Richards and colleagues found that for one in 20 women, delaying treatment bestows a 12% lower five-year survival rate. On the flip side, Richard Sainsbury, lead author of the second study, concluded that if a woman's cancer has already metastasized by the time she first goes to the doctor, it is probably too late; but if the cancer has not spread, a few months' delay would not be fatal because the cancer grows so slowly (Rothenburg, New York Post, 4/2).

Yes, No, Maybe So
      In an accompanying Lancet editorial, Alan Coates of Sydney University in Australia "criticizes the Imperial study, saying it could have been skewed by women who underestimated their delay in seeking help, since the research depended on anecdotal reporting." He wrote, "Breast cancer is not a medical emergency. Adequate resources for care ... are likely to yield better returns than an obsession with speed" (Ross, AP/New Jersey Online, 4/2). Dr. Robert Smith of the American Cancer Society said women should not delay treatment because there is no way of knowing how far along the cancer is, but they should also take the time to carefully weigh their treatment options (Post, 4/2).