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Incidentalomas

A friend was diagnosed recently with prostate cancer. While his cancer was found to be relatively insignificant, he battled questions about treatment. Some physicians he sought counsel from at an East Coast medical center advised a-wait-and see attitude. Others suggested that he not wait and recommended immediate aggressive treatment. He chose the former. Stanford's Abraham Verghese, MD, a correspondent for The Atlantic magazine, has an interesting brief in the magazine's current issue about the over-diagnosis of cancer. Technology has given physicians the ability to detect cancers that may never cause clinical problems. Verghese cites a grand rounds at Stanford by Dartmouth's Gilbert Welch, MD, where the cancer expert said he "felt our threshold for diagnosing cancer is too sensitive." A tough question for any individual who hears those terrifying words, "You have cancer" is what's next? Verghese says it all comes down to difficult and personal choices.

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