Eschatology in oncology: life expectancy of untreated patients with malignant tumors

Abstract

The purpose of the article is to remind about the problem of studying the natural life expectancy of patients with untreated cancer. Knowledge of the clinical prognosis of untreated cancer of any localization is useful in patients with advanced disease or in an underdeveloped healthcare system. Historical data on untreated breast cancer patients in some cases demonstrate the possibility of long-term survival. Some cancers are invariably fatal, others are latent and do not affect the patient's life expectancy. For the first time, the research results of the English professor, oncologist and radiologist U.S. Lazarus-Barlow (1865-1950) about natural life expectancy of 2556 untreated patients with cancerous tumors of 29 localizations based on the materials of the 1924 article, were introduced in domestic oncology. The results of a study of the natural life expectancy of patients with untreated breast cancer, hepatocellular carcinoma, adenocarcinoma of the colon and prostate for the period 1964-2018 are presented. The problem of overdiagnosis is considered. This term is used to refer to a side effect of technological progress. Medical imaging technology can detect cancers which have no clinical manifestations and are not fetal. The concept of «non-progressive» tumors (histologically verified tumors that do not grow or even regress) have something in common with overdiagnosis. Biological mechanisms for arresting the progression of cancer are mentioned. Key words: life expectancy, untreated patients, overdiagnosis, breast cancer, prostate cancer.