Yes, of course, it is always possible to “discover it earlier”.

However, the time saved would be very limited in any case, and would have little impact on the probability of cure. For an explanation of this concept, the reader should refer to the previous section (HOW LONG HAS THIS TUMOR BEEN THERE?).

If the tumor has been discovered because, although it has not caused any trouble, it has become perceptible to the touch or visible, as in the case of tumors of the breast or lymph nodes or nodules of 1-2 cm in the lung, earlier detection, when the nodule was 0.5 cm or 1 cm in size (if smaller than this, it would not be seen or felt in any case), would mean reaching a diagnosis about 3 months earlier. This is very little in the case of a tumor that has been there for 10-20 years; indeed, the possibility that metastases will have spread to other sites only in these last 3 months, making the cancer incurable, will have changed very little.

If the tumor was discovered because it was causing symptoms, we can easily understand the patient’s regret at not having gone to the doctor sooner, or his complaints about the doctor because “she didn’t do the tests sooner”. Discovering a tumor in an internal organ when it is already 4-5 cm in size will naturally give the impression that there has been a delay. And indeed, it could have, and should have, been discovered earlier. But that is very difficult. Here, we should remember all the reservations regarding the fact that symptoms and/or disorders must have a certain intensity, duration and evolution before they can be interpreted as an alarm signal and prompt the doctor to prescribe the most appropriate imaging tests (THE FEAR IS JUSTIFIED). 

In general, then, regrets or complaints fall within a “gray area”, in which it is very difficult to blame oneself or others with certainty.  

We might wonder why the international guidelines do not recommend performing tests for the early diagnosis of tumors. Actually, they do (THE “ABC” OF PREVENTION), but only for a few types of tumor: colon, breast, uterus and lung. 

In the case of all the other tumors, the effectiveness of tests for their early diagnosis has been amply studied scientifically, but the results have been disappointing. It may seem illogical, but these tests have often done more harm than good. Indeed, they are complex and may yield doubtful results. Moreover, they may lead to a whole series of other tests, including painful or harmful biopsies that finally prove useless. 

So, at the present time, given the limitations of the tests available, it is by no means easy to diagnose the majority of tumors early. If it were, most of the cancer problem would be solved.

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