Cancer
Myths
In an age of information abundance, myths
about cancer abound.
By Emma Johnson
There has never been more information about the cause, prevention
and treatment of cancer. Record numbers of reports in the academic
and lay press abound, and access to this information is greater
than ever before. Yet the age-old practice of sharing and holding
onto myths about cancer persists today—perhaps more than ever.
Healthcare
workers routinely hear from patients: A positive attitude cures
cancer. Pain associated with cancer treatment is so severe, it is
better to forego it, as pain medication is barely effective and
highly addictive. Surgery only spreads cancer.
Belief in such myths is far from anomalous. A survey commissioned
by the American Cancer Society found that a whopping 41 percent
of people believe treating cancer with surgery can spread the disease
through the patient’s
body, and 27 percent believe that the medical community is withholding a cure
for cancer to boost profits (see sidebar).
While this and other recent studies found that some myths are
intensified in minority groups, cancer myths permeate all populations.
A 2006 Harris Interactive survey underwritten by pharmaceutical
company Eli Lilly found that only 37 percent of women age 55 and
older were concerned about developing breast cancer as they aged,
although age is one of the top risk factors for developing breast
cancer. Further, few people recognize the cancer risks associated
with obesity, while the notions that underarm antiperspirant and
underwire bras contribute to the development of breast cancer are
among the top myths often associated with the disease, says Ted
Gansler, MD, director of medical content for the American Cancer
Society. “There
are all these important things people need to know to prevent cancer
and find it as early as possible. Meanwhile, focusing on things
that are not significant might distract them,” Dr. Gansler
says.
The risk of these
beliefs is much graver than believers embarrassing themselves at
a cocktail party. Myths can be one barrier to getting effective
screening and making appropriate treatment decisions—both of which can result in
decreased survival and increased chances of complications and mortality. “The
big problem with myths is they lead people to not getting appropriate and timely
therapy,” says Timothy Moynihan, MD, an oncologist at Mayo Clinic in Rochester.
Distrust of the medical community can stand in the way of regular checkups, mammograms
and colonoscopies, for example, while fear of surgery spreading cancer can prevent
someone from having a surgical biopsy or invasive tumor removal, Dr. Moynihan
says. Belief that pain medication is ineffective or addictive, as reported in
the ACS study, is another myth that can cause needless suffering.
The conundrum
is intensified when further breakdown of such stats point out that
myths are often aligned tightly with certain minority groups and
the poor—groups
that often do not get the medical attention they need, says Dr. Moynihan. “The
fact is that certain groups are seriously underserved by the medical community.
They are uninsured and less often screened and treated for things like high blood
pressure and diabetes,” he says. Access to care issues can include transportation
and childcare, availability of healthy food and safe exercise. “Effective
cancer screening is just one part of that very complex problem,” Dr. Moynihan
says.
Case in point: Anita Patterson was 30 when she noticed a lump in
her left breast. When a doctor dismissed her concerns because of
her young age, she did too. “I
always thought only older people got cancer,” says the resident of Wapato,
Washington, and member of the Yakama Native American tribe. Five years later,
she was diagnosed with breast cancer after doctors removed an egg-sized lump.
Because of the aggressive nature of her tumor, doctors recommended mastectomy
because of the increased risk of recurrence. Despite their urging, Patterson
chose lumpectomy with radiation, as she had heard from others in her community
about the pain associated with mastectomy.
“I thought, ‘I have to
go back to work—I don’t want to
go through that,’ ” says the married mother of three boys. Her concerns
were complicated by what she says is a stigma in her community associated with
losing a breast, as well as having a disease associated with white people. When
the cancer returned five years later, she had a mastectomy. Patterson, now 45,
says that if she had known the risks and understood the facts 15 years ago, she
could have been saved years of emotional and physical pain.
Experts say there
are real reasons some people hold onto myths about cancer and how
it is detected and most effectively cured. On a fundamental human
level, myths are perpetuated simply because people seek information
from trusted sources, says Angelina Esparza, the American Cancer
Society’s director of survivorship,
quality of life and information. People will usually follow the screening and
treatment directives of a healthcare provider, but in the absence of a long-term,
trusting relationship with a physician and healthcare system, accurate information
competes with messages from mass media and trusted friends and family. “Patients
rely on their various sources for information about their healthcare—providers,
television and family and friends,” Esparza says. “But with all of
the competing messages, how is a patient to figure all of this out and know where
to turn for information?”
Esparza, who has spent a dozen years working in
minority health advocacy, says it is important to develop cancer
education tools that take the culture of various communities into
account. She cites the success of videos for Hispanic populations
that use culturally appropriate scenarios to introduce information,
as well as an emphasis on audio CDs and tapes to reach illiterate
members of all groups. Since many patients obtain information from
the Internet, it’s important
to double-check it with reliable sources, including your physician and organizations
like the National Cancer Institute.
The key is not to simply get the medical information
to the population in an effort to dispel all myths, says Esparza.
Instead, many widely held beliefs can be used to promote sound medical
advice. “You’re
not going to change people overnight,” she says. “What you can do
is integrate information.” If
a person relies on their community to make decisions, the medical team can use
that support system to ensure adherence to a medical directive. If a person relies
on prayer for medical healing, encourage that practice in addition to clinical
treatment. “Start correcting what is wrong and fold it in together with
what they are doing right,” Esparza says. “If we can blend these
things and blend them well, we are providing the patient the best service.”
Experts
agree that the most critical key to dispelling myths is a trusting
doctor-patient relationship. “Once the vast majority of cancer patients are under the
care of a qualified cancer specialist who takes time to explain the disease,
their beliefs in myths will not persist,” says Dr. Gansler. Adds Dr. Moynihan: “We
have to treat each person well, so that person will bring that trusted word back
to their community. That’s the long-term fix. In the short-term, we have
to establish trust.”
As for Patterson, she turned a negative situation into
a positive. Women in her community often approach her with questions
about their own cancer, including her younger sister Andrea Williams,
who found a lump in her own breast at age 30—an age she would have thought was too young to
be vulnerable to cancer if it were not for her sister. Patterson urged Williams
to get a mammogram and early treatment once breast cancer was confirmed. “My
experience was different than my sister’s,” says Williams, who is
now in remission. “If
it weren’t for my sister educating me, I wouldn’t have known what
to do.”
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