Is scientific knowledge about cancer controversial?

Today the British Psychological Society’s research digest has highlighted Lobato & Zimmerman‘s recently published research on how people reason about controversial (*) scientific topics. Their research asked participants to justify their position on evolution, climate change, genetically modified foods and vaccinations.

The researchers found that 34% of participants simply restated their thoughts with no justification. Of the remaining 66% who attempted a justification, 20% were subjective. Subjective justifications favoured personal experience, cultural identity, false reasoning and conspiracy theories over scientific evidence.

45% of participants said that no new evidence would change their minds for at least one of the four topics investigated.

This research is interesting because it questions the received wisdom that giving people more factual information about a topic will enable them to come to a valid conclusion. It could certainly explain why a ‘referendum on the facts’ about Brexit may still deliver the same verdict as in June 2016. Brexit, as the Prime Minister and her cabinet demonstrates, has become an article of faith.

Which brings me to the topic of cancer. Judging by some of the reviews on the Cancer Research UK Facebook page, scientific knowledge about cancer is controversial. Many of the reviews made me feel sad. Others made me angry. Some examples and the facts (even though it appears that facts may not be powerful for some):

Cancer research has NO intention of finding a cure, merely conning people out of money on the premise of such a possibility … You manufacture antiquated TREATMENTS that eventually kill the sufferer! More patients die from CHEMO than cancer!

The facts:

In the 1970s, only a quarter of people diagnosed with a cancer survived. More than half now survive for at least ten years.Novel chemotherapy drugs and other treatments developed through research programmes are responsible for this dramatic improvement in survival rates.

Cancer Research UK is a scam!!! Established 1902 and stil no cure? Makes big pharmaceutical companies billions so, ever wondered why there’s no cure?

The facts:

As cancer is not a single disease, it is unlikely that there will ever be “a cure” for it. Many different approaches will be required. Cancers that used to kill quickly in 1902 but now have a five-year survival rate of around 100% include cervical cancer, prostate cancer, many thyroid cancers and early stage breast cancer. My own non-Hodgkin lymphoma has a rapidly improving survival rate thanks to improved chemotherapy drugs, stem cell transplants and immunotherapy.

Why give cancer patients fatty food and sugar WHEN cancer thrives on sugar.

The facts:

There’s no scientific evidence that removing sugar from your diet improves your survival chances.

And then there’s the comments from the green crayon brigade that really aren’t worth any response at all, but just make me angry.

A cancer charity that doesn’t tell you what causes cancer, or how to cure it. A low fat plant based diet both prevents and cures cancer. Please watch **** and **** and stop supporting corrupt charities like this one.

… what in hell are you researching there’s a cure already it’s called marijuana …

Scare tactics 1 in 2 people will get cancer? Smoking is down, Drinking down yet cancer rates are up..really why don’t you just say everyone will get cancer so just give us all your money.

The cancer research shop window displays have no mention of the ww1 100 years memorial. No poppies. No ” lest we forget” message. Nothing.

THE CURES ARE KNOWN BUT HIDDEN. VITAMIN B17, CBD OIL ETC

Green crayons
Green crayons for use by cancer research conspiracy theorists

 

I could go on, but there’s only so much stupidity I can cope with in one day. Nick Clegg is certainly going to have his work cut out cleaning up fake news or whatever it is he’ll be doing at Facebook in 2019.

 

(*) The participants were 244 American university students and staff, which may explain the inclusion of evolution as one of the controversial topics.

The C word

No, not that C word.

And not ‘Chope’ either, though goodness knows his antics and those of his filibustering friend have made me furious over the last few days.

The C word this blog post is about is cancer.

A few days ago I noticed this tweet – and it moved me sufficiently to object. (There’s that O word again – but I promise this isn’t going to turn into a rant about Chope).

I’m all for doctors being honest with their patients. And on reflection, telling someone they have a tumour, malignancy or mass isn’t helpful. It’s definitely avoiding the issue. But so is always using the word cancer in a diagnosis conversation.

Cancer covers a vast number of different diseases, each with their own unique challenges. Saying ‘you have cancer’ to a patient is about as useful as telling people with (say) liver cirrhosis, heart disease or a kidney infection that they have an ‘organ problem’.

In my own experience, the specificity of the discussion I had on first diagnosis (firstly around lymphoma, then the specific type, followed by the treatment options) was far more important than the use of the C word. I think the use of the C word might even have been counter-productive in my case – it would have terrified me. To be honest, I don’t believe that any of my consultants have ever used the C word in conversation with me, and I’m glad that they haven’t.

The unhelpful stereotypes that the word cancer induces would probably have stopped me from listening. It certainly wouldn’t have helped with my decision to go on watch and wait. After all, the cancer treatment stereotype most common in public discourse is that treatment should always be immediate. In the early days, I lost track of the number of times I had to convince friends and colleagues that immediate treatment, in my case, was unhelpful. However, talking about my condition as lymphoma rather than cancer (or even blood cancer) helped people to understand that what I was facing was a little different to the usual cancer stereotype.

Now, I’m certain that different people will react differently to this. If there’s one thing that being a lymphoma patient has taught me is that everyone reacts differently to the news – and to their treatment programmes.

So my revised #tipsfornewdocs would be to make time to have a proper discussion with your patient about their diagnosis. Take time to understand what they already know, and what they don’t know. Definitely don’t beat about the bush – just talking about a mass, malignancy, tumour or even cancer is not enough. Be specific. But do use terms like lymphoma or leukemia if that’s what they have. Explain the consequences and treatment options for the diagnosis. And if the C word isn’t helpful in describing these, don’t feel the need to use it.

The NHS belongs to the people ... and your diagnosis belongs to you, the patient.
The NHS belongs to the people … and your diagnosis belongs to you, the patient.