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World Cancer Day - Myths & True World Cancer Day - Myths & True
by The Ovi Team
2018-02-04 11:28:14
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February 4th. World Cancer Day is a chance to raise our collective voices in the name of improving general knowledge around cancer and dismissing misconceptions about the disease. From a global level, we focused on three myths. Learn the truth and supporting evidence.

Myth 1: We don't need to talk about cancer

Truth: Whilst cancer can be a difficult topic to address, particularly in some cultures and settings, dealing with the disease openly can improve outcomes at an individual, community and policy level.

WHEN YOU OR SOMEONE YOU KNOW HAS CANCER

Talking about Cancer

cancer01For most people, a diagnosis of cancer is a life-changing event commonly evoking feelings of shock, fear, anger, sadness, loneliness and anxiety. Talking about cancer to partners, family members, friends and colleagues can help to alleviate these feelings, and yet many people find it difficult. 

In most settings, cancer remains taboo and people with cancer are even subject to stigma and discrimination that may stop them from admitting they have cancer. 

Negative public perception of cancer can stifle informed public discussion and perpetuate a cycle of fear and misinformation that hinders raising awareness about cancer prevention and the importance of early detection. Countering cultural barriers against speaking about cancer and contesting misinformation is therefore essential.

Even within highly engaged communities, the level of knowledge of cancer and the willingness to talk about it with friends and family can be low.  

There are campaigns that specifically challenge the taboos and embarrassment surrounding some male cancers (prostate, testicular and colorectal cancers) and create awareness of early signs and symptoms.

Cancer Caregiving and Support

Cancer caregiving can also have an enormous influence on both physical and mental health. Cancer carers – most commonly partners, family members or friends – often receive little information or support, and as a consequence many of them experience emotional distress leading in some cases to depression.

Providing the right support for both the carer and the person living with cancer can help with coping and improve quality of life. Partners, friends, and family members can help in their own ways, for example, by choosing to join support groups. 

Support groups can provide a caring and supportive environment for people living with cancer to express their feelings and reduce anxiety and fear as well as a place to share information about cancer treatment options and their side effects.

Cancer and the Workplace

There is a substantial financial burden associated with cancer patients and their carers both in out-of-pocket expenses and in lost income and benefits.

For both patients and their carers, receiving support in the workplace can be a significant factor. A supportive approach from employers can reduce anxiety and provide the skills and confidence to deal with cancer at work. Making adjustments such as supporting a phased-return to work can be an important factor in getting people back to work successfully. A job can restore normality, routine, stability, social contact and income.

In low resource settings, the costs of cancer can be catastrophic for families, with the high costs of cancer treatment and absence from work, impoverishing families.

Cancer, Body Image and Sexual Wellbeing

The impact on sexual wellbeing is, for many, one of the most devastating consequences of a cancer diagnosis. 

Issues of body image and sexuality can have a significant impact on partner relationships and in some cases can be the cause of partner rejection. These issues are not restricted to women. Men facing cancer, particularly prostate and testicular cancer, face issues around self-esteem and sexual intimacy as well. 

The global health community must address the concerns and issues that impact the physical and mental health and wellbeing of cancer survivors and their carers deserves.

“Due to a lack of knowledge, when they hear the word ‘cancer’ they get scared, some hide it and some use traditional medicine until it becomes too late for treatment.” - A workshop participant from Ethiopia in an interview on beliefs and practices in breast cancer

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Myth 2: There are no signs or symptoms of cancer

Truth: For many cancers, there are warning signs and symptoms and the benefits of early detection are indisputable

RECOGNISE SIGNS AND SYMPTOMS

It is important for individuals, communities, health professionals and policy makers to be aware of, and educated in recognising the signs and symptoms for cancer (where possible).

It is true that early signs and symptoms are not known for all cancers, but for many cancers, including breast, cervical, skin, oral and colorectal cancers, and some childhood cancers, the benefits of early detection are indisputable.

Awareness is the first step to early detection and improving cancer outcomes. Whilst some of the cancers with the poorest survival rates, such as ovarian and pancreatic cancers, rarely show early warning signs, cancer researchers globally are seeking innovative ways to improve early detection and develop new tests for early diagnosis for these cancers. 

With few exceptions, early stage cancers are more treatable than late stage cancers.  

Equipping primary healthcare workers with the appropriate knowledge and tools to recognise the warning signs and symptoms of cancer is essential to reduce the likelihood of misdiagnosis and ensure prompt referral to specialist medical care at an early stage of the disease.

Strategies for help-seeking behaviour should be encouraged.

Recognition of early warning signs of some cancers is particularly relevant in low resource settings – it is cost-effective and in some cases does not require any specialist diagnostic technologies. E.g. clinical breast examination (CBE) performed by primary healthcare workers has the potential to detect cancers earlier, particularly in areas where the majority of breast cancers are diagnosed at an advanced stage. 

EARLY DETECTION

Early detection is multifaceted. Strategies that raise awareness about cancer and the importance of seeking care when symptoms are present, along with interventions for early diagnosis have the greatest chance of improving cancer outcomes. 

ACHIEVING EQUITY IN EARLY DETECTION

Achieving equity in cancer early detection and care should be a priority.

In low resource settings, many cancers are being diagnosed at a late stage due to:

A lack of investment in cancer services, particularly at the primary healthcare level.

Limited awareness about the value of early diagnosis and the importance of seeking care when signs and symptoms are present, even among health professionals.

Proliferation of myths and misconceptions about cancer diagnosis and treatment, as well as stigma, gender and social inequities, can lead individuals to seek alternative care in place of standard treatment or to avoid care altogether. 

For cervical cancer, studies have shown that even a single screening between the ages of 30 and 40 can reduce a woman’s lifetime risk of cervical cancer by one third.

For colorectal cancer, there is a wide and growing range of testing options that can be tailored to a country’s resources and burden of disease. 

The critical issues for all screening programmes are to select the test that is most appropriate for the context in order to achieve high screening coverage, high quality testing and reliable follow up. 

BUILDING CAPACITY OF HEALTHCARE WORKERS 

For many developing countries, the provision of a skilled cancer workforce to diagnose and manage cancer remains a challenge, with most facing a severe shortage of oncologists, and other specialists including pathologists. 

Whilst specialty care is essential, this can be complemented by a skilled workforce at the primary care level, facilitating greater access to cancer control and care initiatives.

It is possible for tasks to be shared among health workers with differing levels of training to effectively engage community health workers, clinical health assistants, nurses and physicians working in primary care level facilities.

Primary healthcare workers can be trained to perform effective clinical breast exams, especially where the objective is to reduce the number of very late cases that are easily detected with clinical examination. 

For colorectal cancer, studies have shown that nurses and non-medical endoscopists can satisfactorily perform diagnostic tests.

The potential exists to address the gaps in the training of healthcare workers by increasing the use of Information and Communication Technologies (ICTs) including mobile and online approaches to complement traditional teaching methods. 

Developing education and training programmes for healthcare workers that build on existing materials, training networks and infrastructure is essential.

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Myth 3: There is nothing I can do about cancer

Truth: There is a lot that can be done at an individual, community and policy level, and with the right strategies, a third of the most common cancers can be prevented.

PROMOTING HEALTHY LIFESTYLES

The conditions in which people live and work, and their lifestyles, influence their health and quality of life.

Global, regional and national policies and programmes that promote healthy lifestyles are essential to reducing cancers that are caused by factors such as harmful use of alcohol, unhealthy diet and lack of physical activity.

Tobacco use, the most common risk factor, is linked to 71% of lung cancer deaths and accounts for at least 22% of all cancer deaths. Based on current trends, tobacco use is estimated to kill one billion people in the 21st century.

Alcohol is a known risk factor for cancer. It is strongly linked with an increased risk of cancers of the mouth, pharynx, larynx, oesophagus, bowel and breast, and may also increase the risk of liver cancer and bowel cancer in women. 

Overweight and obesity is increasing globally at an alarming rate, including among children and adolescents. Also of concern is the high proportion of overweight people living in low resource settings (two-thirds of the global total). Overweight and obesity is also strongly linked to increased risks of bowel, breast, uterine, pancreatic, oesophagus, kidney and gallbladder cancers.

Rising rates of obesity will lead to increased cancer rates unless policies and actions are taken to improve people’s diets and levels of physical activity.

 Healthy Workplaces

Organisations of all sizes can create environments that protect and promote the health of their employees, by providing: 

100% tobacco and smoke-free environments

Provision of and access to healthy food options

Workplace health education programmes and policies that create awareness of cancer risk factors and the importance of early detection.

Specific efforts are also needed to reduce the global burden of occupational cancer risks.

The World Health Organization (WHO) estimates that 177,000 cancer deaths each year are related to occupational exposure to selected carcinogens, with one in every three deaths estimated to be caused by asbestos.

Another known recreational and workplace exposure is ultraviolet (UV) light, usually from the sun.  Exposure to UV light is the main cause of skin cancer.

REDUCE THE RISK OF INFECTION-RELATED CANCERS

For developing countries, the situation often goes beyond addressing behavioural change, with many countries facing a ‘double burden’ of exposures, the most common of which is cancer-causing infections.

Chronic infections are estimated to cause approximately 16% of all cancers globally, with this figure rising to almost 23% in developing countries. 

Several of the most common cancers in developing countries such as liver, cervical and stomach cancers are associated with infections with hepatitis B virus (HBV), the human papillomavirus (HPV), and the bacterium Helicobacter pylori (H. pylori), respectively.

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