Last week I received a press release from the British Dental Health Foundation, aiming to raise awareness about mouth cancer. It had asked 2500 people to give the words they most associated with cancer. “Deadly”, “devastating” and “scary” were the three most common answers – although the word “curable” was also up there, said the foundation hopefully.
The survey got me thinking about cancer and the fear factor, particularly in the light of recent cancer charity fundraising campaigns in the UK. Ringing disconcertingly in my ears even at this moment are the appeals of Movember to fight prostate cancer and a national Cancer Research UK campaign telling us to “Stand Up To Cancer” (catchphrase: “It’s payback time”) which culminated in a national fundraising telethon in October.
Stand Up to Cancer was a celebrity-focused effort to encourage the public to give to cancer research. But its telethon illustrated how charity fundraising can become fear-based. The heart-rending story of a young footballer being struck down by a medulloblastoma was repeated throughout the evening. A long comedy segment encouraged all men to get their prostate checked, until a casual query to the resident doctor revealed that it was only worth doing if you were in a high risk group.
The dramatic climax was when one presenter gave a monologue about the people he knew who had died of cancer, yelling “You know what, f*** you cancer.” “You’re like a seventies entertainer, you’ve touched a lot of people,” he said, “and there are ongoing operations to get rid of you.”
It was genuine, and reflected the feelings of many people touched by cancer. But it also demonstrated that, for all the good that cancer fundraising can achieve, there is a risk that it can perpetuate distorted and unhelpful messages – because they are the most effective way of getting people to give.
Research funded by Cancer Research UK has made a big difference to the lives and prospects of many patients, and it deserves every penny it can get. But as I watched Stand Up to Cancer I thought of those thousands of people who will receive a cancer diagnosis and the hundreds of thousands who are living with cancer, and I wondered how the message about the disease being deadly, a bully, the enemy within, impacts on them?
The message given out by Cancer Research UK’s excellent website has a very different aim: to give accurate information to help people take good decisions, based not on fear but on evidence.
I received a thoughtful response to my last blog post about the need for evidence-based decision-making about screening to prevent overdiagnosis. Dr Nicole Guiochet wrote that such arguments about risks and benefits are hard for healthy people because they have a fixed view about diagnosing cancer early. “He or she cannot imagine nor understand he or she will die with another illness because cancer remains the most frightening of all, even if detected early,” she wrote.
She is right, and public fear of cancer is entirely understandable. But does someone have to address the charity fundraising question: are the messages being sent out by the highly competitive world of fundraising holding back good understanding and good decision-making about cancer? Yes, the money raised does a lot of good, but is stoking up the fear factor too big a cost for those living with cancer or about to receive a diagnosis?