Worrying news stories about people with cancer seem never-ending, from the famous (Kate Middleton and King Charles) to the not-so-famous (a local nurse, teacher or schoolchild). Small wonder. The condition is often cruel, and a common killer. It also has unique psychological characteristics that make it particularly fearsome.
We are more frightened by threats over which we feel we have no control, that cause great pain, that we have personally experienced and that feel imposed on us. More than any other disease, cancer triggers all those alarms, which helps explain why it has been the in richer nations with longer lifespans for decades.
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One overlooked effect of all this fear has been the creation of a new condition, which George Crile Jr. called “cancerphobia” in an in 1955. He wrote: “It is possible that today, in terms of the total number of people affected, fear of cancer is causing more suffering than cancer itself.” This remains true, even more so given the progress we have made against cancer. In important ways, our deep fear of it is outdated, a phobia that no longer matches the evidence and causes huge harm.
Most people still that a diagnosis of cancer is a death sentence. That is no longer true. Slow but steady progress in the past few decades has made roughly two-thirds of all cancers as chronic diseases or curable outright.
Many people believe cancer screening is always beneficial because it is always best to find it as early as possible. That isn’t entirely true either. Screening helps, certainly, but it also harms. Mammography and prostate-specific antigen screening produce large numbers of frightening false positives, and there is a rich body of evidence that these scares can leave lasting psychological scars.
Even worse, screening disproportionately finds more cancers – common types of breast, prostate, thyroid and lung cancers, for example, that are found early when they are small and localised and that meet the pathological criteria of cancer under a microscope, but grow slowly or not at all and don’t cause any symptoms. We have learned by watching such cases over time that they almost never pose any health threat.
But even after doctors assure such people that their condition is essentially non-threatening, those frightened by the dreaded words “you have cancer” often choose more aggressive and risky surgeries than required. Tens of thousands of people seriously harmed or left with additional health conditions by these procedures. Some die. Healthcare systems spend billions on this clinically unnecessary care.
Most people that the majority of cancers are caused by environmental carcinogens, largely industrial chemicals. That has never been true. We now know that cancer is predominantly caused by naturally occurring mutations to DNA that accumulate as we age. Cancer only became common in the early 1900s, as average life expectancies in richer nations .
As a result of this false belief, governments spend vastly more to reduce the risk from environmental carcinogens than on any other environmental health threat. Much more is spent on cancer prevention than heart disease prevention, though kills more people globally.
We can’t entirely cure cancer – it is wired into our biology – nor can we entirely “cure” cancerphobia, the part of cancer fear that is a natural product of our instinctive risk-perception psychology. But we must work to reduce the harm they both cause to our health and to society in general. Research into combatting cancer has come a long way. The work on our cancerphobia is just beginning.
David Ropeik is a science journalist and author of
