Debunking myths about cancer

The Washington Post

June 10, 2022

Marlene Cimons

Debunking myths about cancer

For someone recently diagnosed with cancer, or just terrified of getting the disease, the world — especially social media — is full of scientifically inaccurate information about how to avoid it, how to treat it and what to fear about it.

Yet to the frustration of many cancer doctors, these outdated myths — such as whether, absent scientific evidence, you should eat or avoid certain foods, take herbs or other supplements, or skip therapy in favor of a “naturalistic” approach — continue to appeal to many patients, harming how they cope with a cancer diagnosis and putting their treatment at risk.

“When something triggers emotions, it can be hard to get logic and reason through because cancer is scary, especially for people who have never seen it, or for people who have watched family members who have had it,” says Rachel Buchsbaum, director of the cancer center and chief of hematology/oncology at Tufts Medical Center. “It’s hard to get the message across that today’s treatments and technologies are a lot better than they used to be. The fear of cancer is still so pervasive, that they often continue to hang with the emotion.”

Research suggests that despite steady decreases in cancer mortality rates in recent years, most Americans still see cancer as a death sentence, a perception that is not only false but also dangerous if it leads people to forgo prevention, early detection and treatment, experts say. More than 16.9 million Americans who had invasive cancer years ago still were alive as of Jan. 1, 2019 — the most recent year statistics were available — with no signs of disease, according to the American Cancer Society. By Jan. 1, 2030, an estimated 22.1 million or more Americans will be cancer survivors, the ACS says.

“Cancer care, including the emotional and psychological stress surrounding a diagnosis, the sense of uncertainty that results, as well as the complexities of treatment decisions, make patients vulnerable to harm caused by misinformation,” says Wen-Ying Sylvia Chou, a program director in the health communication and informatics research branch of the National Cancer Institute’s Behavioral Research Program. “We all want good information, but the information environment sometimes turns us in other directions.”

Many popular but inaccurate assumptions about cancer cause needless worry, sometimes prompting people to disregard established prevention behaviors, such as exercising, quitting smoking or avoiding the sun, and can result in unwise treatment decisions, experts say.

“People Google things and don’t understand the nuances involved in cancer care, treatment and prognosis.” says Julie Nangia, associate professor of medicine at the Baylor College of Medicine and medical director of breast oncology at its Dan L. Duncan Comprehensive Cancer Center. “All cancers are not the same, and cancer knows no rules or boundaries so you can’t predict it.”

The Washington Post asked several cancer experts to address some of the most common myths about cancer:

Cancer is almost always a death sentence. “Many decades ago that’s how people felt because the death rates were higher and the research and treatments were not as advanced as they are today,” Mayo Clinic oncologist Karthik Giridhar says. “Now we have prevention, early detection and cutting therapies and the vast majority of people are surviving longer, with increases each decade, and living better and more productive lives.” Early detection is critical. For example, the breast cancer death rate, which peaked in 1989, has since decreased by 42 percent as of 2019, thanks to early screening, better treatments and increased awareness. For prostate cancer, the five-year survival rate approaches 100 percent for the majority of men diagnosed with “local” or “regional” prostate cancer, meaning before it has spread.

Cancer is contagious. This is false. You cannot “catch” cancer. But certain viruses and bacteria can raise the risk of cancer, including human papillomavirus (cervical cancer), hepatitis B virus (liver cancer) and the bacterium Helicobacter pylori (stomach cancer). Vaccinations can prevent HPV and HBV. And there is no need to avoid contact with someone who has cancer. “You can hug and kiss someone with cancer, or even be intimate and there is no risk to you or the person with cancer,” Nangia says.

Everything causes cancer, so why bother trying to protect myself? “Everything doesn’t cause cancer,” Buchsbaum says. “There are a few clear lifestyle things people can do to lessen the chance of getting it. Exercising every day. That’s a big one. It’s the best thing you can do for yourself, that and not smoking, keeping your weight in the normal range and limiting alcohol to less than one drink a day, which should be the target you shoot for if you are going to drink regularly.”

Diane Reidy-Lagunes, associate deputy physician-in-chief of Memorial Sloan Kettering Cancer Center’s Regional Care Network in the New York metropolitan area, and host of the hospital’s Cancer Straight Talk podcast, agrees. “Cancer typically is an accumulation of genes that get damaged over time, often over many years, which is why cancer is much more common with older people,” she says. “For that reason, exercise, eating well and avoiding harmful exposures like smoking and alcohol can lower the risk of developing cancer.”

Chemotherapy side effects are horrible. “This is definitely not true,” Nangia says. “The supportive care medications are amazing now and most patients do very well. It is not common for patients to have nausea that is not controlled with medications or severe side effects that cannot be managed.”

Reidy-Lagunes agrees. “Today’s chemotherapy treatments are given for many reasons and for many different types of cancer,” she says. “Sometimes chemo is given to shrink a tumor before surgery. Sometimes it is given to control disease and keep a patient stable. Doctors take many factors into consideration when developing their patients’ treatment plans,” and make every effort to help their patients avoid side effects.

Reidy-Lagunes says that patients today can take medicines before chemotherapy to prevent side effects such as nausea and vomiting. “The most common side effect is fatigue, which accumulates over time,” she says. “Some experts compare treatment to a prize fight. The first time you get knocked down, you jump right back up. After the second or third, you still get up quickly. By the time you get to the fifth or sixth knockdown, you get up more slowly — but you still get up.”

Hair won’t regrow after chemo. One of the dreaded side effects for women in particular is hair loss and the fear that it won’t come back. Experts say it may take some time but in most cases hair does return, although it can be a different texture or even color. “Chemotherapy works by attacking fast-growing cells,” Reidy-Lagunes says. “Cancer cells are fast growing, but so are other cells, such as hair cells. Chemotherapy can cause hair loss on your scalp, eyebrows, eye lashes, arms, legs and pubic area. Depending on your chemotherapy, you can lose hair in none, some or all these areas. Once your treatment ends, hair should begin to grow back. Hair regrowth can take three to five months. When hair grows back, it may have a different texture or color and in rare cases, hair won’t grow back as fully as it did before. Radiation therapy to the head often causes hair loss on the scalp. Sometimes, depending on the dose of radiation, hair may grow back differently from how it looked before, or in a very few cases it may not grow back at all.”

“It may be more curly, but hair grows back in the vast majority of patients,” says Andrew M. Evens, associate director for clinical services at the Rutgers Cancer Institute.

Rarely, with a chemotherapy agent called docetaxel, which is sometimes used in treating breast, prostate, stomach, and head and neck cancers, and certain lung cancers, there can be permanent hair loss, Nangia says.

Reidy-Lagunes recommends “scalp cooling” as a way to reduce hair loss while undergoing chemotherapy for solid tumors, that is, cancer that is not a leukemia or lymphoma. Scalp cooling, which has been approved by the Food and Drug Administration, involves wearing a cold cap device on your head before, during and after receiving chemotherapy and has been shown in studies to reduce hair loss.