17 August 2018

Do we need to go easy on dropping the ‘C-bomb’?

Cancer Communication General Practice

What’s in a word? Plenty, if that word is cancer, Australian researchers have said in an article in the BMJ.

Arguing that the “C-word” should be dropped when referring to very low-risk conditions, such as localised prostate cancer, low and intermediate-grade DCIS and intrathyroidal papillary thyroid cancer, the authors said the use of more medicalised labels could increase levels of anxiety and the desire for more invasive treatments.

Using the term cancer for non-growing or very slow growing tumours could lead patients to seek high-impact treatments, such as surgery or chemotherapy, rather than more conservative options such as active surveillance.

“While active surveillance is increasingly being recognised as a safe management option for some patients with cancer, there is still a strong belief that aggressive treatments are always needed,” senior author Kirsten McCaffery, from the University of Sydney, said.

However, RACGP President-elect Dr Harry Nespolon disagreed with the study, saying withholding details of a diagnosis from patients was the wrong approach.

“This takes us back 50 years to a paternalistic form of medicine where doctors know best and they tell patients what they need to know and what they don’t,” Dr Nespolon told newsGP.

Dr Nespolon said GPs deliver any cancer diagnosis by putting it into context.

“GPs provide background – the risk, low-grade or high-grade, treatments, referrals, and coordinating the care of the patient from the time of diagnosis,” he said.

“Changing words [away from cancer] gives the impression the profession is hiding things from them.”

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Liam Tjia
Liam Tjia
9 months 2 days ago

Good on you Dr Nespolon! I don’t know why experts in public health feel qualified to advise on clinical practice – if they had to actually meet an individual patient in real life, take responsibility for helping with what the patient actually wants help with, they’d be all at sea.

Great comment on MHR too. Please come and fix up my RACP once you’re finished with your own college.

Dr Liam Tjia
Paediatrician, Melbourne