The Winner on Fear-Factor: Cancer

Posted on February 23, 2012 by

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It’s kind of morbid, but sometimes, in an effort to feel grateful, I go through all the horrible illnesses I could have but don’t. It ‘s like counting sheep when my arthritis keeps me up at night.

And here’s the thing—there some  illnesses that are so totally dreadful I fear even thinking of them, almost as if the thought of them could allow them entrance into my body.

ALS is unremittingly horrible. Parkinson’s strikes me as a slow encasing of a person inside their own corpse. Alzheimer’s, in stealing a person’s mind, takes away their very personhood, leaving only detritus in its wake. I had a patient with Scleroderma, an autoimmune disorder, which means that her immune system mistakenly attacked and destroyed her healthy body tissue. Going into gory details to plead my case seems rather perverse, but her illness was [she succumbed to it] grim, unrelenting, debilitating—it comes in high on my list.

One of the diseases, ironically, that doesn’t make my top ten—cancer.  I’ve seen a lot of cancer patients, and I’ve seen some make it and some not, and the struggle is terrible—there’s no negating it. But I still harbor fear of these other illnesses more, in their debilitation, their hopelessness for improvement, the rapid and brutal progression, their stealing of the personhood.

Apparently–I’m alone.

Overall, people fear cancer more than any other illness.

In a survey of 1,007 adults conducted by Harris Interactive for the MetLife Foundation and published in early 2011, cancer lapped the other illnesses. With far and away most participants identifying cancer as their most-feared illnesses (41%), an interesting second was Alzheimer’s disease at 31%. Fear of both of these illnesses rose in comparison with a benchmark 2006 study

It’s a free world, and people may fear what they will, but what’s odd about the cancer domination is that it’s not in line with the diseases people are most likely to succumb to. In an article with a title that leaves little to the imagination or hypothesis, “Women Most Fear Breast Cancer, but Heart Disease Is the Top Killer,” the article notes that—and perhaps you really don’t need me for this interpretation, do you?], although heart disease kills more American women than any other illness [that title is really a spoiler], according to a survey by the Society for Women’s Health Research in Washington, D.C., women still fear—well, you can read titles as well as I..

Just how mis-matched are we, in our fears of what might kill us vs. the reality? Well, the article notes that “Heart disease was responsible for 28.6 percent of all deaths in U.S. women in 2002, the last year for which complete data is available from the Centers for Disease Control and Prevention. All cancers combined, however, represented only 21.6 percent of women’s deaths that year. Breast cancer [a major fear for women—in some studies it tops the list] was responsible for less than four percent of all deaths.”

A more scientific study in the October 1982 article in the American Journal of Psychotherapy, entitled “Psychological concomitants of cancer: clinical aspects,”  confirms that cancer holds the blue ribbon of fear. [Authors suggest that “lack of personal control over the current treatment methods and the uncertainty about outcome” play a major role in this fear. Perhaps—more on what causes this fear in a moment.]

And the Brits are no better off when it comes to the cancer bugaboo. An August 2011 Cancer Research UK Press Release revealed that over a third of people in the UK fear cancer more than any other life-threatening conditions—that’s including heart disease, stroke, Alzheimer’s—a whole gamut of illnesses that might have placed first.

So what’s up?

Sherry Marts, PhD,. the Society for Women’s Health Research vice president of scientific affairs, offered her two cents: breast cancer organizations have done an excellent job in raising awareness.

So perhaps, if I understand her correctly, people just know more about breast cancer due to PR pushes [and, I add, know more people with it.  In an informal survey I ran among my family members, we concluded that we did, indeed, all know someone with breast cancer. Maybe try this at home.], and thus the illness is simply around in our conscious to come attach to the fear-receptors of the mind. Seems plausible.

Dr. Michael Remetz, associate professor of cardiology at Yale Medical Center, offered his hypothesis , different from Dr. Marts’, about cancer’s primacy in the fear field. He suggests that heart disease is viewed more as a chronic illness that people can live with—something that won’t kill them immediately.  Assumedly, then, he must think people fear cancer because they’re afraid they’ll succumb immediately, and, frankly, in my experience that’s not true. It’s the treatments, the indignities, sometimes even the mere lingering that comprise the fears. I’m not sure I’m impressed with this theory—any takers?

I thought Dr. Rametz did better when he suggested that breast cancer particularly may inspire such fear because of the thoughts of the mutilating surgery involved, while with heart disease there are meds, stents—things that don’t alter the physical appearance in a way that is emotionally painful. And I think he’s got a point there. The breast surgery treatments do start to feel like cut, slash and burn—and to parts that are inextricably connected with our femininity. Seems to me the doctor redeems himself somewhat here.

Over my years of working with cancer patients in treatment, I’ve come to believe that Zofran itself has made a significant difference in treatment—but that the collective mind has not internalized the amazing turn-around the anti-nausea drug has made to chemotherapy response. While formerly patients were so sick with vomiting they couldn’t attend support groups and appointments, and lay in bed, a pail by their side, Zofran has revolutionized their ability to live fuller lives. But I think we’re still fighting that image of the vomiting patient, too sick to lift her head..

Additionally, aside from Zofran, there are other positive realities about current cancer courses and treatments that people simply don’t realize.

And I stop here, taking a break from regularly scheduled programming, to declare this: Cancer is a terrible illness, and I do understand that people are afraid. I would be appalled at myself if I acted the part of Pollyanna: “Aw, shucks, don’t be afraid of cancer; it’s just ducky!” I just simply, both due to my scientific mind, and the sheer number of patients I’ve seen who ran the cancer course without undue, terrible results, am curious why cancer remains the number one feared illness, when there are so many awful ones—and when it is not even the leading killer. So bear with me.

Another theory: I, being one, probably like many people, who’s basically wholly against pain as a concept, of course fear illnesses—and cancer included—because of the pain these illnesses might cause me. And that is surely one of the reasons cancer tops out the fear charts—people connect it with the idea of severe, intractable pain.

But heartoftheredwoodscommunityhospice.org created a pain document for cancer, and I found this statistic astonishing—and quite heartening [click here to see their 6-page paper on pain control: Pain control article from redwoodshospice].  They write that “some cancer patients experience little or no pain and only about 40% have pain severe enough to require pain killers.”

And the way I read that, that means any pain killers—like aspirin or tylenol—not necessarily the big oxycontin guns. So that’s leaving more than half of the cancer population in little enough pain that they don’t even need to pop an Advil—which has become a nightly  ceremonial practice in my house, what with each member’s aches and pains—and have I mentioned my arthritis?

I wish I could wish the fear away–wave a magic wand and tell you that those who fear cancer have nothing to fear but the fear itself. But I’m no FDR–and I’d really be lying. In fact, Michael Marshall speaks more to me, in his The Upright Man:

You can’t stop begin afraid just by pretending everything that scares you isn’t there.”

But maybe just by knowing about Zofran, or knowing about the tolerable levels of pain–maybe these can help you feel less afraid. Or maybe just knowing you’re not alone, that if you fear cancer more than any other illness, you’re in great company–maybe that can offer you some level of comfort. Because key in this battle for survival that we call life is often simply that–knowing you’re not alone.

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