When Fran Parson of North Plainfield, New Jersey, was diagnosed with breast cancer in 2002, she was dumbfounded. "I had no family history," says the 38-year-old secretary for Sisters Network of Central New Jersey, a national organization of African American breast cancer survivors.

“I’d never had a mammogram. I had no reason to. I thought cancer was caused by things like smoking, drinking or eating too many fatty foods, things I didn’t do. I’m healthy and exercise and go for annual exams.”

Like many others, Parson thought young women with no family history have little chance of getting breast cancer. But what she didn’t know was that only 15 percent of women diagnosed with breast cancer have a close family member with the disease1 and a smaller percentage are the result of an inherited genetic mutation.2

Misinformation abounds about cancer, its detection and treatment. Understandably, many people don’t think about cancer until they or a loved one is diagnosed. “We all have this myth of immortality and we’re going to live forever,” says Timothy Moynihan, MD, cancer specialist at the Mayo Clinic in Rochester, Minnesota. “If you haven’t been affected, the average patient won’t pay too much attention.” 
 

Common misconceptions about cancer are that the medical industry is withholding a cure; pain is inevitable; treating cancer with surgery can make it spread throughout the body; microwaving plastic containers and wraps releases harmful, cancer-causing substances into food; antiperspirants or deodorants can cause breast cancer; cancer is contagious; and all you need to overcome cancer is a positive attitude.
 

“There’s no clear evidence that patients with a positive attitude have a better outcome,” says Dr. Moynihan, “but a positive attitude does makes people more active in their treatment and they tolerate therapy better.” There’s also no evidence that underarm deodorant can cause breast cancer3 or that microwaving in plastic can cause cancer.4 These are popular urban myths, he says. 

Sociodemographic Factors

In 2002, the American Cancer Society surveyed 957 U.S. adults who had never been diagnosed with cancer about their beliefs toward cancer and its treatment.5 Higher education and income levels were associated with more accurate responses to questions about cancer myths. In contrast, people who were nonwhite, 65 years or older, residents of the South and those who reported being not very or not at all informed about cancer had the highest misconception scores. When people hold certain beliefs, they may be less likely to seek treatment and have poorer outcomes, according to the study.

Misperceptions about breast cancer have led to the greatest number of questions at the American Cancer Society’s call center, says Ted Gansler, MD, director of medical content for the American Cancer Society in Atlanta. That’s because breast cancer is so common and its causes and preventive strategies aren’t as well known as other cancers, he says. “For example, we know that 85 to 90 percent of lung cancer cases are due to smoking,6 but it’s much more difficult to say what causes breast cancer. There’s an opportunity for a lot more public speculation and misperceptions.” 

In unpublished data from the 2002 ACS survey, people were asked whether getting a mammogram caused breast cancer from radiation. Ten percent of the general population said that was true and 16 percent said they weren’t sure. “That concerns us because it leads women to forgo opportunities to detect breast cancer early when it’s most effectively treated,” says Dr. Gansler.

Mistruths are borne in many ways. People want explanations for things and hang on to these things, says Dr. Moynihan. “Sometimes it is not understandable information. People prefer what they can understand and what makes sense to them.” 
 

The Impact of Myths

Misconceptions can interfere with screening habits and treatment choices. For example, the outcome for breast cancer for African American women is worse than for white women even though African American women have a lower incidence rate.7 This disparity may be due to a delay in diagnosis or a difference in the biology of the disease, says Dr. Moynihan. “Stage-for-stage African American women might do just as well, but a delay in diagnosis or lack of insurance or a concern about going to the doctor may worsen your prognosis. Any group that seems to have been disenfranchised or for any reason doesn’t feel part of the mainstream culture may not trust the system and may delay diagnosis and therapy.” 

An alarming 41 percent of respondents in the ACS survey endorsed as true the statement “treating cancer with surgery can cause it to spread throughout the body.”5 According to Dr. Gansler, “Once you’re diagnosed, hopefully you are under the care of qualified cancer specialists and have opportunities to learn more about cancer so you can make informed choices about care.” 

In the ACS survey, 19 percent of participants endorsed the statement “pain medications are ineffective against cancer pain” and 13 percent were unsure.5 “It’s tragic that many people are not getting the best available pain control,” says Dr. Gansler. “Some people think that enduring pain will strengthen you. In fact, those who get pain medication will do much better and be better able to get out of bed and do more of the things they enjoy in life.” 

In the same survey, 27 percent of respondents endorsed the misconception “the medical industry is withholding a cure from cancer from the public in order to increase profits.” To a certain extent, Parsons believes this may be true. “I’ve changed doctors more than anyone I know diagnosed,” she says. “There are some doctors who are convinced that there are doctors who can cure people, and that the government ran all five out of the country. In my early years of treatment I asked doctors, ‘Do you think I need to add something to my diet?’ My oncologist kept saying, ‘No, eat anything in moderation.’ I asked, ‘Should I take any vitamins or supplements?’ She kept saying no, but the chemo was weakening my immune system and they weren’t telling me to take anything to boost it.”

Dr. Moynihan acknowledges many people believe the medical establishment is withholding a cure. “It reflects some people’s frustration with not having better cures and easier answers. It’s human nature to think that way,” he says. “But you must consider the unimaginable fortune and fame that awaits a cure for cancer. The pharmaceutical industry makes a huge amount of money providing treatments that are partially effective. Imagine how much they could charge, and how much people would be willing to pay for a cure.”
 

Making Informed Choices

Radita Melente of Glenview, Illinois, never thought she’d get cancer. “I never thought it would happen to me,” says the Romanian-born Melente, 44. “My family are healthy people.”

But in January 2002, she began to feel tired. The married mother of three thought her fatigue was from work and stress. After several tests and a second opinion, doctors found an early stage gastrointestinal tumor that had spread to her ovary. It was surgically removed and she remains cancer free.

 “We need people to be able to think more independently to critically judge information that is presented to them,” Moynihan says. “People need to be able to weigh the facts and the fiction. I tell patients they’re going to hear a million things about various treatments but the most important thing is to bring in a healthy dose of common sense. If it sounds too good to be true, it probably is. If you have to mortgage the house, don’t buy it. If something sounds reasonable, read up on it.”

One misconception about sun protection is that a dab of sunscreen will protect you for the day. “People significantly underestimate the amount of sunscreen you need to cover the adult body,” Dr. Gansler says. The amount people need is about the size of a golf ball, he says. “Apply it twice when you first go out, and periodically reapply after swimming and towel drying.”

How do patients’ attitudes toward cancer change once they’re diagnosed? “Hopefully, says Dr. Gansler, “Once they are under the care of qualified oncologists and get information from reliable sources they learn what they need to know to make wise choices about their care.”