People are more likely to opt for aggressive treatments when their condition is labelled cancer, even if the risk of progression is lower than another condition labelled a ‘tumour’ or ‘nodule’.

‘Cancer’ is a loaded word, linked to death, difficult treatments and hardship. But while many cancers are deadly, others are slow-growing or relatively benign.

Some doctors have raised concerns about what we call ‘cancer’ because having your disease labelled as such can cause undue stress and fear. For some prostate, thyroid and breast tumours, the best form of treatment may simply be to watch and wait because these diseases can sometimes take years to have an impact and may never cause you harm at all.

So how much can the label cancer influence a patient’s treatment decisions, and could it be motivating them to undergo unnecessary – and potentially harmful – treatments?

In a recent American trial, they asked healthy people to choose between a series of paired hypothetical questions, centred around the language used to describe their disease (either a cancer, a tumour or a nodule) and the risk of that disease progressing one, two or five per cent risk of progression.

For example, they might be asked to choose between having a tumour with a two per cent risk of progression, or a cancer with a one per cent risk of progression. After analysing their answers, the researchers were able to work out how much the label of cancer changed what condition a person would hypothetically prefer to have, and what treatment option they would opt for.

They found that people were much more likely to be concerned about something called cancer, as opposed to something called a tumour or nodule. For example, having a thyroid cancer with a one per cent risk of progression was ironically perceived as bad as having a nodule with a five per cent risk of progression.

Decisions depend on which organ the tumour is in and the stage it’s at ie how early and aggressive.

The label cancer also made people more likely to opt for aggressive forms of treatment such as surgery, compared to watching and waiting (also known as active surveillance).

Implications

Cancer affects so many lives and the prospect of being diagnosed with cancer can be terrifying. But under the broad umbrella of ‘cancer,’ there are many different conditions, some of which may allow you to live a happy, healthy life with minimal treatment for many years.

Asking your doctor questions about your level of risk, the type of cancer, and the different treatment options, can empower you to make the decision you feel is best about your condition.

Last Reviewed: 23/03/2020

© Norman Swan Medical Communications.



References

For reference: Dixon, et al (2019). The Role of Disease Label in Patient Perceptions and Treatment Decisions in the Setting of Low-Risk Malignant Neoplasms. Cochrane Library doi: 10.1002/14651858