Last week a chest X-ray that I had ordered returned an unexpected 'shadow' on the report. The radiologist had gone ahead and ordered a CT scan and I sat in front of a very scared, otherwise well 70-year-old non-smoking lady, explaining what was happening. "Is it cancer?" she said, pleading with her eyes to be reassured.
It's always with us - the fear. The fear of having it and dying. The fear of losing someone we love because of it. The fear of missing it (as a diagnosis). One of my safety-netting thoughts has changed little over my 20 years as a GP; could this be cancer?
We are afraid because statistics tell us to be. Half of us born in the UK after 1960 will be diagnosed with some form of cancer in our lifetime. For most people, as my terrified patient above, the thought of cancer still brings them closer to the possibility of their own death than any other. TV and media education and advertising of national screening programmes have done a lot of great work. People are generally much more aware of red flags. They know when they should tell us something's wrong. They also know smoking is generally bad news if you're trying to avoid cancer. However, they're still afraid, so they don't come. They still smoke. Some of them just don't want to know.
So, I think we need a campaign that balances the fear. We need to broadcast the good news.
In 2016 in the UK half of all the people diagnosed with cancer will survive for at least 10 years.
That survival rate has doubled since 1975. With continued research it will continue to improve. Cancer Research UK hopes that by 2036 three out of four people with cancer will survive.
Two common types of cancer are prostate (men) and breast (women).
Prostate cancer survival figures show that:
• Around 95 out of every 100 men (95%) live for a year or more after they are diagnosed
• Almost 90 out of every 100 men (90%) survive for five years or more
• More than 80 out of every 100 men (80%) survive for 10 years or more after diagnosis.
Breast cancer survival figures show that:
• Almost 90 out of every 100 women (90%) will survive for 5 years or more after diagnosis
• Almost 80 out of every 100 women (80%) will survive for 10 years or more after diagnosis
• Around 65 out of 100 women (65%) are expected to survive for more than 20 years after diagnosis.
Also remember that your outcome depends on which type of cancer you have and how well you are generally. The figures above will include both fit and frail people and these figures represent the overall picture. There are good reasons to be hopeful and people need to be more aware of them.
Breaking unexpected bad news is always a balance of honesty, sensitivity and hope. At the time it is never good for either party but every now and then, fate is kind. Thankfully, my patient does not have cancer and it was wonderful to tell her so.