Eric Rosenthal Reports: Placing Cancer Fear in its Proper Perspective

Annual Meeting of the American Society of Clinical Oncology at McCormick Place in Chicago, Ill.
Annual Meeting of the American Society of Clinical Oncology at McCormick Place in Chicago, Ill.

During his first inaugural address in 1933, President Franklin D. Roosevelt famously said, “the only thing we have to fear is fear itself.”

It was in the midst of the economic Depression and the newly elected president was trying to raise the hopes of a nation in despair suffering also from the throes of psychological depression.

Earlier this month while attending a fundraising dinner for the American Society of Clinical Oncology’s Conquer Cancer Foundation during the society’s 53rd annual meeting in Chicago, I heard another phrase that really resonated with me: “a world free from the fear of cancer.

Those words expressed Conquer Cancer’s vision, which I’ve long thought to be a far more realistic goal than those claiming cures, eradication, or ending death and suffering from the more than 200 diseases called cancer.

This was my 29th consecutive annual meeting of the American Society of Clinical Oncology (ASCO), and as a journalist and communicator covering issues, controversies, and trends in oncology for several decades, I’ve witnessed and written about advances in cancer research, treatment, and prevention and control.

I’ve concurrently seen “quality of life” rise to a reasonable and achievable goal for many of the now more than 15 million cancer survivors in the United States alone.

Interestingly, just days before the meeting, Nancy G. Brinker and I co-authored an op-ed in The Hill related to Olivia Newton-John’s recent revelation that she had been diagnosed with metastatic breast cancer 25 years after her initial breast cancer diagnosis.[1]

Brinker, who founded Susan G. Komen, the world’s largest breast cancer charity 35 years ago, and is a breast cancer survivor herself, noted that many breast cancer survivors often live in constant fear that their disease might return and spread after it had been treated.

And that fear factor is still a critical component of how cancer has been perceived in our personal and collective psyches.

Over the years, the stigma of cancer has decreased and today the word once shunned from society is now ubiquitously uttered and heard.

Photo 1.0: Meeting – Siddhartha Mukherjee, MD, DPhil, speaks during Opening Session at the 53rd annual meeting of the American Society of Clinical Oncology (ASCO) on Saturday June 3, 2017.

Its status as the “Emperor of All Maladies,” as characterized in the Pulitzer Prize-winning book by oncologist Siddhartha Mukherjee, MD, DPhil, and the subsequent PBS documentary by Ken Burns has perhaps outlived its longtime reputation as a death sentence to one commuted in many cases as a manageable and chronic condition.

ASCO and other cancer research meetings have been the venues for announcing many significant scientific advances in understanding, treating, and preventing cancer.

But what was significant this year was ASCO’s inclusion of several psychosocial intervention studies (detailed elsewhere in Onco’Zine) under the meeting’s patient and survivor care track. [2]

One particular study looked at the long-term results of a phase II randomized controlled trial of a psychological intervention–Conquer Fear–to reduce clinical levels of fear of cancer recurrence in breast, colorectal, and melanoma cancer survivors.

The study found that Conquer Fear helped reduce fear of cancer recurrence more than relaxation training, and the point of this article is not to describe the mechanisms of the intervention itself, but to note that these so-called soft science studies are being untaken with their results subsequently disseminated through traditionally harder science conferences.

Several years ago the American College of Surgeon’s Commission on Cancer mandated that its more than 1500 cancer center and hospital members institute a number of psychosocial services for accreditation starting in 2015.

These included patient navigation, psychosocial distress management, and survivorship plans, and were in alignment with previous recommendations from the National Academy of Sciences Institute of Medicine’s reports including From Cancer Patient to Cancer Survivor: Lost in Transition. [3][4]

All of these efforts have yielded a world where many more people are living with cancer rather than dying from it, and a few quantum and many incremental scientific advances have made a tremendous difference in decreasing mortality from the once nearly always-fatal malady.

However, it still remains for cancer to be put into a proper psychological perspective where the conquest of unreasonable fear is far more reasonable than the continued hope of curing something that will always be replaced by other things that make us all mortal.

Which makes Conquer Cancer’s goal to help us deal with coping with the doable both laudatory and achievable.

This is the first in a series of the revival of Eric Rosenthal Reports, formerly featured in Oncology Times.

Last editorial review: June 21, 2017

Featured Image: ASCO 2017  Courtesy: © 2017 ASCO/Scott Morgan. Used with permission. Photo 1.0: Siddhartha Mukherjee, MD, DPhil. Courtesy: © 2017 ASCO/Scott Morgan. Used with permission.

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