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CAMHS won't see you now

Let's be clear on cancer... campaigns

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No doubt you’ll recall all the jolly japes we had with the ‘If you’ve coughed more than three weeks FOR GOD’S SAKE RUN, RUN FOR YOUR LIFE, RUN TO YOUR DOCTOR, IT COULD BE LUNG CANCER, DON’T LET THEM FOB YOU OFF OR IT’LL BE TOO LATE, WE’RE ALL GOING TO DIE’ campaign, which, let’s face it, seems like only yesterday.

Unfortunately, as you might recall, some of the nuances of lung cancer symptomatology were lost in that campaign, as minor details like age and smoking status didn’t fit neatly into the headlines. And that resulted in me, like you, having to deal with a flood of the worried well, including the parents of a coughing child who were agitated that their little poppet had The Big C when in fact it was just a cold, with a decidedly little ‘c’. Still, can’t be too careful, as some – though not all – of us agreed at the end of that particular consultation.

Now we can relive all that fun, albeit with the punters angst-ing about a different pathological possibility: because, this time, the ‘Let’s Be Clear On Cancer’ Whole Body Tour has just rolled into kidney and bladder territory. I quote from the patient blurb, ‘If you notice any blood in your pee, tell your doctor straight away.’ True, the small print mentions age and offers some reassurance. But there isn’t the key contextualisation explaining the whole world of difference between painful and painless haematuria. Quite the opposite: ‘needing to pee very often or suddenly’, and ‘pain while peeing’ are actually cited as ‘other bladder cancer symptoms.’

Result? Many people with OAB will be running to the doc when they’re not running to the loo, and absolutely everyone with haemorrhagic cystitis will be - and not just to get the antibiotics they need. Still, NHS /Public Health England can back it all up with the results of pilot studies, which in the world of cancer campaigns appears to constitute gold-standard evidence.

Look, I know they mean well. But the simple fact is that you really can’t condense the subtleties of cancer symptoms into snappy headlines or catchy slogans. And trying to do so ends up causing more harm than good: anxiety, unnecessary appointments, increasing pressure on overstretched services and a general ratcheting-up of the climate of health fear.

So put the dates in your diary (15 October to 20November ) and batten down the hatches. Let’s be clear on cancer? Let’s confuse and catastrophise, more like. It certainly feels like someone is taking the piss, and I can only hope it won’t be me.

 Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield.

Readers' comments (7)

  • Incidentally, having booked this one for in the flu season, the next campaign launch is timed for the end of February next year to add to your QOF year end fun.

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  • Just a comment on the bowel cancer campaign ........ This offered very clear advice on when to see your GP....... If you have had "looser poo" or "blood in your poo" for THREE weeks. Why then did I end up seeing literally DOZENS of patients with a just a single smear of blood on the toilet paper about half an hour before their appointment???

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  • So how would all you critics increase patient knowledge about these issues?

    I'm getting really tired of the constant carping without any suggestions on how it should be done.

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  • Mr Swain
    1 I'm not convinced there's good evidence that patients do incur significant delays on the basis that they 'ignore' blood in their urine.
    2 Headlines and sloganeering about cancer are likely to cause more inappropriate anxiety than appropriate awareness.
    3 Given the above, the basic ethical principle of medicine,'first do no harm', should apply ie it's arguable that anything ought to be done at all until we have a sound evidence base for a) A need b) A solution.

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  • Mr Swain,
    Please read T'he Patient Paradox' by Margaret McCarthy.
    This will enlighten you about why searching for solutions to problems isn't as simple or desirable as first it may seem.

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  • copperfield is so right.
    not only do we have to cope with the massive tsunami wave of ill educated information in the media about medicine and endless poor reporting about health scares..but even OFFICIAL campaigns get it woefully wrong.
    you couldn't even dream it up

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  • Russell Thorpe

    I enjoy DC immensely and always head straight for his column. Deep down inside he knows that the joy of general practice has always been about panning the Tsunami of misery that swamps our waiting rooms each morning for that nuget of true pathology. The Be Clear on Cancer campaings are all about raising awareness of and empowering people to act on symptoms that could be a cancer. Finding a curable cancer is a true prize so think of the campaigns as "increasing the joy"!

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder