Posted by: Tony Copperfield11 October 2013
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 firstname.lastname@example.org and follow him on Twitter @DocCopperfield.