Transcription:
Cancer Myths and Citizen Science

Melanie Cole (Host):  With so many cancer myths and urban legends out there, it can be confusing as to what to believe. Here to debunk cancer myths while sharing cancer facts that matter such as risk factors, prevention and the research underway at City of Hope, is my guest Dr. James Lacey. He is associate professor at City of Hope's Division of Cancer Etiology and a member of the Cancer Control and Population Sciences Program.
Welcome to the show, Dr. Lacey. So, let's talk about some of the cancer myths that people have because there are so many out there. In your opinion what is the most single thing that you hear that people ask and you say, “No; that is absolutely not true.”

Dr. James Lacey (Guest):  A common question we are often asked is, “Do power lines, cell phones or radiation cause certain kinds of cancers?” Brain cancers, leukemia and things like that and the motivation for that question from a lot of folks comes from a good place. People, we tend to want to put a narrative on things, and for some of these cancers we still, as a research community, don't quite know yet what causes them. So, I think it's just natural for folks to want to take things that they see as observations and ask, “Are these things related?” In essence, what people are doing is being scientists and that is the basis of scientific methods. That said, it's one thing to notice those connections, it's another thing altogether to then systemically apply the scientific method and investigate, okay, do power lines cause leukemia? Are brain cancers caused by cell phones? And for those two things, the data that have been accumulated thus far from lots of studies, lots of people all over the world indicate that the answers are really “no” and “no” right now.

Melanie:  No and no. So, I am glad you brought up the cell phone because also with Bluetooth, people wonder if that's contributing to brain cancer.

Dr. Lacey:  It's a good question. What’s underlying that question as well is an interesting nuance on how we do these new kinds of sciences. As you mentioned, I am in the population sciences program, that means that one of our key priorities-- one of our responsibilities-- is to get in the community and research what are people doing? What things are happening in the community and how do those things relate to health and wellness and disease?
Now, when we do that we can, of course, only study things that exist and cell phones and Bluetooth are relatively new. So, when the public comes up with a very reasonable question, “Are cell phones causing brain cancer?” They'll turn to us and say, “Give us the answer.” At some point we are having to play catch up. We don't have the luxury of having 100 years’ worth of data that we can go back and mine quickly and to say, “What about the people who used cell phones a hundred years ago? Did they have an increased risk of brain cancer?”
So, in that sense it's somewhat of a rush to try to get an answer as soon as possible, while the underlying exposures in the live cells in the population are changing at the same time. It's challenging. It's not impossible but that's one of the reasons that you hear a lot of nuance and a lot of clauses and things. “Well, based on the evidence to date and what we have seen so far…”  Now, for cell phones and brain cancer there has been a great collaborative effort across the research community to try to assemble all the information thus far, and based on the best information right now, it looks like cell phones are not an important cause of brain cancer.

Melanie:  So, with all of the availability now -- and we'll get to some more myths in a while -- but with all of the availability of information out there, people think they have a symptom of something, they run to the internet and it tells them what type of cancer that they have.
They go to the doctor armed with printed sheets of things that they have researched; of treatments, of types of cancer, of cures of all these things. What do you think, as a physician, of this citizen's science, as it were, of people researching all of these things themselves and bringing it to doctors, claiming that they have the information?

Dr. Lacey:  On the whole, I think it's great. It raises a couple of new challenges and a funny story that we can all remind ourselves of -- there is a word for this that physicians have used for a long time called the “intern syndrome.” It's based on the idea that when medical students start reading the pathology books and all of the other medical specialty training books, they see new diseases, lots of diseases, lots of symptoms and they start to say, “Hey I have that. Hey, I’ve had that.” And so, there is this process of almost paranoia amongst interns and medical students who are finally learning about all these new diseases. What your question says is what we have all noticed. Particularly, because of the internet, now we can all be interns and we can all have intern syndrome. So, it's perfectly natural, I think, for us to see things and to go to public websites and say, “Hey, that sounds like what I have,” or “Hey, that sounds familiar.” The good component of that is that empowers us as patients to be more proactive about telling our healthcare providers what we are doing, what medicines we are taking, what supplements we are going to be taking, what changes there be in our life style. So, to the extent that this interest by we citizens and we patients can help physicians get a better handle on what we are actually doing, that's a great thing. Now, for providers there is that challenge of how to sort of manage expectations and talk about some of the things that I mentioned earlier and that is that sometimes the best answer is “We don't know.” Sometimes the best answer to a question is, “I can see why you think that way but, in fact, the science says otherwise.” So, it's a challenge to manage and I think overall it’s a good thing and it's a perfectly natural evolution of how we get information these days.

Melanie:  And you don't think that docs are insulted when people bring this information and especially when they bring the information to a mainstream western medicine doctor about all these alternative treatments and say, “Why aren't I trying these?” Or, “Why aren't you telling me about these?”

Dr. Lacey:  It's a good question and I think we can all imagine how that conversation could be insulting to either the provider or the patient for variety of reasons. If the patient comes in starting from the stand point of this western medicine approach is wrong and I know better than that. You know, if we are the physician sitting on the other side that would be a little off-putting. On the other hand, none of us as patients like to be sort of patted on the top the head and say, “No, no. You’re wrong and trust me. I am the physician.” And we can all think back to parts of the medical environmental videos that have been that kind of paternalistic and we can all think of instances where a patient might have been too zealous in saying that no he or she has all the answers. What it really comes down to is communication and I think the healthcare community both on the research side and the provider side is realizing that what this opportunity presents for us is there a chance to remind everyone particularly about health information – communication, communication, communication.

Melanie:  And I think it does offer that communication, that we are able to now come a little bit more armed with information--some of it pretty good. Do you have any advice for listeners on finding quality information and being able to discern. We don't have a lot of time, Dr. Lacey, but being able to discern the fact from the fiction that they see on the internet?

Dr. Lacey:  Yes. In a short amount of time, here are the bullet points that I would provide for them.  If you are looking at a bit of health information particularly on the web and it's crystal clear who wrote that information or created those data, where that person is, is that in a university, hospital, an institution and who is reporting it? Those are three key indicators that if you see those things present, you can start to dive into some of the details. And then, does it pass the sniff test? Do other people tend to say the same thing? And then talk to your physician and health care providers and go from here. It's a fun journey, I think.

Melanie:  Well, I think so, too. And I think that we all are looking for the good quality information and that really good advice so that we can feel like we’re a part of our own healthcare and being our own best advocate. So, in just the last minute, please give your best advice for those myths and facts and citizen’s science, as it were.

Dr. Lacey:  At heart I am a cancer scientist and when folks ask me, “How should I reduce my risk of cancer? What can I do to prevent cancer?” It goes back to a lot of things we have heard for a long time: eat right, exercise as much as you can, don't smoke, apply sun screen, try to maintain a healthy weight, get your cancer screening, know your family history and, finally, and this really gets to that the key distinguisher. Pay attention to your health. Each of us is probably the best gauge of our bodies, our health, and our lifestyle. If something seems amiss, don't be afraid to mention it, to dig into it, to explore a little bit and then start your conversation with your health care provider.

Melanie:  Thank you so much. That is great information, Dr. Lacey. For more information you can go to cityofhope.org. That's cityofhope.org. You are listening of City of Hope Radio. This is Melanie Cole. Thanks so much for listening and have a great day.