CANCER TREATMENT Myth keeps people from surgery that could extend their lives

Respondents were mostly middle-aged or elderly.
PHILADELPHIA (AP) -- A belief that cancerous tumors spread when exposed to air is so ingrained among some people that they would reject surgery to treat lung cancer even if their doctors told them their fears were baseless, according to a survey published Tuesday.
Researchers administered a voluntary and anonymous questionnaire to patients at Philadelphia, Los Angeles and Charleston, S.C., clinics specializing in lung diseases and lung tumors. Of 626 who responded, 38 percent said they believed that if a cancerous lung tumor is exposed to air during surgery, the cancer will spread.
Based on that belief, nearly one-fourth of that group said they would reject lung cancer surgery, and nearly one-fifth said they would reject surgery even if their doctor told them their belief had no scientific basis, according to the survey in Annals of Internal Medicine.
Most were black
Out of the group who believed that air exposure causes tumors to spread, 61 percent were black and 29 percent were white. Larger percentages of blacks also said they would refuse surgery and wouldn't believe their doctors' reassurances.
"It may be surprising for some people to hear about this, but it's not surprising to me or for many doctors who confront patients with [cancer]," said lead researcher Dr. Mitchell Margolis, director of clinical medicine at the Philadelphia Veterans Affairs Medical Center, one of the clinics involved in the study.
The questionnaire was given between 1999 and 2000 at five urban outpatient facilities to mostly male respondents. Margolis -- who said he got the idea for the survey after hearing the myth repeated by a "disconcerting number" of patients -- said the respondents were largely middle-aged or elderly, so it couldn't be determined whether the belief is more pronounced among older people.
Asked from where they learned about the perceived link, respondents said they couldn't recall or gave vague answers like "the gossip mill."
However, Margolis' own patients often make the connection after seeing family members hospitalized for cancer surgery and die shortly afterward -- likely an indicator of minorities and poor people getting treatment too late, he said.
"I can tell you from my personal experience, some patients can be convinced to have the surgery and some absolutely cannot," Margolis said. "This also is not unique to lung cancer patients or urban settings. ... We've heard of similar beliefs in patients with other types of cancers and at rural sites."
None of the respondents said that they hadn't been aware of the belief but that they believed it, which suggests the questionnaire didn't plant the idea in someone's head who had never heard of it before.
'Folk beliefs'
Dr. Alfred Munzer, past president of the American Lung Association, said he had not heard a patient express a link between air exposure and tumor spread -- but added that such "folk beliefs" are not uncommon, especially among minorities, the poor and the less educated.
"The overall message here is the importance of cultural sensitivity among health-care providers in general, a greater awareness of what people's fears are, and being able to listen for them," said Munzer, a lung specialist at Washington Adventist Hospital in Takoma Park, Md.