Can we talk about cancer as if it were diabetes or cholesterol? A patient can be asked how long has he been cured? In short, is it possible to lighten the emotional burden that cancer still carries with it? The answers – all affirmative – come from the oncologist Gianni Amunni, Director General of the Institute for the Study, Prevention and Cancer Network of the Tuscany Region (Ispro), and by the scientific journalist Walter Gatti, who co-wrote the book ‘De cancer. Experiences and stories to demythologize the dark evil ‘(Caissa Italia Editore, pages 144, euro 15.00), a volume that aims to tell about cancer as a chronic disease. In Oncoline, Professor Amunni explains how it is possible to create a new cultural, social and organizational climate which then has concrete repercussions on the dissemination of information and healthy preventive habits also on the ‘healthy’ population and not only on cancer patients.
How do you demythologize the dark evil? Although it is true that much progress has been made and today the tumor can become chronic, for those who receive a diagnosis it is still bad news….
“We still use the languages of the last century to talk about a disease that should be read according to today’s numbers. If we continue to call the healed survivors and the chronic, long-surviving patients we have a strongly partisan language approach that is no longer suitable. It is true that it is a serious and difficult disease to cure, but the numbers tell us that today the possibilities of a cure are much improved and that all cancers are not the same. For example, the healing of breast cancer diagnosed at screening reaches almost 90% of cases with a much better value than many other diseases of which we are not afraid and of which we speak more lightly “.
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What is the role of information?
“It is fundamental, I would say almost therapeutic because today the chances of recovery are much more and informing about this is very important. But often also in the media there are schizophrenic attitudes: on the one hand the scientific press which tends to inform with a lot of conscience, on the other the generalist press which still speaks of ‘incurable disease’ and this does not help, but rather generates confusion ”.
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How should we write about cancer then?
“Information should help overcome the emotional burden on this pathology by addressing it for what it really is, knowing what research offers us today and making it a collective problem. Unfortunately, there is still talk of cancer in small circles made by patients, doctors and drug industries, but a disease that currently has 3 million and 600 thousand cases prevalent, that is to say a number equivalent to that of the Tuscan population cannot be a problem of others. It should be told to everyone also to encourage prevention “.
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Is it also a question of language? We often call the healed ‘survivors’ and the chronically ill ‘long survivors’. Is it time to update the vocabulary?
“These are terms that suggest, more than the clinical course of an illness, stories of zombies, unexpected prizes from impossible lotteries, escapes from Alcatraz. But we moved on. The drugs with which tumors are treated today have gone from poisons that were used for chemical warfare in the Second World War to tools for reengineering one’s own immune defenses to fight specific neoplastic sites “.
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What can the oncologist do today to better communicate cancer to both patients and the public considering the limited time available?
“The oncologist is always the professional who deals with the terrible disease of ‘another’ and when you meet him too closely you either ‘touch’, or cross your fingers, or greet him with an affable ‘we hope to never need her. ‘ Precisely for this reason, the oncologist was at the beginning the first victim of this way of thinking. It is time to regain possession of all the themes of prevention, both primary and secondary, which until now have been little in his DNA. It is the right time to do this as many patients today feel finished and hopeless when they are diagnosed with cancer. Sensations that can make them victims of so many scoundrels and wrong information that increases their fragility “.
Could the pandemic have contributed to the demythologization of cancer? Did we experience something that scared us more than a tumor?
“Paradoxically, yes, because the pandemic was characterized by a unique thought on Covid-19 and this on the one hand made people move away from screening and health thinking. But the upside is that it has demystified other diseases, including cancer. We should start from this awareness to think more balanced about cancer. Of course, we must make up for the great delay in diagnoses interrupted by the pandemic ”.
And then there are those who can’t make it …
“There are still many, too many not to understand that the road is still long and that defeats are the heaviest obstacle to hope and trust in science. It is difficult to show confidence in the future to those who have finished every possibility of treatment, to those who see their disease progressing, to those who leave us after a long path of suffering. We “healthy” people have obligations towards them: to impose support and dignity in the final phase of life by all means, to be active witnesses to the fact that things are changing, to fight any difference in opportunities for treatment by wealth, culture or geographical area ” .
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