Beliefs of lung cancer patients may compromise treatment

Many patients wrongly believe that exposure of lung cancer to air during surgery causes the tumor to spread, results of a survey indicate.

This belief is particularly common among African Americans and may help explain why they undergo surgery for early lung cancer less often than do white patients.Although surgery is the treatment of choice for most early-stage lung tumors, widespread acceptance of this erroneous belief could undermine the best chance for cure, Dr. Mitchell L. Margolis, of the Philadelphia Veterans Affairs Medical Center, and colleagues note.Dr. Margolis’ team observed that patients evaluated for lung tumors frequently raised concern that their lung cancer would spread when exposed to air during surgery. This motivated his team to survey 626 consecutive patients being evaluated at their clinic, another VA clinic in Los Angeles, and patients seen at the University of Pennsylvania and the Medical University of South Carolina. Some subjects had lung cancer and others had risk factors for the disease. In this prospective study, 67% of those surveyed were white and 27% were African American.They report in the October 7th issue of the Annals of Internal Medicine that 38% of those questioned did in fact believe that exposing a lung tumor to air during surgery would make it spread. Considerably more African American than white patients felt this was true, 61% versus 29%, respectively.Nineteen percent of African Americans and 5% of whites were opposed to lung cancer surgery based on their belief. In addition, 14% of African Americans and 5% of whites indicated on the survey that they would not believe their physician if told the belief was false. The idea that lung cancer surgery causes tumors to spread is “very prevalent,” Dr. Margolis told Reuters Health, especially among African Americans, and it may lead them to reject lung cancer surgery even if their physician recommends it. He emphasized that “there is no scientific basis to support this belief and it is not a valid reason for not proceeding with needed surgery for lung cancer.” Where did this belief come from? Respondents were “vague” on this point, Dr. Margolis said. “Some said they heard it from a friend or through the gossip mill. Others cited cultural beliefs.” (Source: Ann Intern Med 2003;139:558-563: Reuters Health: Megan Rauscher: October 6, 2003: Oncolink)