Breast cancer misinformation does not impact treatment adherence, study shows

Although three-fourths (76%) of breast cancer patients are exposed to cancer misinformation, perpetuating fear in 38%, it did not increase rates of treatment nonadherence, according to the results of a survey published recently in Oncology.

A team of researchers, led by David Gibbes Miller, M.D., and Kaitlyn Lapen, M.D., Memorial Sloan Kettering Cancer Center, New York City, designed an online survey taken by 997 breast cancer patients.

Fear was measured using the Fear of Cancer Recurrence Inventory-Short Form scale of 0-36. Scores of at least 22 were considered clinically significant. Approximately 38% of participants reported clinically significant fear.

Patients were more likely to encounter misinformation about breast cancer risk factors than ways to reduce recurrence (76% vs. 54%, respectively).

Sugar consumption was the most encountered myth, reported by 61% of participants, followed by deodorant use (22%), cellphone use (8%), getting vaccines (8%) and bra type (8%).

In years past, rumors have circulated that underarm antiperspirant use, specifically ones that contain aluminum, changes estrogen cell receptors. Other rumors have stated that wearing a bra increases breast cancer risk, namely a 1991 study that found premenopausal women who don’t wear bras are half as likely to develop breast cancer as those who do wear bras. However, this could be explained by having a large cup size, which can be caused by obesity, a known risk factor of breast cancer.

Over half (54%) of participants reported reading misinformation about ways to reduce recurrence. Organic food consumption was the most encountered one, at 41%, followed by taking oral vitamins and supplements (29%), adhering to an alkaline diet (12%) and undergoing vitamin infusions (7%).

A sociodemographic analysis of responses showed that some racial groups may be more exposed to medical misinformation than others. Hispanic patients showed higher reported exposure to misinformation than White patients; however, because they represented a small proportion of the study population (4%), these results may not be generalizable.

Misinformation can be encountered in a variety of ways, including social media, product advertising, and even from other healthcare professionals.

A separate 2018 study done by the American Society of Clinical Oncology found that 39% of Americans believe that cancer can be cured solely through oxygen therapy, diet, vitamins and minerals. A follow-up survey found that 16% of Americans believe that cellphones cause cancer.

Social media platforms, the authors say, are particularly important sources of information because of the support systems and sense of community they can foster.

“We found no correlation between awareness of misinformation and cancer recurrence fears or treatment adherence,” Miller and Lapen write. “One possible explanation for this finding is that patients may not internalize all misinformation they encounter. Other factors such as preexisting health beliefs, relationships with health care professionals, psychosocial support and health literacy may influence behavior or health beliefs more than misinformation alone.”

Miller and Lapen also emphasized the importance of strong survivorship education and communication.

To combat misinformation, there is growing research around how to improve the “psychological immunity.” Suggested ways to do this include creating misinformation intervention protocols, patient conversation guides for clinicians and partnering with survivors to design resources that promote digital literacy.