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Many popular beliefs are wrong and cause needless worry, sometimes prompting people to disregard prevention behaviors. They can also result in unwise treatment decisions.
“When something triggers emotions, it can be hard to get logic and reason through because cancer is scary, especially for people who have never seen it, or for people who have watched family members who have had it,” says Rachel Buchsbaum, director of the cancer center and chief of hematology/oncology at Tufts Medical Center. “It’s hard to get the message across that today’s treatments and technologies are a lot better than they used to be. The fear of cancer is still so pervasive, that they often continue to hang with the emotion.”
Research suggests that despite steady decreases in cancer mortality rates in recent years, most Americans still see cancer as a death sentence, a perception that is not only false but also dangerous if it leads people to forgo prevention, early detection and treatment, experts say. More than 16.9 million Americans who had invasive cancer years ago still were alive as of Jan. 1, 2019 — the most recent year statistics were available — with no signs of disease, according to the American Cancer Society. By Jan. 1, 2030, an estimated 22.1 million or more Americans will be cancer survivors, the ACS says.
“Cancer care, including the emotional and psychological stress surrounding a diagnosis, the sense of uncertainty that results, as well as the complexities of treatment decisions, make patients vulnerable to harm caused by misinformation,” says Wen-Ying Sylvia Chou, a program director in the health communication and informatics research branch of the National Cancer Institute’s Behavioral Research Program. “We all want good information, but the information environment sometimes turns us in other directions.”
Many popular but inaccurate assumptions about cancer cause needless worry, sometimes prompting people to disregard established prevention behaviors, such as exercising, quitting smoking or avoiding the sun, and can result in unwise treatment decisions, experts say.
“People Google things and don’t understand the nuances involved in cancer care, treatment and prognosis.” says Julie Nangia, associate professor of medicine at the Baylor College of Medicine and medical director of breast oncology at its Dan L. Duncan Comprehensive Cancer Center. “All cancers are not the same, and cancer knows no rules or boundaries so you can’t predict it.”
The Washington Post asked several cancer experts to address some of the most common myths about cancer:
Cancer is almost always a death sentence. “Many decades ago that’s how people felt because the death rates were higher and the research and treatments were not as advanced as they are today,” Mayo Clinic oncologist Karthik Giridhar says. “Now we have prevention, early detection and cutting therapies and the vast majority of people are surviving longer, with increases each decade, and living better and more productive lives.” Early detection is critical. For example, the breast cancer death rate, which peaked in 1989, has since decreased by 42 percent as of 2019, thanks to early screening, better treatments and increased awareness. For prostate cancer, the five-year survival rate approaches 100 percent for the majority of men diagnosed with “local” or “regional” prostate cancer, meaning before it has spread.
Cancer is contagious. This is false. You cannot “catch” cancer. But certain viruses and bacteria can raise the risk of cancer, including human papillomavirus (cervical cancer), hepatitis B virus (liver cancer) and the bacterium Helicobacter pylori (stomach cancer). Vaccinations can prevent HPV and HBV. And there is no need to avoid contact with someone who has cancer. “You can hug and kiss someone with cancer, or even be intimate and there is no risk to you or the person with cancer,” Nangia says.
Everything causes cancer, so why bother trying to protect myself? “Everything doesn’t cause cancer,” Buchsbaum says. “There are a few clear lifestyle things people can do to lessen the chance of getting it. Exercising every day. That’s a big one. It’s the best thing you can do for yourself, that and not smoking, keeping your weight in the normal range and limiting alcohol to less than one drink a day, which should be the target you shoot for if you are going to drink regularly.”
Diane Reidy-Lagunes, associate deputy physician-in-chief of Memorial Sloan Kettering Cancer Center’s Regional Care Network in the New York metropolitan area, and host of the hospital’s Cancer Straight Talk podcast, agrees. “Cancer typically is an accumulation of genes that get damaged over time, often over many years, which is why cancer is much more common with older people,” she says. “For that reason, exercise, eating well and avoiding harmful exposures like smoking and alcohol can lower the risk of developing cancer.”
Chemotherapy side effects are horrible. “This is definitely not true,” Nangia says. “The supportive care medications are amazing now and most patients do very well. It is not common for patients to have nausea that is not controlled with medications or severe side effects that cannot be managed.”
Reidy-Lagunes agrees. “Today’s chemotherapy treatments are given for many reasons and for many different types of cancer,” she says. “Sometimes chemo is given to shrink a tumor before surgery. Sometimes it is given to control disease and keep a patient stable. Doctors take many factors into consideration when developing their patients’ treatment plans,” and make every effort to help their patients avoid side effects.
Reidy-Lagunes says that patients today can take medicines before chemotherapy to prevent side effects such as nausea and vomiting. “The most common side effect is fatigue, which accumulates over time,” she says. “Some experts compare treatment to a prize fight. The first time you get knocked down, you jump right back up. After the second or third, you still get up quickly. By the time you get to the fifth or sixth knockdown, you get up more slowly — but you still get up.”
Hair won’t regrow after chemo. One of the dreaded side effects for women in particular is hair loss and the fear that it won’t come back. Experts say it may take some time but in most cases hair does return, although it can be a different texture or even color. “Chemotherapy works by attacking fast-growing cells,” Reidy-Lagunes says. “Cancer cells are fast growing, but so are other cells, such as hair cells. Chemotherapy can cause hair loss on your scalp, eyebrows, eye lashes, arms, legs and pubic area. Depending on your chemotherapy, you can lose hair in none, some or all these areas. Once your treatment ends, hair should begin to grow back. Hair regrowth can take three to five months. When hair grows back, it may have a different texture or color and in rare cases, hair won’t grow back as fully as it did before. Radiation therapy to the head often causes hair loss on the scalp. Sometimes, depending on the dose of radiation, hair may grow back differently from how it looked before, or in a very few cases it may not grow back at all.”
“It may be more curly, but hair grows back in the vast majority of patients,” says Andrew M. Evens, associate director for clinical services at the Rutgers Cancer Institute.
Rarely, with a chemotherapy agent called docetaxel, which is sometimes used in treating breast, prostate, stomach, and head and neck cancers, and certain lung cancers, there can be permanent hair loss, Nangia says.
Reidy-Lagunes recommends “scalp cooling” as a way to reduce hair loss while undergoing chemotherapy for solid tumors, that is, cancer that is not a leukemia or lymphoma. Scalp cooling, which has been approved by the Food and Drug Administration, involves wearing a cold cap device on your head before, during and after receiving chemotherapy and has been shown in studies to reduce hair loss.
Antiperspirants or deodorants cause breast cancer. “This is a definite myth likely coming from the fact that when women get mammograms, they are asked not to use deodorants or antiperspirants,” Nangia says. “The reason women are told this is that deodorants and antiperspirants contain aluminum which on an X-ray or mammogram can mimic calcium and interfere with the mammogram results.”
Microwaving food in plastic containers and wraps releases cancer-causing substances. “This is only true of older plastic material and if the plastic contained chemicals like BPA or phthalates,” Nangia says. “New plastics do not contain these chemicals, and if plastic is labeled as ‘microwave safe,’ it does not contain these chemicals and will not cause cancer.”
Cancer is always genetic. “Some cancers can run in families and put families at much higher risk, but the reality is that cancer can occur anytime in one’s lifetime, and the prevalence increases as we age so it is a disease of aging,” Nangia says. “Most people who develop cancer do not have a family history. It is sporadic. However, it is important to identify families that have hereditary cancer syndrome genes, such as BRCA1 and BRCA2 — which increases the risk of breast and ovarian cancer — so family members can be screened more closely and have possible preventive therapies.”
Cancer is always environmental. “Environmental factors — like smoking and diet and exposure to many chemicals, such as benzene and asbestos — do raise the risk, but not everything in the environment causes cancer,” Giridhar says. “Sometimes there is no clear single reason why cancers develop. It’s probably multifactorial, including exposure to certain environmental toxins, genetics or nothing obvious at all.”
It’s probably better not to know you have cancer. “Absolutely not,” Evens says. “Most cancers are treatable, and many are curable.” It is important to undergo regular screenings — mammograms, colonoscopies, prostate exams, for example — because treatment and cure often depend on early detection, experts says.
Drinking green tea will protect you against cancer. The active ingredients in green tea include polyphenols such as EGCG, or epigallocathechin-3-gallate, which is a strong antioxidant, says Ting Bao, director of integrative breast oncology, integrative medicine and breast medicine services at Memorial Sloan Kettering Cancer Center. “In vitro [lab] studies show that these ingredients may help prevent cancer by inhibiting cancer cell proliferation,” she says. “Therefore, in theory, drinking green tea could prevent cancer. But probably one would have to drink huge amounts a day for it to have an effect.”
Studies, however, provide limited evidence that using green tea reduces cancer risk, she adds. Also, “these studies showed side effects from high intake of green tea, such as gastrointestinal discomfort and elevated liver enzymes,” she says. “Most of these studies were conducted in Asian populations, which limits their generalizability in other populations.”
Pregnant women can’t receive, or should stay away from, cancer treatment. “We usually try to avoid therapy in the first trimester to protect the baby, but it is safe to do surgery and certain chemotherapies during the second and third trimester,” Nangia says. With breast cancer, for example, there are many studies that demonstrate the safety of chemotherapy during pregnancy to the pregnant woman and the fetus, she says. But “radiation is best to avoid during pregnancy if possible,” she says, since radiation exposure can harm a developing fetus.
I don’t smoke, so I won’t get lung cancer. While it’s true that the vast majority of lung cancers — about 80 to 90 percent — occur among cigarette smokers, according to the Centers for Disease Control and Prevention, other tobacco products, and exposure to secondhand smoke and radon also raise the risk of getting the disease, CDC officials say. “The odds of getting lung cancer are much lower in nonsmokers, but 10 [to] 20 percent of lung cancers are in people that have never smoked or smoked fewer than 100 cigarettes in their lifetime,” Nangia says.
A biopsy or surgery will cause cancer to spread. “There is a myth that exposing the cancer to air via biopsy or surgery will make cancer spread which is not true,” Nangia says. “The reality is that when people have cancer requiring a biopsy or surgery, some of these cancers will be aggressive and recur. This is because of the biology of cancer, not because of the biopsy or surgery.”
The National Cancer Institute says surgeons take special precautions during surgeries and biopsies to prevent cancer cells from spreading, such as using separate surgical tools for different areas of the body.
Eating sugar causes cancer to grow. “There are no data that consumption of sugar leads to cancer growth,” Reidy-Lagunes says. Although cancer cells do consume more sugar than normal cells, according to the NCI, no studies have shown that actually eating sugar worsens cancer, or that cutting out sugar helps or prevents the disease, NCI says. A high sugar diet, however, can result in weight gain, and obesity does raise the risk of certain cancers, such as endometrial and esophageal cancers, among others, according to NCI.
Cellphones and artificial sweeteners cause cancer. No evidence exists that phones or sugar substitutes contribute to cancer, according to various studies over the years and the NCI.
A lump in your breast always means breast cancer. Some breast lumps are cancerous, but most are not, according to the CDC. Experts say, however, you should have every lump evaluated. “An ultrasound can help characterize masses felt in the breast and often if it is clear, the mass is benign and a biopsy is not necessary,” Nangia says.
Cancer always comes back. “Most cancers do not come back, thankfully, and advances in medicine continue to decrease the risk of recurrence,” Reidy-Lagunes says. “The number of cancer survivors living in the U.S. continues to increase.”
The five-year survival rate for all cancers combined has greatly increased since the early 1960s, from 39 percent to 68 percent among White people and from 27 percent to 63 percent among African Americans because of advances in treatment and earlier diagnosis, according to the ACS.
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