Correspondence
Deceptive information and the financial burden for Chinese cancer patients We read with great interest the Commission by Paul Goss and colleagues1 in The Lancet Oncology, which gave a profound and incisive review of cancer control in China. Goss and colleagues believe that the false belief in Ming— an invisible force that governs everything throughout the course of an individual’s life—conflicts with patients’ cognitive and behaviour strategies for dealing with cancer and survivorship. This notion is mostly true, especially for patients older than 50 years of age. However, the passive attitude of the Chinese people to cancer is not only due to cultural instinct, but also to a lack of education and to misinformation. A great proportion of information provided by the Chinese mainstream media, internet, and advertisements is misleading. For example, Chinese people have great faith in the benefits of health foods. In China, the sale of these products is a lucrative business. Various health foods, including anticancer soda water, anticancer protein powder, and traditional Chinese medicines that are declaimed to be effective in cancer control are promoted as having exceptional anticancer efficacy with minimal or no sideeffects according to television, internet, pharmacy, and newspaper advertisements. Many Chinese patients spend huge amounts of money on these expensive health foods and therefore are unable to afford all the standard treatments in hospitals. Distrust of doctors increases the amount of money spent on health foods to the financial detriment of the patient.2 Patients and their families tend to presume that doctors e299
are likely to over treat them, and prefer to believe unproven anticancer theories. Also, most health books are not written by professionals or doctors, which can lead to serious mistakes in the treatment of patients with cancer. The profit-oriented mainstream media is responsible for the spread of inaccurate information about over-the-counter medicines and the hype about miracle-working doctors. For example, a so-called miracleworking doctor in traditional Chinese medicine was prescribing mung bean as a cure for cancer. Censorship of health advertisements is not effective for the prevention of the dissemination of inaccurate health information. A lack of health education in the school system is the latent cause of all the above issues. The general population of China is not adequately informed about health and prevention of disease,2,3 making them more likely to believe deceptive health information. Thus, it is imperative to include education about health and death in schools. We declare no competing interests.
Xing Li, Yun Deng, Jie Chen, Dan-Yun Ruan, Zhan-Hong Chen, Yan-Fang Xing, *Xiang-Yuan Wu, Min Dong [email protected] Department of Medical Oncology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China (XL, JC, D-YR, Z-HC, X-YW, MD); Department of Radiation Oncology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhu Hai, China (YD); and Department of Nephrology, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou, China (Y-FX) 1
2
3
Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15: 489–538. Li X, Xing YF, Chen ZH, Dong M, Wu XY. Palliative care in urban areas of China. Lancet Oncol 2013; 14: e339. Qiu WL, Lin PJ, Ruan FQ, et al. Requests for health education from Chinese cancer patients during their recovery period: a cross-sectional study. J Cancer Educ 2013; 28: 428–34.
Cancer care and research in India: what does it mean to Nepal? We read with interest the Commission on cancer care in China, India, and Russia, and the Series of papers on cancer care in India.1–4 Comprising more than a third of the world’s population, India and China unsurprisingly have the largest burden of patients with cancer. However, Nepal—with its diverse geography and population, located between China and India—is usually forgotten by the world. Nepal has a strong relation with India in terms of medical services, assisted by an open border, a visa waiver programme, and similarity in languages. India is a common destination for Nepalese students and doctors to pursue medical education and fellowships. Nepal relies heavily on India for cancer drugs and investigations—eg, patients or samples from them are sent to India for PET scans or fluorescent in-situ hybridisation testing for mutation analysis, respectively. Visual inspection with acetic acid for cervical cancer screening has become a common practice in Nepal too. Thus, the progress in cancer care and research in Nepal parallels that in India. We were pleased to discover the interest of the oncology community in cancer research and care in India. We would like to draw attention to a few other aspects of optimism and opportunity for cancer treatment and research in Nepal and India. Ample opportunities exist in Nepal for research and clinical trials, with southern and northern populations closely resembling Indian and Chinese populations, respectively. India and Nepal should explore research in, for example, spiritual healing, ayurveda, yoga, meditation, and other cost-effective alternatives that are unique to the www.thelancet.com/oncology Vol 15 July 2014
Deceptive information and the financial burden for Chinese cancer patients We read with great interest the Commission by Paul Goss and colleagues1 in The Lancet Oncology, which gave a profound and incisive review of cancer control in China. Goss and colleagues believe that the false belief in Ming— an invisible force that governs everything throughout the course of an individual’s life—conflicts with patients’ cognitive and behaviour strategies for dealing with cancer and survivorship. This notion is mostly true, especially for patients older than 50 years of age. However, the passive attitude of the Chinese people to cancer is not only due to cultural instinct, but also to a lack of education and to misinformation. A great proportion of information provided by the Chinese mainstream media, internet, and advertisements is misleading. For example, Chinese people have great faith in the benefits of health foods. In China, the sale of these products is a lucrative business. Various health foods, including anticancer soda water, anticancer protein powder, and traditional Chinese medicines that are declaimed to be effective in cancer control are promoted as having exceptional anticancer efficacy with minimal or no sideeffects according to television, internet, pharmacy, and newspaper advertisements. Many Chinese patients spend huge amounts of money on these expensive health foods and therefore are unable to afford all the standard treatments in hospitals. Distrust of doctors increases the amount of money spent on health foods to the financial detriment of the patient.2 Patients and their families tend to presume that doctors e299
are likely to over treat them, and prefer to believe unproven anticancer theories. Also, most health books are not written by professionals or doctors, which can lead to serious mistakes in the treatment of patients with cancer. The profit-oriented mainstream media is responsible for the spread of inaccurate information about over-the-counter medicines and the hype about miracle-working doctors. For example, a so-called miracleworking doctor in traditional Chinese medicine was prescribing mung bean as a cure for cancer. Censorship of health advertisements is not effective for the prevention of the dissemination of inaccurate health information. A lack of health education in the school system is the latent cause of all the above issues. The general population of China is not adequately informed about health and prevention of disease,2,3 making them more likely to believe deceptive health information. Thus, it is imperative to include education about health and death in schools. We declare no competing interests.
Xing Li, Yun Deng, Jie Chen, Dan-Yun Ruan, Zhan-Hong Chen, Yan-Fang Xing, *Xiang-Yuan Wu, Min Dong [email protected] Department of Medical Oncology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China (XL, JC, D-YR, Z-HC, X-YW, MD); Department of Radiation Oncology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhu Hai, China (YD); and Department of Nephrology, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou, China (Y-FX) 1
2
3
Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014; 15: 489–538. Li X, Xing YF, Chen ZH, Dong M, Wu XY. Palliative care in urban areas of China. Lancet Oncol 2013; 14: e339. Qiu WL, Lin PJ, Ruan FQ, et al. Requests for health education from Chinese cancer patients during their recovery period: a cross-sectional study. J Cancer Educ 2013; 28: 428–34.
Cancer care and research in India: what does it mean to Nepal? We read with interest the Commission on cancer care in China, India, and Russia, and the Series of papers on cancer care in India.1–4 Comprising more than a third of the world’s population, India and China unsurprisingly have the largest burden of patients with cancer. However, Nepal—with its diverse geography and population, located between China and India—is usually forgotten by the world. Nepal has a strong relation with India in terms of medical services, assisted by an open border, a visa waiver programme, and similarity in languages. India is a common destination for Nepalese students and doctors to pursue medical education and fellowships. Nepal relies heavily on India for cancer drugs and investigations—eg, patients or samples from them are sent to India for PET scans or fluorescent in-situ hybridisation testing for mutation analysis, respectively. Visual inspection with acetic acid for cervical cancer screening has become a common practice in Nepal too. Thus, the progress in cancer care and research in Nepal parallels that in India. We were pleased to discover the interest of the oncology community in cancer research and care in India. We would like to draw attention to a few other aspects of optimism and opportunity for cancer treatment and research in Nepal and India. Ample opportunities exist in Nepal for research and clinical trials, with southern and northern populations closely resembling Indian and Chinese populations, respectively. India and Nepal should explore research in, for example, spiritual healing, ayurveda, yoga, meditation, and other cost-effective alternatives that are unique to the www.thelancet.com/oncology Vol 15 July 2014
