Cancer and Society
and around the world. And, with a lot of those productions being made for less than $25 000, Living Funeral exemplifies some of the ambition and talent that Nollywood is beginning to bring to its productions. Living Funeral is explicitly designed to raise awareness of breast cancer,
and it does it by concentrating on the emotional toll that the disease extracts, both on those who suffer from it and those who are left behind. It’s a subtly-handed film that avoids both maudlin treacle and the dry, stuffy informational tone that films designed to raise awareness often
fall victim to. No one needs to be reminded that it’s a tragedy when the young die before their time, or when a mother has to bury their child, but Living Funeral foregrounds those emotions vividly and memorably.
Aaron van Dorn
Psychology Selling hope: advertising and patient expectation See Online for appendix
798
In a 2012 article for the Annals of Family Medicine, Steven Woolf explored why patients often expect health-care services to deliver unrealistic outcomes. “False beliefs meet the psychological needs of patients for hope and safety, as well as for action, agency, and a sense of control”, he wrote. An article in the New England Journal of Medicine article from the same year hinted at the prevalence of such beliefs: the researchers found that large proportions of patients with advanced lung or colon cancer thought that chemotherapy could cure them. Where do these expectations come from? A new study has thrown light on the marketing techniques used by American cancer centres. “Studies on unrealistic expectations have often concluded that it must be because physicians aren’t communicating appropriately about cancer treatment”, explains Yael Schenker (University of Pittsburgh Medical Center, PA, USA). “We were interested
in communication outside the doctor– patient encounter, and given how prevalent cancer centre adverts have become, we thought it would be interesting to look at them”. Schenker and her colleagues examined more than 400 television and magazine advertisements for around 100 cancer centres. They found that the advertising tended to evoke narratives of hope or fear (“our advanced care adds another dimension to your cancer care. Hope”; “I didn’t know if anyone survived pancreatic cancer”). Moreover, the information provided by the advertisements was usually inadequate. None of them described the outcome a typical patient could expect, and less than 2% outlined the potential risks from treatment. “Emotional appeals coupled with incomplete information are being widely used to promote services”, concluded the authors. How to strike a balance between the emotional and the rational
is a question that public health campaigners must also tackle. “We tread a very fine line”, explains Cancer Research UK’s Amanda Boughey. “We want people to know that if they present earlier, they have a much better chance of improving their outcome—it is about portraying that degree of hope but without misleading people, or putting it in a context that wouldn’t be appropriate”. Disentangling the role advertising plays in all of this is tricky, and Schenker stresses that the question as to whether advertising campaigns by cancer centres help foment false expectations has yet to be resolved. “We don’t know how these adverts affect patients’ health-care decisions”, she said. However, it easy to see how some unrealistic expectations come about. “Your last hope”, proclaims one strapline cited in the paper. In advertising, it may be easier to sell hope than to traffic in reality.
Talha Khan Burki
www.thelancet.com/oncology Vol 15 July 2014
and around the world. And, with a lot of those productions being made for less than $25 000, Living Funeral exemplifies some of the ambition and talent that Nollywood is beginning to bring to its productions. Living Funeral is explicitly designed to raise awareness of breast cancer,
and it does it by concentrating on the emotional toll that the disease extracts, both on those who suffer from it and those who are left behind. It’s a subtly-handed film that avoids both maudlin treacle and the dry, stuffy informational tone that films designed to raise awareness often
fall victim to. No one needs to be reminded that it’s a tragedy when the young die before their time, or when a mother has to bury their child, but Living Funeral foregrounds those emotions vividly and memorably.
Aaron van Dorn
Psychology Selling hope: advertising and patient expectation See Online for appendix
798
In a 2012 article for the Annals of Family Medicine, Steven Woolf explored why patients often expect health-care services to deliver unrealistic outcomes. “False beliefs meet the psychological needs of patients for hope and safety, as well as for action, agency, and a sense of control”, he wrote. An article in the New England Journal of Medicine article from the same year hinted at the prevalence of such beliefs: the researchers found that large proportions of patients with advanced lung or colon cancer thought that chemotherapy could cure them. Where do these expectations come from? A new study has thrown light on the marketing techniques used by American cancer centres. “Studies on unrealistic expectations have often concluded that it must be because physicians aren’t communicating appropriately about cancer treatment”, explains Yael Schenker (University of Pittsburgh Medical Center, PA, USA). “We were interested
in communication outside the doctor– patient encounter, and given how prevalent cancer centre adverts have become, we thought it would be interesting to look at them”. Schenker and her colleagues examined more than 400 television and magazine advertisements for around 100 cancer centres. They found that the advertising tended to evoke narratives of hope or fear (“our advanced care adds another dimension to your cancer care. Hope”; “I didn’t know if anyone survived pancreatic cancer”). Moreover, the information provided by the advertisements was usually inadequate. None of them described the outcome a typical patient could expect, and less than 2% outlined the potential risks from treatment. “Emotional appeals coupled with incomplete information are being widely used to promote services”, concluded the authors. How to strike a balance between the emotional and the rational
is a question that public health campaigners must also tackle. “We tread a very fine line”, explains Cancer Research UK’s Amanda Boughey. “We want people to know that if they present earlier, they have a much better chance of improving their outcome—it is about portraying that degree of hope but without misleading people, or putting it in a context that wouldn’t be appropriate”. Disentangling the role advertising plays in all of this is tricky, and Schenker stresses that the question as to whether advertising campaigns by cancer centres help foment false expectations has yet to be resolved. “We don’t know how these adverts affect patients’ health-care decisions”, she said. However, it easy to see how some unrealistic expectations come about. “Your last hope”, proclaims one strapline cited in the paper. In advertising, it may be easier to sell hope than to traffic in reality.
Talha Khan Burki
www.thelancet.com/oncology Vol 15 July 2014
