Journal of Enam Medical College
Vol 11 No 1 January 2021

4

Editorial

Cancer Phobia
Received: 16 February 2020    Accepted:  18 November 2020

doi: https://doi.org/10.3329/jemc.v11i1.63167

In one morning session of my private practice 
at Rajshahi, I found a group 10−12 females and 
accompanying two males waiting in the patients’ 
waiting room. Their ages ranged from 35 to 50 years, 
all were looking very tired an anxious. They came 
from long distance by overnight train journey. Seeing 
a group of same aged village women I became little bit 
astonished. I asked my chamber assistant about them. 
He told me that all were patients and they wanted to 
consult with you.

At first one female and a male person entered into 
my room and took their seats. The male person said 
they were husband and wife and the wife had been 
suffering from breast problems. Rest other patients 
were his relatives and neighbours.

I asked the patient to state her problems. She stated her 
breast problems nicely and briefly. Then rest others 
met me one by one and stated their breast problems. 
The gists of the ten female patients’ clinical histories 
were almost similar.

All were married and multiparous suffering from breast 
pain, lump, occasional fever and general weakness. 
Their problems aggravated following death of a breast 
cancer patient of their locality. They said that the 
deceased was my patient and I operated her about six 
months back. At the time of discharge from hospital I 
told her husband that his wife would not survive for 
a long time. And she died within six months. So they 
came to me to get their breasts examined and to know 
whether they were suffering from breast cancer or not.

I could guess why they came en-mass with their 
breast problems. I listened to them with patience 
and examined each patient very carefully. Physical 
examination revealed none of them was breast 
cancer patient. Two of them had fibroadenosis, one 
fibroadenoma and one chronic mastitis. These four 
females were advised some essential laboratory 

investigations and asked to attend in the evening time 
of practice.

They came accordingly with investigation reports. 
Investigation found no evidence of malignancy in any 
case. I met them all at a time and discussed freely and 
affectionately about breast cancer. I told them that it 
was good that they were conscious about carcinoma 
breast and so they came in a group for examination of 
their breasts. They were very happy to know that none 
of them was suffering from carcinoma breast.

I thanked them for their consciousness not to become 
frightened unnecessarily. I told them, “Breast cancer 
is not an infectious or contagious disease. So it does 
not spread from person to person and it will not attack 
close neighbour and relatives. Fear, being frightened 
and scared on false believe of cancer is very harmful 
for mental and physical health.You have come here 
en-mass due to panicky attack of cancer as one of your 
relative died from breast cancer. So, my advice is that 
please examine your breasts with your hands at least 
at the time of taking bath. If you feel any lump in your 
breast then please attend an experienced and senior 
doctor for further consultation.”

Role of doctors in cancer phobia

After taking clinical history and necessary physical 
examination of a patient, if it seems clinically that the 
patient has been suffering from cancer (malignancy), 
it should not be disclosed to the relative or to the 
patient instantly by the doctor.

•	 Which is unethical and may create anxiety, worries 
and panic.

•	 If requisite cancer proving investigations such as 
a FNAC, biopsy-histopathology, X-ray, CT-scan, 
blood test etc. find evidence of cancer, then fact 
should be disclosed to the patient’s party and 
patient after proper counseling.



January 2021J Enam Med Col Vol 11 No 1

5

•	 Sometimes clinical diagnosis does not correlate 
with confirmatory tests. Prior false information 
of cancer is very much disgusting and disgraceful 
to that doctor. It is also responsible for producing 
unnecessary panic to close relatives and patient.

•	 This type of wrong information sometimes 
produces misunderstanding between the doctor 
and patient’s party. So a doctor should maintain 

delicacy and etiquette before giving breaking bad 
news of cancer.

Md. Khalilur Rahman
Former Professor, Department of Surgery
Rajshahi Medical College & Hospital, Rajshahi and 
Enam Medical College & Hospital, Savar, Dhaka