Gene S Lysko, Medical Writer
Very
few people need to know that the evolution of multicellularity requires the
suppression of cancer. Yet, that cancer can be suppressed or prevented would
certainly interest many.
The
basis for the belief that cancer can be prevented is established in a mouse
study conducted by Peto et al in 1975, who found a direct, non-age-related
correlation between the length of exposure to carcinogens and the risk of
cancer (Br J Cancer. 1975;32:411-426). Their findings have yielded what is
today known as Peto’s Paradox, which Roche et al describe succinctly as “the
absence of a correlation across species between cancer and body size or
longevity” (BMC Cancer. 2012;12:387).
So what’s that have
to do with patient education?
Peto’s
Paradox is a concept that explains the very existence of blue whales. Yup. Blue
whales. Read on; there’s a connection.
Cancer
occurs as mutations accumulate in somatic cells, which are any of the body’s
cells excluding the reproductive or “germ” cells. Because each proliferating
cell is at risk for malignant transformation, organisms with many cells (a greater
chance of tumor initiation) and/or long lifetimes (a greater chance to
accumulate more mutations), should have an unusually high probability of developing
cancer.
This
is the hypothesis of equivalent carcinogenic risk among mammalian cells. The
hypothesis predicts that everything else being equal, blues whales have virtually
no chance of living a cancer-free life. But many blue whales appear to do just
that. Or, with greater certainty, we can say that cancer hasn’t caused the
extinction of the blue whale.
Although no patient needs to understand or even be aware of the concept of Peto’s Paradox to be informed about his or her condition, especially outside of oncology, the ability to make the seemingly incomprehensible understandable (think mitochondrial disease or chromosome translocations) is vitally important. Patients who understand their disease, the impact of their lifestyle, the importance of their treatments, and the role that they play in their own care tend to do well. We know this is especially true when it comes to chronic asymptomatic conditions, hypertension being a good example.
Make the
complicated simple
It’s
safe to assume that most patients are completely unaware of the most basic
anatomical vernacular and even more ignorant of medicine in general and
pharmacotherapy, specifically. Patients, more often than not, need a Great
Explainer, such as Isaac Asimov (1920-1992).
Asimov
is renowned for presenting scientific concepts in an entertaining and
enlightening way. He grounded each topic in historical background, distilling
questions down to their simplest foundation and defining and explaining terms
by revealing their origin, how they may have changed with time, and with
pronunciation guides.
Here’s
where taking a page from Asimov’s book to popularize science by clearly
simplifying complex concepts helps patients. Neither patients nor their
caregivers can make informed decisions if they don’t understand their condition
or its treatment or how critical their role is in their own care. A key element
of patient education is to provide patients with the knowledge that will
empower them to participate as an important member of the healthcare team.
Patient education can help patients appreciate the importance of following
directions, solving problems, and preventing or minimizing avoidable
complications, and it can teach them the skills needed to handle these tasks
successfully.
Patients
need clear, actionable, relevant, and engaging (CARE™*) education to understand
the increasing complexities of disease and its treatment. It’s an art form. Artcraft Health can help.
*Learn
more about our CARE™ principles at http://www.artcrafthealth.com/principles/care-principles.aspx.
