Tackling fear and fatalism – our Talk Cancer workshops

“Well, it’s cancer isn’t it! There’s nothing you can do about it.” Cancer has long been a topic that people have been afraid to mention. From our many years of experience talking to the public, we know that some people still believe that cancer is always a death sentence.

We hear echoes of this view among some working in healthcare too.

But fear and fatalism can stop people from taking action at a stage where they may be able to change their outcome – whether that’s making positive lifestyle changes to help reduce their cancer risk, or going to the GP with possible signs and symptoms.

So increasing people’s knowledge and understanding of cancer, and helping them overcoming these barriers would save many more lives.

Turning our experience into a practical tool

For the last eight years, our Cancer Awareness Roadshow nurses have been visiting communities across the UK, sharing information about health and cancer, signposting people to services, and hearing the various misconceptions that still exist around cancer.

In 2010 we were asked if we could put this knowledge to further good use, so we worked with a Public Health Consultant from Sandwell Primary Care Trust, to ‘package’ what we’d learnt from eight years of talking to the public into a training programme for community-based health workers.

The main aim was to give trainees the knowledge and confidence to have similar face-to-face conversations about cancer with people in their area.

This resulted in a workshop that covered key messages on cancer prevention, screening and early diagnosis, as well as cancer myths.  A crucial feature of the training is that we focus on how to put it all into practice – including useful tips for overcoming people’s obstacles to seeking help.

Starting in April 2010, we ran a pilot training programme and, over the following year, held 14 of these workshops for nearly 200 local health staff and volunteers. And we evaluated what participants thought of it, and how their knowledge improved.

The results were very encouraging. We saw substantial improvements in trainees’ knowledge – nearly eight out of 10 participants correctly identified 10 out of 11 known cancer risk factors compared to just two out of 10 before the training. The proportion of trainees who said they felt confident discussing signs and symptoms of cancer also increased dramatically – from three in 10 (32 percent) before the training to well over nine out of 10 (96 per cent) one month afterwards.

The full results from our evaluation, published in Perspectives in Public Health last week, showed that interactive and discussion-led training could improve understanding of cancer, and equip health workers with more confidence to talk to the public about cancer.

‘Talk Cancer’ was born

We formally launched Talk Cancer in April 2012, building on the success of the pilot. Workshops are led by experienced trainers, who have worked on the Cancer Awareness Roadshow and have nursing backgrounds. They are aimed at any teams and organisations responsible for promoting health and well-being in their community.

We want to give people the tools to make a difference through their existing roles in the community, by not only knowing what to say but how to say it. The training is tailored to the audience – to their roles, local needs and priorities, and existing knowledge and capability.

We are commissioned by a range of different organisations, including parts of the NHS called ‘Strategic Clinical Networks’, who are keen to build the skills of primary care staff, and local authorities who want to train a variety of staff with a public health or well-being focus.

Since the launch of Talk Cancer we have now trained more than 1,000 people, including pharmacists, health trainers, nurses, healthcare assistants and volunteers. Encouragingly, 99 per cent of trainees tell us that they would recommend Talk Cancer to a colleague.

Challenging negative attitudes and changing minds

At the start of each workshop, the Talk Cancer trainers ask the group: ‘What words come into your head when you hear the word ‘cancer’?’ The responses typically include pain, fear, death, sickness and treatments:

Commonly used words before the workshop

Working in health settings, those who come to the workshops have no doubt seen some of the poorer outcomes of cancer, as well as uplifting stories of survival. And their views are also likely to be shaped by experiences in their personal lives.

Through this exercise, we encourage trainees to look at their personal perceptions of cancer and consider the potential of their role in communicating positive messages that encourage others to take action. We also look at how survival rates have improved for many cancers over the last few decades thanks to significant advances in knowledge and research.

Worrying about what the doctor might find is a big fear for many people. But talking about cancer in a more positive way can start to break down some of the barriers that prevent people from getting themselves checked out sooner.

At the end of the workshop, when asked again what words come to mind when discussing cancer, we hear things like hope, detectable, survival and support:

Words used after the workshop

Small things can make a big difference

It’s been wonderful to see so many people’s confidence grow, and we’ve heard some truly inspiring stories about what Talk Cancer has helped people achieve.

One man, who admitted at a workshop that he had himself been experiencing abnormal bleeding for five years, told us a few weeks later that he had finally been to the doctor. And another trainee explained how she played a part in encouraging two people to see their GP, which resulted in their cancers being diagnosed earlier.

Talk Cancer is not about becoming an expert on cancer, and we certainly don’t expect trainees to leave our workshops with all the answers. It’s about understanding the power of planting a seed, and giving that nudge that could change someone’s life.

Sometimes it’s simply about giving people the confidence to just say the word ‘cancer’ – something one health professional told us, before coming to training, he just wouldn’t do.

Caroline

• Caroline Philpott is a senior health community engagement manager at Cancer Research UK

• For more information about Talk Cancer, including details on how to commission or attend a workshop in your area, please visit www.cruk.org/talkcancer or email [email protected]

Reference

• Grimmett, C., Macherianakis, A., Rendell, H., George, H., Kaplan, G., Kilgour, G., & Power, E. (2014). Talking about cancer with confidence: evaluation of cancer awareness training for community-based health workers Perspectives in Public Health, 134 (5), 268-275 DOI: 10.1177/1757913914534840