Fear of medical evaluations or treatment can kill

A funeral was held for a teenager last month that never should have happened.

Young Michael Rushby, at 16 years of age, died of testicular cancer.

He had spent months hiding the obvious tumor from his family and friends because he was so embarrassed by it and afraid to be diagnosed.

By the time he showed his brother what was happening, it was too late.  Two weeks after the cancer was diagnosed he passed away.

Under normal circumstances, testicular cancer is reported to be up to 96% curable.

This young man was very popular with his friends and very involved with his family.  He is remembered as being very charming and fun to be around.

Had he not been too embarrassed to tell his family about the tumor for eight long months, he would likely still be with them.

This tragic story is a dramatic illustration of something that happens every day to millions of people in one form or another. 

Over the years I have encountered many patients that have reluctantly admitted that they are afraid to go see a primary care doctor about some condition that concerns them.  The fear might be embarrassment like Michael, or may be the fear of facing a dreaded diagnosis, or perhaps the fear of the discomfort of examination or treatment.

Recently a news story revealed some disturbing facts about the role fear plays in delaying diagnosis and treatment of colon cancer.

The story in Washington Post reported 79% of patients over age 50 had never had a fecal occult blood test.  This test is simple and can be done in your doctor’s office or home kits are available in some areas.

It is also reported that 38% of people over 50 have never had a colonoscopy or sigmoidoscopy.  These tests are more involved and must be done by specialist in a facility such as a hospital or outpatient procedure facility under some form of anesthesia.  The procedure usually takes up to an hour.

Colonoscopy is recommended for everyone by age fifty and is the most accurate way to find early signs of tumors and polyps.  The test should be repeated on a schedule recommended by your doctor.

Colon cancer is very successfully treated if found early enough.  However a delay in treatment can result in difficulty in obtaining a cure.

Although these are some of the most common tests avoided by people due to fear, there are many other examples.

Some patients avoid examination because they fear they will be diagnosed with diabetes and dread the changes in lifestyle that may be recommended.

Dealing with diabetes today is much different that even a decade ago.  Patients can address the condition more successfully now than ever, with less discomfort and inconvenience.

For some patients, just knowing that they have gained weight is enough reason to avoid the doctor.  They know that they will be counseled about their condition and are embarrassed by what they may feel is a personal failure in gaining weight.  Instead of working up the courage to discuss the situation with their doctor they evade the doctor’s office.

In these types of cases the best answer is to face your fears and go to the doctor.  There are a number of ways to overcome this type of fear-based behavior.

It is important first to recognize this in yourself, a co-worker, friend or a family member.

Steps to overcome the anxiety include:

• Asking a friend to go with you to the appointment.  It may be easier to deal with if you have a friend along to encourage or distract you from the fear.
• Calling the doctor’s office ahead of time and discussing the situation with the staff.  It may be easier to address the issue at first over the phone and the staff can be reassuring about what you may undergo in the form of testing.  Often our imagination is much worse than the actual thing we fear.
• If the fear is severe, it may be necessary to work with a trained counselor or therapist.  You are not the first person to have to deal with this type of anxiety.  You can find help in overcoming it.

If you have found yourself being described in the paragraphs above, start today to face up to your fear in whatever ways are necessary.  Your health or perhaps survival may depend upon you finding success.

- Dr. Mark Kestner