October is Breast Cancer Awareness Month, drawing attention to the risk and burden of breast cancer, which will affect around one in seven women and one in 833 men during their lifetime.1 Breast cancer is the world’s most prevalent cancer, with 2.3 million diagnoses and 685 000 deaths globally in 2020.2
Cancer diagnoses are uniquely stressful and leave patients particularly vulnerable to exploitation by bad actors. The rise in popularity of social media has helped facilitate the sharing of medical misinformation,3 a phenomenon which has been further exacerbated by a diminished sense of trust in medical expertise by the public. The Lancet Oncology attributes this to a number of causes, citing “a collision between personal autonomy, specious journalism, social media, widespread disinformation, and political marginalisation, which together undermine the value placed on science and academic endeavour”.4
One in three cancer articles shared on social media contain elements of misinformation or potentially harmful assertions.5 Users of online platforms aimed at breast cancer patients and survivors have reported encountering posters promoting fraudulent treatments, who are later revealed to be salespeople promoting their product.6 The advertising algorithms used by social media platforms mean that users who post about having cancer are then targeted for, often fraudulent, cancer treatment advertisements.7 In 2017, the UK charity Macmillan Cancer Support hired its first ‘digital nurse’, a role created specifically to address the spread of misinformation about cancer online.8
Inaccurate stories or articles about breast cancer are more widely shared than scientifically accurate pieces across Facebook (which had over 2.7 billion active monthly users as of 2020), Pinterest (442 million users), Reddit (430 million users) and Twitter (321 million users).9 Pinterest, whose user base is around 70% female, is described as a “significant vector of misinformation” about breast cancer, with more than half of allegedly factual claims about prevention and treatment made on the site containing misinformation.10
YouTube, which has more than 2.3 billion active monthly users as of 2021,11 has drawn particular criticism for its tolerance of misinformation. A 2019 BBC investigation found advertisements for major commercial brands such as Samsung and Heinz displayed alongside misleading and potentially dangerous videos promoting fake cancer cures.12 Elsewhere, a 2020 study assessing the veracity of YouTube content covering breast cancer in particular found that few of the videos hosted on the site contained information of significant quality, and that many of the videos were in some way inaccurate or misleading.13
Addressing and preventing harm
Misinformation about cancer treatment is actively harmful, as it can lead to people refusing conventional treatment in favour of unproven therapies – with a correspondingly heightened risk of death.21 Patients who rely on unproven ‘alternative’ medicines to treat breast cancer are nearly six times more likely to die from their cancer than those who undergo conventional treatment.22 There is still a pressing need for further extensive research into the spread of cancer misinformation on social media.23 Researchers advocate a “multifaceted” approach to addressing cancer misinformation online, highlighting the benefits of public awareness campaigns, the role of media outlets in moderating user content, and the need for updated, enforceable legislation governing the promotion of alleged cancer treatments online.24
There is a wealth of reliable, evidence-based sources of information on breast cancer available, both on and off the internet. Charities including Breast Cancer Now,25 Cancer Research UK26 and Macmillan Cancer Support27 offer a range of accurate information and support for breast cancer patients and their caregivers; as does the UK’s National Health Service.28 These online resources can also help users to find local in-person patient and survivor support groups, which are particularly beneficial in enabling members to stay informed and supporting their mental wellbeing.29
- Breast Cancer Now. Facts and statistics 2021. Available at: https://bit.ly/3b3znFe [Accessed October 2021].
- Breast Cancer UK. About breast cancer: facts and figures. 2021. Available at: https://bit.ly/30H6o8i [Accessed October 2021].
- Spirit, an OPEN Health company. Fake news: misinformation and COVID-19. 2021. Available at: https://bit.ly/3BwjAdb [Accessed October 2021].
- Editorial. Oncology, “fake” news, and legal liability. Lancet Oncol 2018;19(9):1135. https://doi.org/10.1016/S1470-2045(18)30610-7
- Virgil H. Social media proves to be a landscape of misinformation on cancer. Cancer Network 2021. Available at: https://bit.ly/3vGOLkx [Accessed October 2021].
- Grimes DR. How to survive the fake news about cancer. Guardian 2019. Available at: https://bit.ly/3BdKK8v [Accessed October 2021].
- King AB. When hope kills: social media’s false promises to cancer patients. Healthy Debate 2021. Available at: https://bit.ly/3nt88cZ [Accessed October 2021].
- McPake E. Ellen McPake: combating fake cancer news online. Nursing In Practice 2017. Available at: https://bit.ly/2ZupAGf [Accessed October 2021].
- Biancovilli P, Makszin L, Csongor A. Breast cancer on social media: a quali-quantitative study on the credibility and content type of the most shared news stories. BMC Women’s Health 2021;21(1):202. https://doi.org/10.1186/s12905-021-01352-y
- Wilmer T, Holton A. Breast cancer prevention and treatment: misinformation on Pinterest, 2018. Am Journ Pub Health 2020;110(S3):S300–S304. https://doi.org/10.2105/AJPH.2020.305812
- Global Media Insights. YouTube user statistics 2021. Available at: https://bit.ly/3pBuA6K [Accessed October 2021].
- Carmichael F, Gragnani J. YouTube advertises big brands alongside fake cancer cure videos. BBC 2019. Available at: https://bbc.in/3ElvBnv [Accessed October 2021].
- Brachtenbach T, Cardenas R, Pate H, et al. YouTube: searching for answers about breast cancer. Breast Dis 2020;39(2):85–90. https://doi.org/10.3233/BD-200445
- FDA. Do not use: black salve is dangerous and called by many names. 2020. Available at: https://bit.ly/3vLilFA [Accessed October 2021].
- Subramani T, Yeap SK, Ho WY, et al. Vitamin C suppresses cell death in MCF-7 human breast cancer cells induced by tamoxifen. J Cell Mol Med 2014;18(2):305–313. https://doi.org/10.1111/jcmm.12188
- Loprinzi CL, Levitt R, Barton DL, et al. Evaluation of shark cartilage in patients with advanced cancer: a North Central Cancer Treatment Group trial. Cancer 2005;104(1):176–182. https://doi.org/10.1002/cncr.21107
- American Cancer Society. Impact of attitudes and feelings on cancer. 2020. Available at: https://bit.ly/3B9OW9a [Accessed October 2021].
- Brody H. Cannabis: a field in flux. Nature 2019;572(7771):S1. https://doi.org/10.1038/d41586-019-02523-6
- Shi S, Brant AR, Sabolch A, Pollom E. False news of a cannabis cancer cure. Cureus 2019;11(1):e3918. https://doi.org/10.7759/cureus.3918
- Weiss MC, Hibbs JE, Buckley ME, et al. A Coala-T-Cannabis Survey Study of breast cancer patients’ use of cannabis before, during, and after treatment. Cancer 2021; online ahead of print. https://doi.org/10.1002/cncr.33906
- Johnson SB, Park HS, Gross CP, Yu JB. Complementary medicine, refusal of conventional cancer therapy, and survival among patients with curable cancers. JAMA Oncol 2018;4(10):1375–1381. https://doi.org/10.1001/jamaoncol.2018.2487
- Johnson SB, Park HS, Gross CP, Yu JB. Use of alternative medicine for cancer and its impact on survival. J Natl Cancer Inst 2018;110(1):121–124. https://doi.org/10.1093/jnci/djx145
- Walsh-Buhi ER. Social media and cancer misinformation: additional platforms to explore. Am J Public Health 2020;110(S3):S292–S293. https://doi.org/10.2105/AJPH.2020.305949
- Editorial. Acting on misinformation to prevent patient harm. Lancet Oncol 2020;21(9):1123. https://doi.org/10.1016/S1470-2045(20)30487-3
- Breast Cancer Now. Facing breast cancer. 2021. Available at: https://bit.ly/3noQ5Vs [Accessed October 2021].
- Cancer Research UK. Breast cancer. 2021. Available at: https://bit.ly/3mcDGVk [Accessed October 2021].
- Macmillan Cancer Support. Breast cancer. 2018. Available at: https://bit.ly/3bcUJ36 [Accessed October 2021].
- NHS. Overview: breast cancer in women. 2019. Available at: https://bit.ly/3EjlQGa [Accessed October 2021].
- Cipolletta S, Simonato C, Faccio E. The effectiveness of psychoeducational support groups for women with breast cancer and their caregivers: a mixed methods study. Front Psychol 2019;10:288. https://doi.org/10.3389/fpsyg.2019.00288