The nocebo effect

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The nocebo effect is how the expectation of pain or negative effects of a treatment increases the chances people will feel them — even if they're aren't any. So, tell someone that a treatment will hurt or have side-effects and they're now more likely to feel that pain or find something wrong.

Taken together with the placebo effect I guess we might do well, for normal affairs, to let people know that what they will get will probably help them and not raise unnecessary expectations that something might hurt.

Published 12 Jan 2017

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1 in 8 men in the UK get prostate cancer, according to the charity Prostate Cancer UK, and the risk of prostate cancer doubles if you're black. It's also the second most common cause of death from cancer for men in the UK, after lung cancer. Prostate cancer is not always life-threatening, but an early diagnosis can be life-saving. So, for Men's Health Week 2024, I worked with experts at Prostate Cancer UK to visualise how screening for and diagnosing prostate cancer has changed. In short, it's more accurate and safer than before and needn't rely on a chance conversation to trigger a discussion—you can do a 30s online check for your prostate cancer risk on the Prostate Cancer UK website right now. The new way has reduced reliance on the imperfect DRE (digital rectal examination—the test that might come to mind for many). After a suspicious PSA blood test result, you can be referred for a pre-biopsy MRI scan. Clinical trials show that pre-biopsy MRI triage can rule out 27% of men from having an unnecessary biopsy (a biopsy is when a doctor removes some cells for analysis). Biopsies have also improved and can now be guided by imaging, allowing doctors to identify the areas of the prostate they need to biopsy. It makes it safer and has fewer side effects. These changes, together, mean fewer unnecessary biopsies and diagnoses that find a higher proportion of clinically significant cancers over clinically insignificant cancers (which may not require treatment), meaning fewer men are at risk of harm from the screening. Rob Bell, host of the Sketchplanations podcast among many other talents, is an ambassador for Prostate Cancer UK, which supports our "dads, brothers, partners and friends by raising awareness, funding life-changing research, campaigning for change and providing much-needed support." Rob made the connection (this isn't a paid promotion), and you'll hear our discussion with Amy Rylance, Assistant Director of Health Improvement, on how screening has changed in this week's podcast. Medical research and knowledge is always changing. This sketch has been checked by the team at Prostate Cancer UK based on research. See, for example, the article Fewer Men Face Harm in Prostate Cancer Diagnosis. It's intended to raise awareness, help early diagnosis now or in the future for men reading this, and maybe even save a life. If you have feedback or comments on it, please do write to me: jono.hey@gmail.com Didn't know when Men's Health Week was? I learned that International Men's Health Week is the week preceding and including Father's Day. Don't forget, you (or someone you know or love) can do a 30s online prostate cancer risk check online now. Aside from helping your father avoid prostate cancer, he might like a copy of Big Ideas Little Pictures. Also see: The Swiss Cheese model Dracula sneeze Reference: Most common causes of cancer death1 in 8 men in the UK get prostate cancer, according to the charity Prostate Cancer UK, and the risk of prostate cancer doubles if you're black. It's also the second most common cause of death from cancer for men in the UK, after lung cancer. Prostate cancer is not always life-threatening, but an early diagnosis can be life-saving. So, for Men's Health Week 2024, I worked with experts at Prostate Cancer UK to visualise how screening for and diagnosing prostate cancer has changed. In short, it's more accurate and safer than before and needn't rely on a chance conversation to trigger a discussion—you can do a 30s online check for your prostate cancer risk on the Prostate Cancer UK website right now. The new way has reduced reliance on the imperfect DRE (digital rectal examination—the test that might come to mind for many). After a suspicious PSA blood test result, you can be referred for a pre-biopsy MRI scan. Clinical trials show that pre-biopsy MRI triage can rule out 27% of men from having an unnecessary biopsy (a biopsy is when a doctor removes some cells for analysis). Biopsies have also improved and can now be guided by imaging, allowing doctors to identify the areas of the prostate they need to biopsy. It makes it safer and has fewer side effects. These changes, together, mean fewer unnecessary biopsies and diagnoses that find a higher proportion of clinically significant cancers over clinically insignificant cancers (which may not require treatment), meaning fewer men are at risk of harm from the screening. Rob Bell, host of the Sketchplanations podcast among many other talents, is an ambassador for Prostate Cancer UK, which supports our "dads, brothers, partners and friends by raising awareness, funding life-changing research, campaigning for change and providing much-needed support." Rob made the connection (this isn't a paid promotion), and you'll hear our discussion with Amy Rylance, Assistant Director of Health Improvement, on how screening has changed in this week's podcast. Medical research and knowledge is always changing. This sketch has been checked by the team at Prostate Cancer UK based on research. See, for example, the article Fewer Men Face Harm in Prostate Cancer Diagnosis. It's intended to raise awareness, help early diagnosis now or in the future for men reading this, and maybe even save a life. If you have feedback or comments on it, please do write to me: jono.hey@gmail.com Didn't know when Men's Health Week was? I learned that International Men's Health Week is the week preceding and including Father's Day. Don't forget, you (or someone you know or love) can do a 30s online prostate cancer risk check online now. Aside from helping your father avoid prostate cancer, he might like a copy of Big Ideas Little Pictures. Also see: The Swiss Cheese model Dracula sneeze Reference: Most common causes of cancer death

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