When doctors tweet about oncology, they tweet about breast cancer. A lot. Last year, about 4,000 doctors tweeted about cancer generating somewhere in excess of 80,000 tweets. And more than one in four — a whopping 26 percent — mentioned breast cancer, according to an analysis of physician tweets that we conducted for the American Society of Clinical Oncology meeting.
That doctors talk overwhelmingly about breast cancer is either a ho-hum finding or something surprising, depending on the perspective.
When it comes to captivating the public imagination around oncology, it’s hard to top breast cancer. Thanks to three decades of savvy awareness efforts, breast cancer is top-of-mind whenever oncology is mentioned. It outpaces other cancers in terms of online conversations (creating more dialogue than the next four biggest killers combined). It garners the lion’s share of National Institute of Health research funding, almost doubling the figure for lung cancer, the cancer type with the next-largest share of public research dollars.
But breast cancer isn’t the largest cancer killer (it’s number 3). It’s not the top cancer type by more esoteric measures either, such as disability-adjusted life years lost. And while it has captured the dubious position of most-prevalent cancer (only recently, and only by a small margin), it shouldn’t be assumed that doctors, who understand on a visceral level the grim public health reality around cancer, would automatically favor breast cancer by an overwhelming margin.
The point here is not to suggest that breast cancer receives too much attention or that discussions around cancer are a zero-sum game in which every comment about breast cancer is robbing oxygen from a conversation around colon cancer or liver metastases. Pitting one cancer against another in what the American Cancer Society’s Otis Brawley calls “disease Olympics” is ultimately counterproductive.
Rather, the fact that physicians are so focused, on Twitter, on breast cancer may offer hints on how physician and patients advocates for other cancer may be able to foment a robust discussion online.
First, the more integrated the patient and provider communities are, the better. The much-heralded breast cancer tweetchat (#BCSM), patients mingle with doctors and other providers, breaking down silos and linking networks that, in other areas, often operate in isolation.
Second, a broad range of physician voices can expand a message. One of the more unusual findings in our analysis of conversations about cancer by physicians is that oncologists account for a minority of the tweets: The near-universal interest among different specialties means that building an online community cannot and should not end with members of a specific specialty.
Third, leadership is important. Building communities online is often presented as a magical, organic process, but reality is behind any serious, sustained discussion online is a small cadre of dedicated voices who have assiduously built a place where online give-and-take can occur.
The reality is that there is demand for more conversations about cancer of all types. While Twitter discussions of cancer appear to be down, year-to-year, overall, our MDigitalLife database tells us that the rate of physician tweets rose about 20 percent over the course of 2013. So it’s pretty clear that we’ll all be talking in 2014. The only question is what we’ll all be talking about.