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One of the key findings of the MDigitalLife Social Oncology Report 2013 was that cancer conversations have become increasingly fragmented, specific and sophisticated. The number of journal articles posted to PubMed has increased 349% since 1999 – and the number of cancer-related conversations has exploded in similar fashion. As those cancer-specific conversations continue to grow, we wanted to take a closer look at the physicians who are driving them. This is the first in a series of 4 posts on the subject, which will hone in on doctors’ conversations about breast cancer, gynecological cancers, prostate cancer, skin cancer, and lung cancer.

It’s been interesting to study the similarities and differences between physicians and the general population in relation these specific cancer-related topics. In the MDigitalLife Social Oncology Report 2013, my colleague Brian Reid reported on the events and topics that caused overall conversations to spike (see page 7 of the report). In general, the biggest drivers of public conversation on specific cancer related topics were:

  • [Cancer type] awareness months; and
  • News about celebrities experiencing cancer (either themselves or with a loved one)

We see those patterns continuing to some degree with physicians as well – For example, Breast Cancer Awareness Month was the most prevalent topic among doctors in their October spike (see Figure 1, below). Ian McKellen’s diagnosis of prostate cancer was in the top 4 subjects driving a December 2012 boost in conversations about prostate cancer (see Figure 2, below). However, while public conversation about prostate cancer saw a significant jump in November 2012 as a result of the “Movember” awareness campaign, physician conversations actually dropped in November after a huge spike in October (See Figure 2, below).

Let’s take a brief look at each of the 5 cancer types to analyze what drove the largest increases in physician conversations on the subject.

1. Breast Cancer

Figure 1: Trends in Physician Conversations about Breast Cancer

As mentioned above, the largest spike in physician conversations about breast cancer essentially mirrored that of the public – centering around Breast Cancer Awareness Month in October 2012. It’s interesting to note, however, that we also see the beginning of an elevation in the “conversation floor” for breast cancer conversations – meaning that the average conversation level after the October spike is nearly twice as high as the average conversation level before the spike. This is a relatively common occurrence in online conversations … the events that drive spikes tend to penetrate deeply enough into the consciousness of the population that overall conversation levels increase.

2. Prostate Cancer

Figure 2: Trends in Physician Conversations about Prostate Cancer

The first major spike in physician conversations about prostate cancer happened in May of 2012. The spike was tied directly to the recommendation presented by the US Preventative Services Task Force (USPSTF)on the validity of the PSA test in reducing mortality among prostate cancer patients. The second, much larger spike in October 2012 was the result of a Study at The Institute of Cancer Research in London developing blood test reading like genetic barcode that can identify the most aggressive forms of prostate cancer, and later in the month a discussion around a new and very expensive prostate cancer therapy.

3. Skin Cancer

Figure 3: Trends in Physician Conversations about Skin Cancer

May is skin cancer awareness month and brought lots of discussion on prevention and detection. In particular, there was an event called #MelanomaMonday (May 7th) that generated a lot of buzz. Created as an awareness-raising device by the America Academy of Dermatology, it’s a great example of how physicians can unite behind a common cause to drive greater awareness about critical health issues.

4. Gynecological Cancers

Figure 4: Trends in Physician Conversations about Gynecological Cancers

Gynecological cancers are far from being the most-discussed cancer type among physicians – but they have seen the largest jump in conversations (and as we’ll see in upcoming posts, the widest range in physician specialties leading the conversation). That spike in January 2013 was driven primarily by the fact that January is cervical cancer awareness month. Additionally, though, there was a large amount of conversation in January that could be attributed to a single physician who has a very negative view about HPV vaccines – and tweeted about it more than 4 times per day in January (accounting for 45% of the total volume of tweets for the month).

5. Lung Cancer

Figure 5: Trends in Physician Conversations about Lung Cancer

Online conversations about lung cancer are fascinating to watch – due largely to the massive discrepancy between the large number of people who die each year from it, and the low levels of corresponding conversation. This trend, which my colleague Brian Reid mentioned in the MDigitalLife Social Oncology Report 2013(see page 5 of the report), was echoed by physicians … in spite of what appears to be a significant pattern of peaks and troughs in the diagram above, the overall conversation volume about lung cancer is so low that they’re relatively insignificant. There are two spikes in lung cancer conversations that are particularly worth mentioning. November is Lung Cancer Awareness Month, and the University of California Davis Comprehensive Care Center hosted a well-attended tweet chat  in recognition. Additionally, a new article predicting “Female Lung Cancer Rates to Skyrocket” drew a lot of attention. In February 2013, there was a lot of activity during the month about a study done on selection criteria for lung cancer screenings.

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6. All Cancer Conversations

Figure 6: Trends in Physician Conversations about 5 Common Cancer Types

When viewed together, these conversation patterns tell some interesting stories:

  • While breast cancer does drive the largest volume of physician conversations, the difference is not nearly so severe as it is among the general populace – and in fact is now rivaled by prostate cancer and skin cancer.
  • The fastest-growing conversations are around gynecological cancers, and focus primarily on the issue of HPV vaccine. It will be interesting to monitor whether the awareness levels afforded these cancers (especially cervical cancer) during this period are sustainable, or whether they’ll fall to 2012 levels.
  • Skin cancer conversations are highly seasonal, and reflect the fact that physicians have done an excellent job of focusing on the “high-risk, low-effort” prevention topics that make up so many of our ailments (e.g., wear sunscreen, give your kids swimming lessons, make sure to vaccinate your kids, etc.)
  • Lung cancer, despite continuing to represent an enormous health risk, is lagging in terms of effective advocacy – due, we believe, to the current political incorrectness of its common association with smoking.
As cancer conversations become increasingly diverse, so do the doctors who champion them. In tomorrow’s post, we’ll examine the physicians who are most active in discussing each of these five forms of cancer. Stay tuned!

All data represented in this post were collected from the thousands of validated US physicians in the MDigitalLife database between January, 2012 and May 2013. 

 

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2012 was one heck of a year for new treatments against various different forms of leukemia. In the span of 5 months, the U.S. Food and Drug Administration approved four novel therapies. Drug approvals always come with a spike of media attention, but we at W2O Group have been curious as to how that flood of interest compares with other events throughout the year, not only in news, but in all of the other conversations we have online about cancer.

This is of special interest this week, as thousands of oncologists, patients, advocates and journalists begin arriving in Chicago for the annual meeting of the American Society of Clinical Oncology.

So we decided to look into how we’re talking about cancer, both at the broadest level and in the context of more specific cancers and more specific communities. We’ve collected the results of this analysis in a new report, the Social Oncology Project, that seeks to draw conclusions from hundreds of thousands of tweets, news stories, blog posts and forum entries. We looked both at overall mentions, as well as how doctors talk about cancer, relying on our MDigitalLife database of verified doctors active online.

Our analyses found both encouraging news about the nature of the online dialogue about cancer, as well as some more concerning findings. For starters, there’s no question that we’re talking about cancer. A lot. In the last year, more than 16 million articles, posts, tweets and entries about cancer found their way online in the United States. That’s a lot of talk, and a testament to the impact of awareness raising campaigns.

In fact, there is a direct correlation between awareness campaigns and online conversations. Overall mentions of cancer rise in October due to a surge in posting around Breast Cancer Awareness Month. But similar, if smaller, increases can be seen in almost every cancer type. Lung conversations are highest in November (Lung Cancer Awareness Month). Mentions of colon cancer rise during March (Colon Cancer Awareness Month). Prostate volumes are up in September.

Not surprisingly, the most-talked-about type of cancer is also the one with the biggest awareness push: breast cancer. More people are talking about breast cancer than the other four of the five largest cancer killers combined. (Lung cancer, which kills more than four times as many people as breast cancer, has only 20 percent of the dialogue of breast cancer. Colon cancer, the number 2 killer, has only 10 percent of the conversation compared to breast cancer.)

The larger question of what is driving those conversations, however, paints a muddier picture, one that may be best illustrated by looking back at leukemia conversations. The unprecedented string of new drug approvals in the second half of last year didn’t create so much as a blip in the overall number of online conversations about blood cancers. But football did: when Indianapolis Colts coach Chuck Pagano announced that he had been diagnosed with acute promyelocytic leukemia, mentions shot up tenfold. The next big spike in conversations was also football-related: when the story of Notre Dame linebacker Manti T’eo’s fake girlfriend – who T’eo had said died of leukemia – broke.

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That’s not to say that celebrities and awareness months are the only drivers of attention, nor that the attention in one medium (say, Twitter) is reflective of discussions in others (say, online news). But, overall, we remain a social bunch online: raw data and “new chemical entities” from the FDA might not move us to share and reflect online, but human stories, be they in the news or those we hear from our friends and colleagues during awareness events, have a way of engaging us.