Breaking down cancer taboos in Melbourne's west

There would be very few people in Australia who haven’t been touched by cancer in some way, whether by having cancer themselves or knowing friends, family or colleagues living with cancer. One in every two Australians will be diagnosed with cancer by the age of 85.¹

But for something so common, it is remarkable how rarely we speak about cancer. Despite many high-profile cancer charities and awareness campaigns, talking about cancer on a personal level, about our own risk and the risk for our families, is still a taboo for many people and cultures.

But talking about cancer can’t hurt you — and it could even save your life, with a third of all cancers preventable through lifestyle and other modifications.

To help break down the culture of silence around cancer, a group of health organisations came together earlier this year to run Australia’s first ‘Let’s Talk About Cancer’ pop-up shops in shopping centres in Melbourne’s western suburbs.

The Victorian Department of Health and Human Services funded North Western Melbourne Primary Health Network to trial the pop-up shop concepts, and a collaboration was formed with Western Health, Cancer Council Victoria and IPC Health, who provided oncology and public health nurses, volunteers and cancer resources for the shop. Four-week leases were taken in Sunshine and Caroline Springs shopping centres to run pop-up shops in February and June 2018.

The shops were designed to promote the importance of early diagnosis and screening, improve awareness of common signs and symptoms of cancer, deliver positive health messages, and reduce cancer stigma. The shops were also designed test the acceptability of the pop-up shop model.

The shops were a deliberately ‘non-medical space’ with bright colours and couches, and friendly staff. Cancer nurses provided information, advice, support and referral to other services, but refrained from giving medical opinions.

Several of the nurses believed that many visitors to the shop would not otherwise have sought or understood cancer information.

“I spoke with a lady in her 60s who let me know that she had never screened before in any program (breast, cervical or bowel), and said that her main barrier was the embarrassment and anxiousness, but also not knowing where to go,” one of the nurses said.

“We provided her with information, some education on the importance of screening and risk factors, and she left saying she would read it all, and felt more prepared and able to follow up and make the necessary appointments.”

Volunteers encouraged people to enter the shop, welcomed them and helped direct them on to nurses for more detailed conversations. The shops were designed to be culturally and linguistically inclusive — 12 languages were spoken between the volunteers, and materials were available in 20 languages.

Nurses and volunteers were chosen based on their skills, suitability and availability. Special ‘listen and refer’ training was provided to volunteers prior to both shops, and Western Health’s oncology nurses were trained by Cancer Council Victoria in how to provide cancer support and advice in a community setting.

What was found

Over the course of the two shops, 412 oncology nurse conversations were recorded during 39 days of operation.

The most commonly discussed topics were support, cancer screening, signs and symptoms of cancer, treatment, side effects, family cancer, grief and reducing cancer risk.

Of 243 nurse conversations in the Caroline Springs shop:

• 137 participants talked with nurses about support-related topics.
• 120 participants received information about screening services and were counselled on options.
• 115 participants talked with nurses about reducing cancer risk. Of these, 30% were diet-related, 26% exercise-related and 16% smoking-related.
• 48 participants disclosed current or previous cancers; the most commonly reported cancers were breast, prostate, colorectal and skin.
• 256 referrals to services were made, the most common being Cancer Council Victoria (105), followed by referrals to GPs (71).
• An additional 231 referrals were made to breast, bowel or cervical screening.
   

The Let’s Talk About Cancer shops were a new way for nurses to reach and support an ethnically diverse population and encouraging discussion on a wide variety of cancer topics including screening, lifestyle changes, preventative action and referral to health professionals.

The pop-up shop model has proven to be an appropriate and acceptable format for nurses to provide cancer information in community settings, and a toolkit has been developed for other organisations wishing to run cancer pop-up shops.

For more information, please contact cancerplanning@dhhs.vic.gov.au.

Reference

1. https://www.cancer.org.au/about-cancer/what-is-cancer/facts-and-figures.html