Four tips for overcoming medical phobias

The 59-year-old piano teacher with a well-controlled seizure disorder had been my patient for 13 years before I stumbled upon her secret. I discovered it only because I asked her when she had her last colonoscopy. The subject was out of my scope as her neurologist, but I was glad I broached it.

She reluctantly told me that she had a debilitating fear of colon cancer. Her mother had died of the condition in middle age, and my patient was so afraid it would happen to her that she had avoided seeing her internist for a decade and had put off visiting her gynecologist for even longer. She was an intelligent woman whose visits my whole office enjoyed. But she was letting fear get in the way of her health.

Her reaction is not unusual. Colon cancer is the second leading cause of cancer death in the U.S., and 90 percent of cases can be detected (and often nipped away) through screening. Yet 38 percent of adults age 50 and older have never had a colonoscopy or sigmoidoscopy, and 79 percent have never had a fecal occult blood test. Fears, anxieties, and other psychosocial factors are often barriers to screening, according to a 2012 study in the American Journal of Health Promotion. See more about colon cancer screening. Fear also has been found to delay diagnosis of other cancers, including lung cancer, and to contribute to delays in seeking emergency care for heart attacks and strokes.

If fear is preventing you from getting the care you deserve, here are four tips that might help.

1. Admit that you are afraid.

The first step in facing your fear is to identify it. Are you avoiding a recommended test because you're afraid of what it may reveal? Or because the procedure itself is intimidating? Nearly 40 percent of people in a 2012 United Kingdom survey about attitudes toward cancer admitted that they might delay getting their symptoms checked because of fears of what the doctor might find. Fear of hospitals has also been commonly associated with postponing medical care. And a fear of needles—which may affect about 20 percent of us—has been suspected in playing a significant part in people's failure to obtain recommended tests, dental care, and vaccinations. Homing in on your fear is often the first step in conquering it.

2. Don't keep it to yourself.

Share your fears of the discomfort, pain, embarrassment, or side effects associated with a procedure, test, or treatment with your doctor. We can help. For example, patients are at times referred to me for a type of nerve and muscle testing that involves electric shocks and needles. Many are anxious about the tests, which can be somewhat uncomfortable. So I go over the testing procedure in advance, sometimes even demonstrating the electric shocks on myself. Doctors can lessen your apprehension by letting you know what to expect through diagrams, photographs, or videos. For uncomfortable procedures, a sedative or painkiller can be prescribed.

3. Try therapy.

Cognitive behavioral therapy—a type of treatment that is designed to help people replace negative thoughts, behaviors, and emotional responses with more positive ones—has been found to help with anxiety, among other disorders. Sessions are often short-term and focus on working to resolve present-day problems. CBT can help you develop a more adaptive response to a fear. To find a specialist, contact the National Association of Cognitive-Behavioral Therapists.

4. Bring your spouse or a friend.

If you think you'd feel better bringing someone along, ask your doctor if that would be permissible. Someone to hold your hand or chat with you might distract you from a scary test or procedure. One of my particularly anxious patients recently brought a friend to sit with her through nerve testing. They chatted as if I wasn't there, which was fine with me. If having someone in the room isn't possible (during an invasive test, for example), sometimes simply knowing that the person is in the waiting room can be a source of comfort.

That's what my patient decided to do. When her husband scheduled his colonoscopy, she booked hers for the same morning. His support before and after the procedure helped get her through. And her worst fear never materialized.