Miracles and Deadly Killers: Putting Media Reports on Cancer in Perspective

November 28, 2009 - 3:30 pm email to a friend

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Dr West

There was a time when oncologists learned the latest information about potential risks of cancer and new treatment ideas at major cancer meetings. Nowadays, we’re likely to first learn about these issues from a news report (and often in the business section!) or from patients directly. What’s particularly challenging is that these stories are often reported in extreme terms: Is coffee an amazing anti-cancer treatment or a deadly toxin today? What’’s the miracle cancer treatment of the week?

Most oncologists, including those offering insights here, probably seem very conservative in their responses when patients and caregivers come into the office or write in with breathless excitement about the latest report in the mass media about the newest treatment (see Dr. Weiss’s post on “How to Vet a Treatment Idea” for a balanced perspective). Yes, the person on 60 Minutes (or the 11 o’clock news, or Oprah, or whatever) said it was incredibly promising, but the regular reports of miracle treatments have been far more likely to be mirages than revolutionary treatments.

I give credit to the authors of a recent article in the Journal of the National Cancer Institute for highlighting the problem of how the media handle reporting about cancer. It describes some of the reasons why far too much new information is described in extremely sensational terms. This is a real pet peeve of mine, because I hate the idea that the mass media willfully generate more viewership or readership by whipping up a frenzy of danger or false hope (and I’ve thought that GRACE should announce the ”winner” of an annual GRACIE award for the most socially irresponsible and sensational report of the year).

The authors note that willful misrepresentation is part of the issue, but part of the issue is also the fact that many journalists don’t have the knowledge needed to put the work into the proper context. Many of our reports only include reference to relative risk or benefit (30% higher risk of developing cancer, or 20% improvement in survival) without noting the effect in absolute terms. When journalists just echo what is put out in a press release that is deliberately ambiguous, it’s the fault of the investigators or people putting out the press release to highlight a “20% improvement” without noting the limitation that this may amount to an improvement of only 3 weeks in absolute terms, or that a doubling of risk of developing a rare cancer may mean that the risk escalates from 0.1% to 0.2% over a person’s lifetime.

Another common practice in the media is to obtain a quote or two, often from the person who conducted the research. When you think about it, it would be hard to find anyone more likely to be biased about the importance of the work than the person who led it. I consider it particularly dubious when the leader of very early research, still years away from being vetted in appropriate clinical trials, declare that their research represents a likely breakthrough for cancer patients. This may just be a case of an investigator who can’t be objective because it’s their research (most of us think our own children are beautiful), or it may be motivated by their desire to leverage the attention into more research funding and an opportunity to be perceived as more of a leader in the field. Regardless, a reflexive request by the mass media to have investigators weigh the value of their own work is as pointless as accepting a director’s assessment of his own movie (although I’m pretty sure that the people involved in Ishtar or just about any Paulie Shore movie must not have been able to hide their shame behind pretty words).

One of the other recommendations that is also included in the JNCI paper is that journals demand that investigators describe the limitations of their own work, and/or that the journal offer some context. The Annals of Internal Medicine has recently pursued such a policy, but they’re ahead of the curve in this respect.

There are certainly some journalists (Gina Kolata of the New York Times, for instance, and there are others) who regularly cover the gray areas of a topic and highlight the limitations of early research. We should strive to have more journalists work to provide more than a one-sided story, while medical researchers need to provide more context and less grandstanding. And the general public needs to recognize that there they should be suspicious of easy answers being spoon-fed to them, whether they are fear-mongering or touting a new miracle treatment.

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