Tuesday, March 16, 2010

David Casarett, M.D.: Cancer News Offers Readers Hope and Hype, But No Help

David Casarett, M.D.: Cancer News Offers Readers Hope and Hype, But No Help: "

Cancer is a serious, life-threatening illness that kills more than half a million people every year in the U.S. alone. But you'd never know that if you get most of your information from newspapers and magazines. This is the surprising result of a study that was published this week in the Archives of Internal Medicine.



A group of researchers (of which I was one) examined more than 400 articles about cancer and cancer treatment that appeared in publications with a national and international readership. We looked in magazines like People, Time, and Newsweek, as well as in newspapers like the Chicago Tribune and the New York Times. And what we found surprised us.



For instance, we discovered that although 95 percent reported exclusively on aggressive treatments like chemotherapy, radiation therapy and bone marrow transplants, only 13 percent mentioned that those aggressive treatments can fail. Moreover, less than a third mentioned the adverse effects--like nausea, hair loss, immune suppression, and fatigue--that these treatments can cause.



These results are disappointing, because it's clear that these articles aren't providing readers with the information they need. Imagine if you, or someone you love, have cancer. Now imagine that you're reading one of these articles, looking for advice and guidance about the side effects of treatment. Maybe you want to know if a problem or a symptom is normal. Or maybe you want a sense of what other problems might be lurking around the corner. You're not going to get that information from the articles that we found.



Of course, it's not such a terrible thing if we can't find what we need about cancer in newspapers and magazines. These are just one source of information that's available to us. If we don't find what we're looking for in one of these articles, we can look somewhere else.



That's why the real problem with these articles is not the information that's missing from them, but rather the biased picture that they give of what it's like to have cancer.



For instance, only one percent of these articles focused on palliative interventions like hospice that can improve the quality of life of people with incurable cancer. That's a serious omission because it suggests to readers that these symptoms can't be managed. But that's simply not true. Although cancer may be impossible to cure, pain can always be treated. That's what I tell my patients, and that's what these articles should be telling the public, but they're not.



The most worrisome thing we found in these articles, though, was the way that they carefully avoid mentioning death and dying. In fact, only eight percent mentioned the possibility that people die of their cancer. And of the more than 200 individual patients who were described in these articles, about 80 percent were reported to have survived. That message is unfortunate, because although cure rates are this high for a few cancers, the prognosis for most is much worse.



What's the message that these results offer readers? It's clear: People don't die of cancer. But of course they do. Every day.



Perhaps this bias shouldn't be surprising. It's just one face of the media's hype around hope. We're all scared of getting cancer, and of course we're scared of dying. So these articles play to this fear by reassuring us that there are treatments that work, and that there are cures that are effective. That is, they tell us what we want to hear.



It's unlikely that message is going to change any time soon. People want hope, and newspapers and magazines need to give their readers what they want. That's particularly true today, in this era of shrinking circulations and online competition. So we shouldn't expect a more honest portrayal of cancer anytime soon.



Nevertheless, the future isn't entirely bleak, because we have access to a wide range of other sources of information that can offer a more honest view of what it's like to live (and die) with serious illnesses like cancer. For instance, people are turning to social networking sites like Facebook to stay in touch with friends and family members who are struggling with serious illness. In fact, some sites like CarePages are designed specifically for this purpose. Those sites provide a wealth of facts and feelings and beliefs, raw and unfiltered.



And blogs, of course, are becoming a widely available source of genuine perspectives of real people. Honest, direct, and passionate, many blogs tell it like it is. Like the wonderful blog of Eva Markvoort, a young woman dying of Cystic Fibrosis, who shares what she learns from each day that she has left.



Eva's blog, and many others like it, carry messages of hope, of course. In that regard they're not so different than what we'd get from the New York Times. They tell us what we want to hear.



But they also don't shy away from the realities that people with serious illnesses like cancer face every day. They tell us not only about the good days, but about the bad days, too. They're not just about hope, but also about despair. That is, they're telling us not just what we want to hear, but also what we need to hear.



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