Health News Review

As I wrote late yesterday, CNN’s Sanjay Gupta announced via Twitter:

BREAKING cure for #cancer close says md anderson. plan to “drastically reduce” cases & deaths n 5yrs! im reporting excl details all day @cnn

Some of the reporting is captured on the CNN website.

BREAKING news…breakthrough…cure close…exclusive…”Moon Shots Program”…”Giant leap for mankind”.

We realize that Gupta wasn’t trained as a journalist, and it shows.  “Breaking news” is a term usually reserved for events that have just happened – a train wreck, a Supreme Court decision or the like.  Using “breaking news” to describe a hospital public relations announcement is as inappropriate as calling neurosurgery a walk through the park.

Referring to this as an “exclusive” – as in “excl details all day” – is like referring to the NFL replacement referees as competent.  Again, exclusive details of a hospital PR announcement?!?  Wow, get the journalism award entry ready! And look at the image below to see how “exclusive” is used.  EXCLUSIVE: CENTER AIMS TO CUT CANCER DEATHS.  What about all the other research at all the other cancer centers aiming to do the same thing?

But it’s the simplistic statement that a “cure for cancer (is) close” that is most troublesome.

I asked one of our story reviewers, journalist Andrew Holtz, to review the reporting.  Please note:  Holtz and I were colleagues in the CNN medical news unit in the 1980s – so long ago as to make it almost irrelevant in this discussion but I feel obliged to mention it here.  Here are his comments:

———————————————-

This CNN report is inherently misleading in multiple ways.

The story leads viewers to believe something truly novel is happening, but the claim that cancer cases and deaths can be dramatically reduced by applying existing knowledge is a statement that is almost a cliché in the cancer world. Here’s one example I reported more than five years ago: Dr. Brian Druker, the researcher behind Gleevec, made a similar statement as he stepped into the top job at what’s now called the OHSU Knight Cancer Institute. “It’s already estimated that we could lower mortality rates from cancer by about a third if we implemented what we know. Implementing what we know encompasses a lot of things. It encompasses both screening and prevention, as well as optimizing therapy,” he told me for a profile story I wrote in 2007.

I’m not claiming I scooped Sanjay Gupta by five years. Indeed, he has reported this claim before. For example, the transcript of a CNN report from 2007 includes this quote from Dr. Harold Freeman, medical director of the Ralph Lauren Center for Cancer Care and Prevention in New York, “[W]e’re not applying to what we know to all American people. If we close that gap, that would be the biggest thing we could do to improve the results for cancer.” In that same transcript, Lance Armstrong states that applying existing knowledge about cancer could prevent 200,000 cancer deaths a year in the United States, about a third of the annual total at the time.

The story about MD Anderson Cancer Center does not make clear what makes this time any different.

And I’ll wager that any survey of viewers would find that most believe that Gupta’s report said that a big part of a decline in cancer deaths would come from new discoveries about cancer. The report did not make that claim. Several times it reported that most of the hoped-for improvements would come from applying existing knowledge about preventing cancer, but then the specific examples highlighted, and the video used, implied a different story of promise from new approaches.

After saying  that the biggest advances against cancer would come from applying existing knowledge, MD Anderson Cancer Center President, Dr. Ronald DePinho, told Gupta that screening smokers with lung CT scans would have “an impact on 170,000 deaths per year.” Gupta says proper screening could have “a huge impact.” I would forgive viewers for thinking that the report is claiming that lung cancer screening could save hundreds of thousands of lives a year. It didn’t actually make that claim, but the presentation was confusing. Actually, the biggest study of CT scans indicates you would have to test more than 300 heavy smokers to prevent just a single lung cancer death. And I will spare you a detailed explanation of how the story bungled references to the potential benefits of early detection, while failing to explain that if a disease takes 10 years to kill you, finding it in year 5, instead of year 9, can give the appearance of longer survival without necessarily changing the date of death.

Astonishingly enough, Gupta never mentioned that funding anti-smoking campaigns at the level recommended by the CDC would save many times more lives, while also preventing much of the heart disease, emphysema, bladder cancer and other tobacco-related maladies that lung cancer screening can do nothing about.

In another mixed message, Gupta claimed to have had an “exclusive look” at experimental treatment for melanoma skin cancer that “are reversing” the disease in a handful of cases, followed by a sound bite from Dr. DePinho saying that simply checking people’s skin would have a far greater effect. By the way, it’s very easy to find news releases and journal articles from MD Anderson and other cancer centers talking about experimental treatment for metastatic melanoma that report “handfuls” of cases where the cancers shrank, no “exclusives” necessary.

Gupta wrapped the whole report in a story of a patient that further muddled the message. He refers to the young woman with breast cancer when displaying the massive research investment at MD Anderson, to esoteric and undefined disease labels like “Triple-Negative Breast Cancer”, and to genetic testing of breast tumors. But then what gets the ultimate credit for the patient’s apparently good prognosis? She felt a lump in her breast.

Viewers who have extensive knowledge of cancer prevention and treatment can discern what I think is the intended message of this story: that boosting public health programs, addressing health behaviors, dealing with social and environmental factors and then also improving the performance of the US health care system could help dramatically delay the age at which cancer is likely to strike. But what message does the average viewer get from Gupta’s potpourri of references to experimental and conventional approaches? Probably a foggy sense of something new just around the corner… just around the corner where it was yesterday and last year and where it will be tomorrow and next year… as long as we continue to grapple with all the roadblocks in the way of applying what health experts already know.

By the way, here’s a recent journal article that opened with, “More than half of the cancer occurring today is preventable by applying knowledge that we already have,” and then went on to explain in detail what we should be doing and some of the reasons it is so hard to follow through: “Applying What We Know to Accelerate Cancer Prevention”  Graham A. Colditz, Kathleen Y. Wolin and Sarah Gehlert, Science: Translational Medicine, 28 March 2012: Vol. 4, Issue 127, p. 127rv4

 

—————————

Publisher’s addendum:

Some leading science journalists have weighed in with their own criticisms and concerns.

  • On the Knight Science Journalism Tracker, Paul Raeburn wrote: “If you have cancer, or a family member has cancer, I apologize for bringing this to your attention. Be assured that there was no development on Friday that will change the outlook for a cure. And be assured that neither MD Anderson nor CNN has an “exclusive” on curing cancer. Everyone in cancer research is trying to cure cancer, prevent it, or ameliorate the lives of those who have it. …This could be the worst case of hyping cancer cures I’ve ever seen, and I’ve seen a lot. I’m making a note to check in with Gupta in five years, when cancer cases and deaths are supposed to be “drastically reduced,” and ask him how it’s going. It’s on my calendar.”
  • British science journalist Ed Yong tweeted: “People w/ cancer, and the public, deserve better than CNN’s incompetent, misleading, context-free, mangled buffoonery.”

Don’t miss our followup post on September 26:  “Things CNN didn’t report about the MD Anderson ‘cancer cure close’ story.”

Added October 1:  Curtis Brainard, in the Columbia Journalism Review “Observatory” column, wrote:

“The promise of a cure for cancer has lured many journalists that should know better into holding out false hope to the millions of Americans afflicted by the disease every year. Last Friday, it was Dr. Sanjay Gupta’s turn. The CNN correspondent sent a deplorable tweet to his 1.5 millions followers…Indeed, Gupta, who almost became the nation’s Surgeon General, should be ashamed of himself, and CNN needs to take far greater care with its reporting in the future.”

Added October 8:  Dr. Michael Wilkes of the University of California-Davis addressed the CNN coverage on his Second Opinion podcast for KCRW radio in Santa Monica:

 

Comments

Ken Leebow posted on September 25, 2012 at 10:47 am

I recently heard Dr. Brawley state this: “We, as doctors and profilers, are using a 19th century definition of cancer in the 21st century.”

I wonder if his assessment is more accurate than a “cure is around the corner” attitude.

Ken Leebow
Author of 101 Incredible Diet, Health, and Lifestyle Tips

    Andrew Holtz posted on September 25, 2012 at 1:13 pm

    Indeed. We can reduce exposure to the things that increase cancer risk, and do a better job of managing the cancers that are increasingly likely as our bodies age.

RichATL posted on September 25, 2012 at 12:53 pm

It is bothersome that a physician journalist is willing to knowingly over-hype a story to make it big news so that his story gets more prominence and attention. He certainly is too sophisticated to have misunderstood the significance of the MD Anderson press release. Unfortunately he is by no means alone in this behavior. No wonder the public has such unrealistic expectations.

    Ken Leebow posted on September 26, 2012 at 4:42 pm

    Gupta recently did a segment on 60 Minutes about Sugar Shock … the only problem with this “new” revelation is that I have a video form the late 50′s that discusses the same issue. It’s not new and it’s not news.

    Shannon Brownlee has a good video about this nonsense … just do a google search.

Eva Baron posted on September 25, 2012 at 5:59 pm

ok – how is it that the main point of Sanjay’s statement didn’t get through to you??? Reducing cancer death cases is a BIG deal! why can’t we have good news for a change instead of finding a critique in the way the good news is delivered. shame on you!

    Andrew Holtz posted on September 25, 2012 at 10:37 pm

    Eva,
    What was the main message that you got from the story?
    I was just left wondering, if applying what we already know would have a huge effect, why aren’t we doing it? And then the frequent mentions of experimental treatments, next to comments about how doing a better job of applying existing knowledge would have a greater effect, left me completely confused about the point of the story.
    And then there are the things like claims that lung cancer screening would have a “huge” impact. The available evidence simply doesn’t support that assertion.

Marc Kusinitz posted on October 1, 2012 at 9:44 am

It occurs to me that, just as assiduous application of current scientific knowledge will contribute significantly to cancer treatment and survival, so would assiduous application of the current state of the art of science journalism (as practiced by Healthnewsreview and others) contribute significantly to reducing the hype and foggy reporting that continues to assault audiences eager for hope in the fight against cancer. The knowledge and skill sets are out there to help both issues. It’s just a matter of applying them.