Tuesday, September 25, 2012

How CNN Broke the News about a Cancer Cure

On Sept. 21, CNN Medical Correspondent Sanjay Gupta tweeted: "BREAKING cure for #cancer close says md anderson." (Watch the video.)

The tweet was brought to my attention by Gary Schwitzer, who ran the CNN Medical Unit many years ago and brought me onto the team. Gary wrote about his reaction to the reporting and asked me to comment:

Broke... as in damaged


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 could 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. 

Gupta also reported similar claims years ago


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 doesn't say 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.

No mention of anti-smoking efforts


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.

Mixed messages continue


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.

Takes an expert to discern the point of the story


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, just the sort of information that I think should have been the focus of the CNN story:
  • "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

1 comment:

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