Posted by Gary Schwitzer in Health care journalism
First, we send our sincere best wishes to NBC reporter George Lewis, who this week reported on his diagnosis and treatment for prostate cancer. I have respected his work throughout his career.
But the standards of sound journalism are not suspended when a reporter chooses to report on himself. Indeed, concern for balance should be heightened when a reporter chooses to report on himself. In this story he talked about his choice of proton beam therapy. But he never mentioned questions about the evidence for/against this therapy, the tremendous cost of the therapy (can be more than $50,000 per patient), or the fact that there are only a handful of centers in the U.S. where this is done.
The New York Times, on the other hand, recently had no problem exploring these issues. It found a Harvard radiation oncologist who said “that while protons were vital in treating certain rare tumors, they were little better than the latest X-ray technology in dealing with prostate cancer, the common disease that many proton centers are counting on for business.
â€œYou can scarcely tell the difference between them except in price,â€? he said. Medicare pays about $50,000 to treat prostate cancer with protons, almost twice as much as with X-rays. â€¦
â€œThere are no solid clinical data that protons are better,â€? the chairman of radiation oncology at the University of Michigan told the Times. â€œIf you are going to spend a lot more money, you want to make sure the patient can detect an improvement, not just a theoretical improvement.â€?
The Times also mentioned an economic analysis by researchers at Fox Chase Cancer Center in Philadelphia that found that proton treatment would be cost effective for only a small subset of prostate cancer patients.
Why didn’t NBC include any of that information? Maybe because NBC was more interested in emotion than evidence.
But the flaws in the NBC story didn’t end with the proton beam coverage. The network allowed its reporter to become an advocate and a crusader when Lewis said, “Every guy over 50, doctors say sometimes every guy over 45, should get tested annually for prostate cancer. Thereâ€™s a simple blood test called a PSA and a digital rectal exam where the doctor feels for lumps in the prostate. Early detection is the key.” That is not an evidence-based recommendation.
The USPSTF concludes that the evidence is insufficient to recommend for or against routine screening for prostate cancer using prostate specific antigen (PSA) testing or digital rectal examination (DRE). Although the Task Force found evidence that screening can find prostate cancer early and that some cancers benefit from treatment, the Task Force is uncertain whether the potential benefits of prostate cancer screening justify the potential harms.
The potential harms of prostate cancer screening include fairly frequent false-positive results from PSA screening, which may lead to unnecessary anxiety and biopsies. In addition, early detection and treatment may result in complications from treating some cancers that may never have affected a patient’s health.
We have commented on such stories before. NBC Nightly News had already done something similar to this – when reporter Mike Taibbi advocated lung cancer screening after he was scanned in a story. Such stories violate the Society of Professional Journalists’ code of ethics which states that journalists should “distinguish between advocacy and news reporting. Analysis and commentary should be labeled and not misrepresent fact or context.”
But that was only one episode in NBC’s week of medical news mis-steps.
Last night they aired a piece (as so many media did) on mouse research on a pill for exercise. What was stunning about the NBC piece was the following:
â€¢ It devoted more than 2 minutes out of its total of 22 minutes or so of news time to this story. We are at war. The economy is in the tank. No one can afford gas in the tank. But 2 minutes was given to this mouse research.
â€¢ About a quarter of that time was spent explaining why this wasn’t a story for people yet – ample caveats, indeed. But why, then, did they devote so much time to the story?
â€¢ They used some of the air time to explain that this was a Schering-Plough drug – even putting the company’s name and logo onscreen. Why? With limited airtime, why was that an important nugget? Unless one’s goal is to make drug company sponsors happy.
From these two stories, the big scorecard in the sky reads:
Medical industry interests 2, NBC viewers 0.