Health News Review

I’m supposed to be on vacation this week, but I can’t ignore the new wave of “cancer cure” talk in major news organizations just in the past two days.

Gina Kolata’s front-page New York Times story, which included the quote, “”this is the road map for how we might cure breast cancer in the future,” was the subject of two posts today on the Knight Science Journalism Tracker:

“Sorting out what is new about the breast-cancer-genetics study published Sunday in Nature is proving to be a daunting task. Reading the coverage, however, it seems most of the press made a mistake.

What I read in much of the copy, however, was not included in the release, nor could I find it in the study itself.

Gina Kolata at The New York Times reported that researchers “have identified four genetically distinct types” of breast cancer. But the press release says researchers “described new insights into the four standard molecular subtypes” of breast cancer. Kolata’s lede is apparently wrong, and so is the headline that reflects the error. A Google search turned up many stories that talked about the identification of four types of breast cancer–all, apparently, incorrect. Victoria Colliver at The San Francisco Chronicle seems to make the same mistake, if it is a mistake, in a lede that says researchers “have redefined the disease into four main classes.” So did the AP.

Liz Szabo at USA Today avoids that phrasing, writing that scientists “have finished mapping virtually all of the genetic mutations in breast cancer,” which may be overreaching a bit. The press release says the researchers identified a lot of genetic mutations, but it doesn’t say that the study covered “virtually all” of them. She also writes that the resarch “could soon change the way patients are treated.” In contrast, Harold Varmus, the head of the National Cancer Institute, says in the release, “This treasure trove of genetic information will need to be examined in great detail to identify how we can use if functionally and clinically.” In other words, I think, it will not affect the way patients are treated any time soon.

A lede that noted the similarity between ovarian cancer and one kind of breast cancer would have been safe. So would a lede that said resarchers made a major advance in understanding the genetics of breast cancer, which might one day lead to better care for patients.”

And Dr. Len Lichtenfeld of the American Cancer Society wrote:

“It is important to recall that despite the fact this is incredibly sophisticated and difficult work, it is still reasonably early in our ability to perform the analyses, interpret the data, and determine the best way to apply it to the clinic. We still have a long way to go, and we must always remember that cancer has a way of being more complicated at every turn that we might otherwise anticipate as our research and our knowledge advances. But research such as this also puts more of the pieces of the puzzle of breast cancer together in a way that a solution to the dilemma of understanding breast cancer and how we can apply the best treatment does appear to be more readily at hand.

What is the most important message from this research?

Unfortunately, it is not going to change lives immediately. Your doctor isn’t going to give you a different treatment for your breast cancer today, tomorrow, or next week because of this research. There is no question that doctors involved in breast cancer treatment are going to take a very careful look at this research and determine the best way to apply this information to new approaches to breast cancer as quickly as they can, but that will still take time.

To me, the most important message from this research is to confirm what many of us have been thinking for some time now: we are seeing the fruits of decades—yes, decades—of hard work in the laboratory taking us to a point we are going to have a significant impact on patient care and the outcomes of treatment for cancer. At the same time, the very support for that research is in jeopardy due to decreases in government funding, business investment, and private philanthropy.”

And then there’s CNN’s Sanjay Gupta proclaiming on Twitter:

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

Breaking news?  A hospital PR announcement?

Another proclamation of cure for cancer close?

This isn’t going to be much of a vacation week if this keeps up!

Comments

Liz Szabo posted on September 26, 2012 at 4:24 pm

Gary, thanks for reading our story. I wrote the USA TODAY version of the breast/ovarian cancer news this week. I don’t understand your critiques, though. Are you saying that our story is off-base only because it differs from the official press release? Gosh, that’s a good thing. I actually read the study, interviewed two of the authors, the NIH project director and a couple outsiders, plus lots of patients with triple-negative disease. A researcher was the source of the quote about mapping virtually all the mutations. Also, it’s really NOT far-fetched to say this finding could change treatment quite quickly. As we say in my story — the full version of which is online at beta.usatoday.com — that’s not because there will be a new treatment tomorrow. And we certainly never mention cure. Instead, it’s because this finding supplements earlier research pointing out a better alternative to the standard chemo now given to women with triple-negative disease. Given that they don’t seem to benefit from anthracyclines, which are very toxic, but their tumors are genetically very close to ovarian tumors, researchers told us that it would make sense to switch these women to the chemo regimen currently used in ovarian patients, which is based on platinum drugs. Ovarian cancer docs stopped using anthracyclines about a decade ago with decrease in effectiveness, doctors told us. Platinum has its own toxicities, but would spare patients the heart damage and much higher risk of leukemia from anthracyclines, the researchers told us. I focused on triple-negative disease because it’s a passion of mine. These are often the breast cancer patients most likely to die and most in need of new options. For the lucky ones who survive their cancers, reducing long-term toxicities is a great goal. No cure, but let’s be able to be grateful for something.

    Gary Schwitzer posted on September 26, 2012 at 6:07 pm

    Liz,

    Please take a closer look at what I posted.

    Paul Raeburn wrote that critique, not I. I quoted him and linked to his complete post on the Knight Science Journalism Tracker.

      Liz posted on October 7, 2012 at 4:14 pm

      Thanks for that distinction, Gary. Still, he seems to be using criteria that are the exact opposite of yours, so I’m surprised you quoted him at such length, without critique. He seems to advocate that our stories match the press release.

      I know these critiques have good intentions, but I do get frustrated with the armchair quarterbacking. Sometimes this stuff — all of it, not just you — feels like the words of a music critic on the Titanic, lashing out at the band’s lack of harmony as the ship is cracking in two.

      Gary Schwitzer posted on October 11, 2012 at 11:36 am

      Liz,

      I quoted Paul Raeburn because I tend to listen when a 40-year science journalism veteran offers a critique. Maybe that’s because I’m a 40-year veteran myself and we old dogs at least listen to each other.

      I hear the emotion in your statement of frustration and I understand it. I also understand that the economics of the news industry dictate some of the terms. I don’t think, however, that means that constructive criticism should be shelved because news organizations aren’t making the profits they once did. When the auto industry is hurting financially, that doesn’t mean that buyers should remain silent if the rear axle falls off when they drive away from the showroom.

      I also wish that constructive criticism could be called just what it is – constructive criticism – and not armchair quarterbacking.

      If our story review criteria are wrong or misguided, what would you teach journalists? What would you say are the criteria that consumers need to have addressed in stories that include claims about health care interventions?

      I could turn the Titanic analogy around on you because my funding for this project has been cut back and is itself in jeopardy at this time. So….rather than being the music critic yourself, lashing out at our tunes as our ship is imperiled….what would YOU do to improve on the 1,800 story reviews we’ve worked at over the past 6.5 years? And to improve the health care journalism involved in those stories? What would YOU do to try to lift all ships?

Paul Raeburn posted on October 12, 2012 at 2:45 pm

Liz Szabo posted a version of her comment at the Knight Science Journalism Tracker, and here’s how I responded:

Liz,

Our disagreement seems to be over the meaning of “soon.”

You do indeed attribute the assertion that the findings “could soon produce real benefits” for patients. But in your comment here, you focus on the ovarian cancer link, which was, in my view, the real news. And you did not lead with that, nor with the idea that the findings could soon help only some patients. You led with “soon change the way patients are treated.”

In your comment, you say the findings give doctors a rationale to conduct a clinical trial. The results of that would likely be years away. I would not call that “soon.”

It was a good story. As you can see from my post, I was much tougher on others. But my judgment is that the story would raise false hopes for too many patients. It’s a judgment call; we can disagree.