March 29, 2013

TIME’s “How To Cure Cancer” cover – worst of the year?

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That’s what journalist Seth Mnookin writes on Slate, stating, further, that it is “is wrong, grandiose, and cruel.”

He writes, “I haven’t found a single cancer researcher who believes this means we’re on the verge of curing cancer.”

And he reflects on some journalistic history in the same vein – from 1998:

“…the New York Times…running Gina Kolata’s embarrassing front-page “special report,” which quoted James Watson as saying a researcher at Children’s Hospital in Boston would “cure cancer in two years.” Watson claimed he said no such thing—“When I read her article, I was horrified,” he told a reporter at the time.“

Just 6 months ago, I wrote about how CNN provided another, more recent example:

Mnookin concludes:

The result of this succession of grandiose promises is similar to that of the boy who cried wolf: Eventually, it becomes hard to take even realistic claims seriously. “Historically,” says Mukherjee, “someone then comes and says, Didn’t you promise this then and aren’t we now being duped?’ It creates a cycle of problems down the road.”

Which brings us to the real problem with Time’s headline, which is not that it’s wrong, or even that it might create funding problems for future cancer researchers—it’s that in the context of a fatal disease with excruciatingly painful treatment options, it’s simply cruel.

“It made me bristle,” says Lisa Bonchek Adams, a 43-year-old mother of three with Stage IV breast cancer.* “It means getting messages and calls from people pointing to that and saying, See, you need to have hope—there’s going to be a cure.’ ”

Adams knows that’s not true, “at least not for me. Talking about a sudden cure—it’s magical thinking. My hope is not for a cure, it’s for treatment that can help people with side effects and ultimately treatment that may make this a manageable disease.” Of course, that doesn’t make for a snappy coverline—although it does have the virtue of being true.

Looks like the enthusiasm over a possible journalistic (and health topic) renaissance after Steven Brill’s excellent “Bitter Pill” cover story at TIME was short-lived. Bitter pill, indeed.

Cure was one of the “7 Words You Shouldn’t Use in Medical News” in an article I wrote 13 years ago. I didn’t create that list in isolation; each of the 7 words was suggested to me by sick people I’d interviewed as words to avoid in health care news stories. People like Lisa Bonchek Adams, quoted by Mnookin.

Addendum: Please also see our followup post a few days after this was posted. It was entitled, “TIME, TIME Warner ethical questions raised in cancer coverage.”

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Katherine OBrien

March 29, 2013 at 9:08 am

The Slate article cites a “43-year-old mother of three with Stage IV breast cancer.*”

Technically this incorrect, although many doctors and patients do use the term “Stage IV” interchangeably with “metastatic.” But a cancer’s stage does not change: http://www.cancer.org/treatment/understandingyourdiagnosis/staging

The woman quoted was originally treated for Stage 2 cancer–technically the cancer is still a stage II breast cancer, only with recurrent disease in the bones. Of course, that really doesn’t change the price of beans–this person still has metastatic disease and it is still incurable.

Where I DO think it is important to make a distinction between someone like me who is Stage IV having presented with mets and those had a metastatic recurrence is that one of us is counted and one of us is not. NCI and SEER databases record only breast cancer incidence, initial treatment and mortality data.

No metastatic recurrence records are kept. So how do we know, exactly, how many people are living with metastatic breast cancer?

We kind of don’t.

We cannot manage what we do not measure.

So that is yet another problem with the TIME cover story!

Katherine O’Brien
Secretary
Metastatic Breast Cancer Network (www.mbcn.org)

Hollye Jacobs

April 1, 2013 at 11:17 am

Excellent piece. It is Katherine’s comment that really struck me. Terrific points, Katherine. Thank you for sharing!
Hollye Jacobs, RN, MS, MSW
TheSilverPen.com

Susan Fitzgerald

April 1, 2013 at 3:51 pm

Do people believe these? I never do. I’m no scientist, but it seems to me cancer is much too complex for one single cure. My mom, who died of cancer, said 40 years ago they’ll never find a cure because there’s too much money in treatment. In 4 decades of the “war on cancer” the best they’ve come up with is: stop smoking, move more and eat your veggies. (Mom failed on the stop smoking part.) Billions, trillions spent and really, what more do we have? More and different and costlier ways to slash and burn cancer out of the body.

Dawn Owens

April 4, 2013 at 3:28 pm

What, all the pink ribbons, pink Kentucky Fried Chicken buckets and Run for the Cures rah-rah rallies aren’t enough for you???

Besides, I thought that it was AMA and American Cancer Society protocol to instantaneously offer to buy out anyone who finds a ‘cure’ for cancer, followed by running them out of the country or hounding them legally for the rest of their days, if they won’t submit to being swallowed up by the Military-Industrial-Medical-Legal Complex. All because ‘sufficient studies’ haven’t been performed. And never will be. I would have thought that in a true ‘free’ society, we should be able to go see our quack of choice, regardless of the outcome. In the end, that would be a controlled study by itself.

Just yesterday, I fired my Oncologist after I asked for a prophylactic bilateral mastectomy (based on one side having diagnosed cancer and suspicious DCIS, LCIS cells being seen in the sample after the lumpectomy); he told me that was ‘overkill’. That it would be like ‘having a splinter in your toe and amputating your foot’.

I told him I didn’t have a splinter, but diagnosed cancer, that my boobs weren’t feet, which I actually use, but two pieces of fat hanging off my 60 year old chest that I no longer find useful, and that if all I had was a ‘splinter’, perhaps his recommendation of chemo and radiation was a tad bit of ‘overkill’.

He said I was using circular reasoning and was uppity, pretty much the death knell for a decent patient-doctor relationship. This was 24 hours ago and I’m still aghast at the arrogance and stupidity.

Cheryl Jernigan

April 1, 2013 at 4:19 pm

Thanks, Katherine, for the clarification/education.
Have passed this on to several folks and plan to use it in a cancer biology class where I will be a guest lecture.

Homer Lim

April 7, 2013 at 8:13 pm

I dont think its right to say stage IV cancer is incurable… There maybe no reports but it doesnt mean there aren’t. Just like theres no evidence of disease, doesnt mean there aren’t

Bparga

April 15, 2013 at 7:12 am

Can some cancers be cured? Absolutely! My ex husband was diagnosed with Melanoma in IV stage.. It was 1970. He got a very bad prognosis of life, by doctors here, in the USA and in Colombia, where we were living at that time. Never got chemotherapy. A Colombian cancer researcher gave him a simple, almost pennies cost medicine used for parasites in children, which was found boosted the autoimmune system. No side effects. “I thought your husband would never make it”, said a US doctor. He is now the happy father of two teenagers, re married and a is a happy man.