An NBC Reporter Investigates His Own Cancer

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story included no mention of the cost of proton therapy – which is an important issue.  A single patient’s treatment may be more than $50,000.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

There was no attempt to quantify the benefits of proton beam therapy.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

No harms were discussed for either the proton beam therapy or for the broad PSA testing recommendation that the reporter made. The reporter simply said “protons can be focused right on the tumor with few side effects.”  That is insufficient detail.  What are they?  How often do they occur?

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

As explained in the “disease-mongering” criterion, the reporter did not discuss the evidence about PSA screening.  Nor did he discuss any evidence about proton beam therapy.  How could a journalist handle this issue?  The New York Times included this quote in its recent story:

“There are no solid clinical data that protons are better,” said Dr. Theodore S. Lawrence, the chairman of radiation oncology at the University of Michigan. “If 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.”

Does the story commit disease-mongering?

Not Satisfactory

The reporter, reporting on himself, commits disease mongering when he advises viewers: “Every guy over 50, doctors say sometimes every guy over 45, should get tested annually for prostate cancer. There’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 U.S. Preventive Services Task Force states:

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.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

Claims were made about proton beam therapy, and advice was given about PSA testing, without any expert source being interviewed.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story focused on the reporter’s own proton beam therapy. The reporter said, “I was confused by all the treatment options: surgery, radiation, various other therapies.”  This story didn’t clear up any confusion that viewers might have.

The story also included the reporter’s own recommendation that men should be screened annually for prostate cancer.  The option of not being screened was never mentioned.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The reporter discussed his own treatment choice of proton therapy.  But he never mentioned how difficult it is to find such devices.  The New York Times recently reported that there were only five such devices in the U.S., with about a dozen more planned.

Does the story establish the true novelty of the approach?

Not Satisfactory

The reporter never said anything about the novelty of proton beam therapy, questions about evidence and cost, and about its limited availability.