This was a story about NBC reporter George Lewis’ diagnosis and treatment for prostate cancer. First we want to extend our best wishes to Mr. Lewis for successful treatment and for good health.
But the principles of sound journalism are not suspended just because a reporter is reporting on his own illness. This story violated almost all of those principles. The story did not:
The most serious flaw, though, was that the reporter abandoned journalism ethics and advocated prostate cancer screening. He said: “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.
NBC Nightly News has done something similar to this before – when reporter Mike Taibbi advocated lung cancer screening after he was scanned in a story. We have commented on such news stories in the past. They 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.”
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.
There was no attempt to quantify the benefits of proton beam therapy.
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?
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.”
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.
Claims were made about proton beam therapy, and advice was given about PSA testing, without any expert source being interviewed.
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.
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.
The reporter never said anything about the novelty of proton beam therapy, questions about evidence and cost, and about its limited availability.
The story was about the reporter’s own treatment – so it’s clear it didn’t rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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