Laryngeal papillomatosis (also known as recurrent respiratory papillomatosis) is characterized by recurrent benign growths on the vocal chords. It can cause vocal paralysis and requires repeated treatment. Recently doctors have begun removing the growths with laser surgery to minimize damage to the chords. However, even with laser treatment, repeated treatments are often needed. After laser treatment, injection with the cancer drug Avastin may help prevent the growths from recurring, however little is known about the success of this treatment other than from a few cases. Clinical trials are underway.
This story very dramatically shows one opera singer’s struggle with and treatment for recurrent respiratory papillomatosis. However it provides little for the viewer in terms of useful information. Lacking from the story is any information on availability of the treatment (which is likely to be limited), the cost (which is high), the evidence to support the use of the treatment (which is lacking), the harms of the treatment (which could be substantial), and the alternative treatment options (of which there are several).
Furthermore, the story only quotes one expert who is invested in the results of the treatment since he is the lead researcher. The story should have quoted other experts who could provide some much needed perspective. That researcher may have said that there’s "absolutely no disease" and the patient may have said "You saved my voice" but we think journalism needs to put this into the context of a limited time frame of only a few months and a condition known for recurrence.
The story does not describe the cost of the surgery or the injections. The price of Avastin is notoriously high, calling many to question whether it is worth the cost.
The story does not quantify the benefits of laser surgery with or without Avastin injections.
The story describes no harms of the laser surgery or the drug injections. Laser surgery requires anesthesia, which carries some risks. The laser can also cause scarring and permanent injury to the vocal chords. Furthermore, because Avastin has mostly been studied in the context of cancer along with chemotherapy, it isn’t clear what the side effects of the drug would be in the context of a benign condition.
The story does not describe the strength of the available evidence to support the use of the laser surgery or the injections. The story mentions the presentation this week at the American Broncho-Esophagological Association of new results. These results are limited to the first 22 subjects who have undergone laser treatment (without the drug). Although the story mentions a clinical trial, the story does not make it clear that the use of Avastin in combination with laser treatment has not been studied. Indeed the story seems to suggest that one miraculous case study is in itself proof that the treatment works. Instead of letting Dr. Zeitels get away with saying "…there’s absolutely no disease"…the story should have framed his comment with a unit of time…it’s only 6 months since the last injection in December. Are to assume that if there’s no growth at 6 months then there will be clear sailing forever? The patient says "You saved my voice" but we don’t know that for sure; it’s only been a few months and this is a condition known for recurrence.
The story does not exaggerate the seriousness or prevalence of Laryngeal papillomatosis.
The story quotes only one expert – who is invested in the results of the treatment since he is the lead researcher. The story should have quoted other experts who could provide some much needed perspective.
The story does not describe any alternative treatment options.
It is not clear if the laser treatment or the Avastin injections are available, and if so, how many practitioners are trained in performing the surgery or injecting the drug.
Although laser surgery for Laryngeal papillomatosis is not a new idea, combining it with Avastin injections is.
We can’t be sure of the extent to which a press release influenced the story selection or content. We do know that only one expert at only one medical center appeared in the piece.
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.