We would have liked to have seen a little more detail about the following:
Yes, this approach is being studied for lung, bone, liver and kidney cancers, but it can’t be emphasized enough how preliminary are these findings from this one Italian study that was reported. And a US audience was given no perspective on how/whether it’s being analyzed here.
The story says that the procedure “costs about $2,000, takes about an hour, and the patient is typically kept overnight in the hospital for observation.” That’s good information. Whether most insurance companies cover the therapy would have been good additional context. And the story could have included the costs for complications from the procedure – with 8 of the patients experiencing partial lung collapse with respiratory symptoms, this drives up the cost substantially.
Nonetheless, we’ll give the story the benefit of the doubt on this criterion.
The story says that microwave ablation “eliminated lung tumors in 19 of 28 patients. Eight months later, none of the tumors had come back.” It also paraphrases one of the study’s authors saying “Tumors shrank or stopped growing in the other nine patients”. We were glad to see additional comments later in the story pointing out that eight months is not enough time to determine whether cancer is going to return. Taken as a whole, the story shows readers that the results of this therapy — while dramatic at first glance — require further research.
The story explains the short term harms associated with the therapy, noting that there were no “major complications” and that eight of the 28 patients “had temporary trouble breathing due to a partially collapsed lung, but all got better on their own within a week.” It would help to provide further information about whether those collapsed lungs required additional monitoring or hospitalization days.
The information about the quality of the evidence was a bit scattered, but we think most readers would see that far more work needs to be done to establish microwave ablation as the first choice for cancer patients. The story calls it a “preliminary study” and notes that findings were presented at a Radiological Society of North America conference. The story included boilerplate language at the end about why these findings should be considered preliminary for that reason. The story also notes a key limitation in the study, which is how long patients were followed. It says that patients should be followed for at least five years before declaring that the therapy has adequately eliminated any tumors.
We have a problem in this category. The story lists the total numbers of patients in the US living with lung cancer, when in fact the therapy is only being tested/applicable to patients with inoperable lung tumors. This greatly overestimates the number of people for whom this therapy might be applicable. It would have been possible to provide an estimate of the number of inoperable tumors.
The story quotes one independent source: American Society of Clinical Oncology spokesman Gregory Masters, MD, a medical oncologist at the Helen F. Graham Cancer Center. More sources could have deepened our understanding of the technique.
The story spells out both the current treatment options and potential new therapies. It says, “Standard treatment options include surgery, chemotherapy, and radiation. Researchers are looking at a number of ways of destroying tumors with heat from radiofrequency waves or by freezing it, for example.” But the story could have given even a little information about how the tumor reduction rates in this preliminary study stack up against chemotherapy and radiation.
Readers are really only told that this was a study in Italy and that “US researchers say the technique certainly shows promise.” The story does not make it clear whether a patient could expect to have this technique performed in a typical hospital or how many clinical trials are currently ongoing involving microwave ablation.
As with the “availability” criterion, the novelty of the technique is a bit of a mystery, although the story does say that “microwave ablation is being studied for the treatment of liver, kidney, and bone cancers.” How long has it been studied or in use? We’re not given a clue.
It does not appear that the story relied solely on a press 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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