Cancer and medical “breakthrough” stories are staple diets for the news media. There was another one this week in the Sydney Morning Herald (7 January), apparently triggered by the publication of “preliminary findings” with mice. But how many of these breakthroughs ever actually benefit patients?
We have just published a study into all cancer breakthrough stories published in the Herald in the three years 1992-94. We used words like “breakthrough, hope, promise, research, announce, cure and wonder” to find 31 articles describing alleged breakthroughs in cancer research or treatment: nearly once a month. We sent the news articles, together with any scientific reports we could trace, to cancer experts nominated by the Cancer Council and asked how the breakthroughs were regarded today.
More than half of all the news reports (53 per cent) were judged as now being unsupported and, in some cases, refuted in the decade since being reported, with just over one in four having been incorporated into medical practice.
Cancers are dreaded and common diseases, two elemental newsworthy characteristics which draw journalists to research reports promising hope in treating the disease. Upbeat reportage on cancer breakthroughs conveys to many readers an overall sense that cures for cancer are imminent. Those diagnosed with cancer may take comfort from them, although for many this will be false hope. With just over one in four breakthroughs having been incorporated into practice a decade later, the benefit to patients reading these accounts when they were published would have been rare, given common survival times.
It is the nature of medical research that it evolves, often over decades, through the accumulation of information. Layer by layer, understanding of a disease and its treatment builds as the evidence base for recommending or abandoning a treatment accumulates. While progress in medicine is nearly always “evolutionary”, media reports of developments are typically framed as “revolutionary”, with the unrelenting dictates of brevity mitigating against anything other than a headline-driven summary of what a study found and means. The cautious and conservative nature of scientific assessment is seldom allowed space. Also, a person encountering a media breakthrough report is unlikely to keep track of progress about the research or its translation into clinical practice. Few would have the knowledge or critical appraisal skills to evaluate the meaning of the alleged breakthrough or to place it in perspective against other work in its field.
Moreover, those not living with cancer may have a general predisposition that “science will conquer all” reinforced, perhaps emboldening them to continue smoking or being nonchalant about sun exposure or other modifiable cancer risk factors. The routine media diet provided to the population about cancer breakthroughs is likely to consolidate the community’s understanding that cancer control is mainly about attacking cancer after it is detected rather than preventing it from occurring the first place. The drama and heroics implied in breakthroughs, together with the journalistic convention of often obtaining a welcoming reaction from a person living with the disease, create copy that is often far more compelling than the sometimes imperceptible gains reported in epidemiological cancer research that deal with statistics and not patients and the doctors holding out hope to them.
Journalistic appetites for studies reporting positive outcomes are readily understandable. Unless it involves the overturning of conventional wisdom or long-established practice revealed as being useless or dangerous, there is little news in negative or equivocal research findings, no matter how important such discoveries may be to the overall project of scientific discovery. There are strong imperatives to trumpet seemingly good news in research. Publicity generated by reports of breakthroughs can benefit research institutions, universities and hospitals by raising their profile to private, commercial and government benefactors. The media through its influence on public and political opinion can also affect research funding. Former federal health minister Graham Richardson put this bluntly when explaining why the national research budget for prostate and testicular cancer was $150,000 a year, compared to HIV/AIDS research attracting $13 million: “But it isn't fashionable, it's not at all in the front pages, it's not sexy to have testicular or prostate cancer so you don't get a run."
The breakthrough story would appear destined to remain a staple feature of medical reporting. The group who is least served by the perpetuation of the cancer breakthrough reporting genre is the consumer. Knowing that scientific articles about cancer breakthroughs will often find their way into the news media, medical editors would do well to publish accompanying lay intelligible perspectives on such reports which address such matters as:
- What are the outstanding questions that remain about this research before it would conceivably progress to a stage where patients were to benefit?
- Have patient trials yet been conducted? And to what effect?
- How long is it likely to take before the findings of this research are commercialised, passed through drug or diagnostic regulatory processes and made available to patients?
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