Wednesday, March 17, 2010
Cancer Reporting in the Media - Guess what they report on?
Image via WikipediaSo why the St. Patrick's day logjam of articles? Some may say it is mere coincidence, but I think there may be some meta-meaning here. By the power of
This Archives of Internal Medicine study by Fischman, Have and Casarett shines a light on the bias present in the media towards the 'fight' against cancer. (other good blog posts on words used in cancer: Drew Rosielle on 'Hope' and GeriPal on 'fighting cancer') The researchers looked at 8 newspapers (Chicago Sun-Times, Chicago Tribune, Daily-Herald Chicago, New York Daily, New York Post, New York Times, Philadelphia Daily News , Philadelphia Inquirer) and 5 magazines (Newsweek, Parade, People, Redbook, Time). (What no Washington Post or Cosmo?)
The main points in the articles that were coded if they were mentioned were:
- Survival
- Mortality
- Aggressive/curative
- Treatment failures
- Adverse events
- Palliative focus
The researchers found a very significant bias towards reporting cures/survivors (32%) over deaths (8%) and sadly only 2% that mentioned both. Also they found that adverse events and treatment failures were rarely reported (both less than 30%).
And of course the result you have been waiting for, 11 articles out of 436 (3%) mentioned aggressive and pallaitive measures and only 2 (two, dos, deux, zwei!) of the articles focused exclusively on end of life care exclusively. Well the researches only searched from 2005-7 and so they missed the whole past year of New York Times articles we have been writing about. Still it is shocking in 'cancer focused' articles only 0.5% mention end-of-life care exclusively?!
Pallimed was initially focused on EBM style analysis of palliative care articles, but we have expanded our scope to report on palliative care in the media also, and this study justifies the importance of getting the story about good palliative care into the main media news cycles. It is not just enough that there are articles about cancer treatments (mainly read by cancer patients and their families) or articles about hospice or palliative care programs (read by hospice and palliative care staff and families with hospice experience.) We need articles that combine the two so people are equally exposed to the balance of treatments that exist out there. Few patients or families facing cancer diagnoses will choose to read the 'hospice is valuable' headline when juxtaposed with a 'new cancer treatment' headline.
But it is important to understand the view of the journalist and editors as well. 'New cancer treatment' headlines may sell more copies than 'hospice is valuable' headlines. Also a new treatment being available is news because it is new, different, interesting. Having articles about how people have poor survival with a cancer diagnosis is not new, different or interesting. Palliative care and hospice organizations need to make sure the journalists and editors hear the great stories we see every day in our work. The human interest perspective is very powerful. Some hospices are better at connecting with the media than others. Maybe it was time we all had a lesson in how to best interact professionally with the media.
For reference I have uploaded a slidedeck I gave at the NHPCO conference in 2007 titled: Working With the Media: How to Reach the Widest Audience Possible. It is embedded below.
View more presentations from Christian Sinclair, MD.
Fishman, J., Ten Have, T., & Casarett, D. (2010). Cancer and the Media: How Does the News Report on Treatment and Outcomes? Archives of Internal Medicine, 170 (6), 515-518 DOI: 10.1001/archinternmed.2010.11![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=925e9d42-c730-4063-b3e2-30cc4fa92d66)
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4 Responses to “Cancer Reporting in the Media - Guess what they report on?”
March 18, 2010
As a physician-survivor, I believe part of the solution lies in educating the public about cure's many meanings.
In social and political contexts, we can help elevate the work of researchers and foundations by emphasizing the double entendre-a cure for the disease and a cure for the public health problem.
When tending to patients, we can explain that being cured is no longer a simple dichotomy like being pregnant-you are or you aren't. Cure is a continuum.
I discuss this in "Chasm of a Cure" :http://tinyurl.com/OT-041009
With hope,
Wendy
www.wendyharpham.typepad.com
March 18, 2010
I hate to sound like a broken record....but this just goes to the great need of education about what Palliative Care is!
We need to marry PC with Curative Care from the very beginning. Anyone who has an advanced cancer diagnosis needs to be introduced to PC.
"Hope for the best but prepare for the worst"
And the worst becomes less terrifying if a PC expert is at your side!
Curative & Palliative Care can co-exist and is all win/win...
March 19, 2010
What do we do? Cure the wounds of death!
We should talk more about what that means and how we do it.
March 22, 2010
Attention given articles in JAMA on "cancer reporting" is a reminder of the media's influence with regard public perception or understanding of health matters. There's the unsettling reality that the media carries significant sway, whether at the patient's bedside or in the corridors of government.
It's nigh impossible for voices of calm and reason to be heard above the noise level that the media can create on any given issue. Examples are the near hysterical coverage given the study by Dussel et al in Archives of Pediatrics & Adolescent Medicine ('Considerations about hastening death among parents of children who die of cancer). Other examples of the media's capacity for hyperbole is in its reporting of so-called "death panels" and the issue of assisted suicide. Both have been complicated by attention given a range of issues related to end of life care (e.g., principle of double effect, medical futility, resuscitation, artificial hydration and nutrition, withholding or withdrawal of treatment, palliative or terminal sedation, and persistent vegetative and minimally conscious states).
For the most part, the general public is more often than not ill-informed on these critical issues. The media has consistently demonstrated a lack of understanding or ability to articulate clearly on these and other end of life issues. The public is not well served in coming to terms with dying and death or coming to grips with the complexity of end of life decision making. The media, for the most part, "ain't helping the situation." In an age that insists on brevity in the spoken or written word, there are few opportunities for in-depth reporting. The primary objective of the media, it seems, is to provoke, not necessarily to inform. [The Internet cannot be ignored. It's perhaps sufficient to point out that the Internet is embraced as an inexhaustible source of information ...but, information is not synonymous with knowledge.]
In palliative care there is oft heard the call to "educate" the public. The real need is to educate the "sources" of information that influence a person's decision making. For the one-on-one situation, it's the health professional who is best situated to facilitate discussion. In terms of the public-at-large, however, it remains the media – a double edged sword if ever there was one.
The attention given "cancer reporting" is one side of the proverbial coin; the other, the media's accuracy. A reminder of the latter came with a "correction" from Associated Press (AP). The news outlet reported on a study by Goldstein et al in Annals of Internal Medicine ('Management of implantable cardioverter-defibrillators in hospice: A nationwide survey'). AP reported erroneously the proportion of hospices that had a way to identify implant recipients. The study found 20% had a method to do so, not one in 20 as AP had stated.
I'm reminded of a ten-year-old initiative that may still have relevance today. With a group of health professionals and seasoned medical writers, I co-authored a set of guidelines intended to raise journalistic standards in reporting health matters, published in the journal of the American Medical Writers Association. Regrettably, there was no follow up in terms of tracking the impact the guidelines may have had, if any. In the time since their publication, however, it has become evident that fewer and fewer news outlets have staff dedicated to the "health beat." I'd venture the opinion that centers of research, the organizations that represent health care professionals, and individual health professionals need to take the initiative in more effectively managing the flow of information to the media and in engaging journalists in the reporting process. The reality is that the onus is on them "get it right."
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