NCCNFORT LAUDERDALE, FlaOver a billion people worldwide
have the potential to view or listen to a CNN program at any given
time, Dan Rutz, of the CNN Health and Medical Unit, said at a
roundtable on how the media report advances in cancer. The discussion
was held at the Fourth Annual Conference of the National
Comprehensive Cancer Network (NCCN).
Of course, the number who actually tune in to CNN is smaller but
still impressive. Each month, Mr. Rutz said, about
140 million people see a CNN program or at least a part of it.
And as viewers of CNN know, a portion of the networks
programming is devoted to medical news.
The NCCN panel focused on the medias medical reporting and how
physicians can learn to better manage the process of disseminating
research results to the public.
Dr. Lundberg on Alternative Medicine
When asked if the media give special treatment to reports on
There is medicine that has been scientifically tested and found
Clifford Goodman, PhD, of The Lewin Group, a health care policy
management consultant firm in Fairfax, Virginia, moderated the
roundtable. He asked Mr. Rutz how CNN selects which medical reports
to cover in its broadcasts.
Its governed many times by competitive pressure,
Mr. Rutz replied. If everybody jumps on board with a story, we
feel compelled to follow suit for competitive reasons. Mr. Rutz
went on to say that such herd reporting is not personally
satisfying because reporters would always like to have a scoop. But,
in practice, we take a certain comfort in not sticking our necks out
too far. We know that if were right, were all going to be
right together; if were wrong, the blame can be spread around.
He said that the professional journals are an important source of
ideas for stories, really a comforting source, because they are
peer-reviewed. Most of the journals have gotten quite good at
publicizing their reports, and this fits the model I just discussed.
Everybody is going to have the same stories at the same time.
This is one of the downsides of the media embargoes that journals
place on data until publication, Mr. Rutz said. The hype
surrounding new medical ad-vances is fed by the embargo process, he
said. It encourages the mass release of information, allowing
stories of perhaps marginal significance to take on a life of their
Mr. Rutz added that the rise of the Internet as a source of public
information may ultimately lessen reporters reliance on
Human Interest vs Science
Genevieve Foley, RN, MSN, of St. Jude Childrens Research
Hospital and editor-in-chief of Cancer Practice, the American
Cancer Societys multidisciplinary journal, said that the media
often focus on the human interest aspects of medical advances rather
than the science.
She described the Chad Green case some 20 years ago at Mass General,
for which she was the primary contact with the media. Chad was
a 2-year-old boy with acute lymphocytic leukemia, she said.
He was taken off his potentially curative cancer therapy by his
parents for nutritional intervention. Mass General went to court for
a Care and Protection order, which it was granted. The child remained
physically with his parents, but the medical care was under the
direction of the hospital. After a period of time, however, the
family took the child to Tijuana for laetrile therapy, and Chad died
The media people who came to cover the story were, by and large,
feature writers, not science writers, Ms. Foley said. We found
ourselves caught between the compelling human interest story and the
scientific story. People didnt know the facts about childhood
leukemia. They knew so little at that time that they wondered why
Mass General was bothering with a child who was doomed to die. And
that just simply was not the case.
Dr. Goodman then asked Mr. Rutz if CNN uses specialized medical
reporters, to ensure that the facts are presented and interpreted accurately.
He replied that because CNN is so large, it does use specialized
reporters. But the human side of medical stories is always
stressed, and I applaud that, he said. The anecdote
provides a vehicle for explaining the science. It really is a matter
of finding a balance and responsibly putting the two aspects together.
Joseph V. Simone, MD, medical director of the Huntsman Cancer
Institute at the University of Utah, Salt Lake City, said that
initially, as a clinical investigator, my attitude toward the
press was suspicion, dread, and fear. But I learned that the press
can be good at what it does. I learned that it can become a vehicle
for us to convey to the public information that we could not possibly
do on our own.
Dr. Simone said that pediatric oncology in particular needed the
press in the 1960s, 70s, and into the 80s when rapid
advances were being made in childhood leukemia and other cancers, a
time when he was affiliated with St. Jude Childrens Research
With our help, he said, the journalists who worked
on science or medical issues became very knowledgeable. We could call
them up and offer to discuss research results with them before the
news release came out. So if you develop a good relationship with a
reporter, you can get far better reporting.
In this case, Dr. Simone said, the lay medias reporting on
advances in treating childhood leukemia may have helped spur its use.
At that time, he said, colleagues in the field were criticizing St.
Jude for saying that childhood leukemia could be cured. They
said we were giving false hope to the public and causing trouble for
local physicians because patients had read about the work at St. Jude
and wanted information.
Breakthroughs vs Increments
Dr. Goodman next focused on the difference between the way oncology
advances are often reported (as breakthroughs that can
cure cancer) and how science really works (through incremental
advances leading to new treatments).
Peter Angelos, MD, PhD, of the Robert H. Lurie Comprehensive Cancer
Center of Northwestern University, said that scientists sort of
chip away at the truth as they move toward understanding. But
thats not generally the way scientific advances are portrayed.
The dilemma, he said, is that scientists want an educated public, but
not all the information presented to the public is completely
accurate. Patients know a lot more today; they participate in
their decision making about care, and thats good. On the other
hand, information about medical research is often presented to the
public as sound bites that are too short to deal with the
studys limitations or the caveats that would be found in the
discussion section of a journal article.
George D. Lundberg, MD, former editor of JAMA and now editor-in-chief
of Medscape, a leading medical information website, said that at
all the conferences weve given at JAMA over the years for
public media people, I have always emphasized, dont use the
word breakthrough. Its a bad word. Wash out your mouth with
soap if you use it because there are no breakthroughs. Mostly there
is an incremental wearing away at some research problem.
Science grinds slowly, Dr. Lundberg said, right down to
the final steppublication of findings. He noted that JAMA, for
example, accepts only about 10% of the 4,000 unsolicited manuscripts
it receives each year, and the time lag between acceptance and
publication can be weeks or months, during which time the data are embargoed.
However, he cited what he considers a more harmful type of lag
timethe lag from the time good research supporting a change in
medical practice is published to the time doctors in general actually
adopt it. Thats an important problem in terms of quality
of care implementation in this country, he said, adding that
use of regularly updated guidelines, such as those developed by the
NCCN, will help speed implementation of cancer advances.
Mr. Rutz concluded by saying that the mass distribution of
information is a messy business, but ultimately the public is best
served by the broad distribution of information, even if some of it
is inaccurate or poorly presented.