Editor ’ s Corner
Treating Spin Doctors
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The content of the Editor ’ s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated .
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ECENTLY , A HOSPITAL IN BOSTON announced that a senior staff scientist had developed a “ cure ” for leukemia . I wasn ’ t surprised to read this – there are many clever and creative leukemia investigators in Boston , and promising new developments emerge from local labs on a regular basis . Were I a devoted follower of academic medical center press releases , though , I would have been puzzled that leukemia still needed to be cured . After all , just a few weeks earlier , a hospital in New York had reported the cure of leukemia , and , in the past year , centers in Texas , California , and Ohio had also described how their doctors had ended the scourge of this disease .
I vividly remember when a hospital in Pennsylvania cured leukemia so thoroughly and decisively in 2011 – “ with the AIDS virus ,” no less – that I spent the next couple weeks answering calls and emails from desperate patients with various forms of leukemia wondering how they , too , could be injected with HIV . Two especially heartbreaking calls came from the wives of two men with relapsed / refractory acute myeloid leukemia whom I had just enrolled on hospice care .
Even that excitement was nothing compared to the fervor in 1998 , when a front-page article in The New York Times claimed that all forms of cancer were on the brink of being cured . In that article , Nobel laureate James Watson , PhD , promised that angiogenesis researcher Judah Folkman , MD , would cure the emperor of all maladies within two years , predicting that Dr . Folkman , “ would be remembered along with scientists like Charles Darwin as someone who permanently altered civilization .” The Times ’ s use of more careful language – the article presented several more restrained opinions , and the headline even used the words “ cautious ” and “ mice ” – did nothing to avert breathless enthusiasm about the miracle of anti-angiogenesis therapy . Everyone wanted to get his or her hands on endostatin – even some healthy people , to avoid developing cancer .
In this era of alternative facts , scripted reality , and fake news , journalism is under closer scrutiny than ever before . For journalists working today , integrity and caution are now as critical as the traditional essential traits of courage and curiosity . Health journalism is no exception ; getting it right in stories about advances in science and medicine is arguably more important for society than predicting which NFL draft picks will be a bust or describing the latest narcissistic Hollywood trend .
Some journalists are masters of their craft , but others are careless , lazy , or sloppy . It can be difficult for John Q . Public to tell who ’ s who or what ’ s what . Perhaps it ’ s not surprising that , in a recent Gallup poll , Americans ranked journalists ’ ethical standards and honesty 12th out of 22 professions – just above lawyers and business executives , but below bankers and chiropractors .
Academic medical centers and disease foundations too often make health journalists ’ jobs more difficult than they need to be . Although academic centers ’ communications departments are well-meaning , their aim is as much to improve a center ’ s reputation ( especially when prospective donors might read a
David P . Steensma , MD , is senior physician at the Dana- Farber Cancer Institute and associate professor of medicine at Harvard Medical School in Boston , Massachusetts . report ) as it is to inform . I work closely with my institution ’ s communications staff , and they are genuinely enthusiastic about the cool science being done here and the hospital ’ s mission to cure cancer and blood disorders But when press releases are capped by overpromising headlines , then transmitted across the planet on Twitter and anthologized on Reddit , any caveats or cautionary words in the original stories are inevitably lost in transmission .
Conflicts of interest probably get the most attention in discussions about the quality of health-care journalism , but journalists now commonly report studies ’ funding sources . Incomplete information – especially failure to mention the adverse effects and cost of a new treatment , or that only animals or cell lines were tested – is just as harmful to a story as hyperbole , sweeping claims , and disease scaremongering .
There are some islands of self-policing in health journalism . For example , non-profit watchdogs such as the HealthNewsReview ( healthnewsreview . org ) scrutinize media reports and press releases about medical developments , grading them on a 10-point scale . These organizations are important checks on health journalism ’ s wild excesses , and they deserve support .
We try to be balanced in what we report at ASH Clinical News . I ’ m sure we fumble from time to time , but we routinely note conflicts of interest and the limitations of studies . Also , most of the stories you ’ ll find here are about clinical studies . Preclinical work is important ; at the end of the day , though , human data are what matter most to practicing nurses and doctors , and to our patients .
The danger is that patients and others learn to tune out and miss stories about real advances , like villagers ignoring boys crying wolf . I was recently reminded of this by one of my patients , a middle-aged man who has chronic-phase chronic myeloid leukemia . He ’ s a smart fellow – a senior judge in local court . We ’ ve happily charted his evolving remission , as imatinib induced first an early molecular response , then a complete cytogenetic response , and finally a major molecular response ( MMR ). When he achieved MMR , I told him his life expectancy was similar to someone of the same age without leukemia . He stared at the corner of the room with a look of wonder in his eyes . “ Wow , so there really have been improvements in treating cancer . How about that ! I thought it was all hype , just smoke and mirrors that you guys publicize to try to get more research funding .”
I pled “ not guilty ,” but the evidence was stacked against me .
David P . Steensma , MD
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