Don’t get me wrong, I prefer good health news. Its much more inspiring to hear of innovation, burgeoning cures, survival, getting better, being healthy. But in addition to shades of grey, health news is black and white: With the good news comes bad, the possibility of dying or being plain miserable.
The news media isn’t so good about covering that bad news when it comes to cancer. That’s the conclusion of a new paper in the Archives of Internal Medicine that analyzed 2228 cancer stories from 436 randomly selected American newspapers and magazines. Most articles focused on breast (35%) or prostate (15%) cancers, the most common gender-specific cancers in women and men, 20% addressed cancer more broadly. While interest in cancer is likely motivated by our fear of dying from it, only 7.6% of stories focused on death, while 32% were about survival and being cured, and only 2.3% dealt with survival and death. .
"It is surprising that few articles discuss death and dying considering that half of all patients diagnosed as having cancer will not survive," the authors write. "The findings are also surprising given that scientists, media critics and the lay public repeatedly criticize the news for focusing on death."
Stories of treatment and survival are certainly more uplifting, but even there most failed to provide the whole story: 57% focused on aggressive treatments, but only 13% mentioned that they’re not always successful or that some cancer is incurable. Adverse events of treatments, such as pain, nausea, and hair loss, where mentioned in 30% of stories. End of life (palliative) care was seldom covered: 0.5% of stories focused on it exclusively, and 2.5% mentioned it along side discussions of aggressive treatments.
It’s tempting to over-simplify health stories, assuming that a condition is treatable in all people who undergo a certain treatment for a certain amount of time. But it’s almost always more complicated than that. With cancer in particular, death is often a very real possibility, and while we try desperately to avoid death, it’s not a “bad” thing. Its part of the story of those things we call cancer.
Telling the whole story about health and disease is not just a hallmark of good journalism, it’s part of the larger picture of ethical, patient-centered health care. Over the years we’ve grown accustomed to waging “war” against cancer, where death equals defeat. And in war its considered poor form to plan for defeat. But cancer isn’t an enemy, and treatment isn’t war. We do our best to cure people, but must also be aware that some cancers aren’t curable, and sometimes the best treatment is to stop combating the cancer and focus on controlling symptoms, managing pain, coming to terms with mortality, and letting the natural progression of disease take its course. That’s not failure, that’s not defeat, it is part of being human. It’s also what palliative care provides, and it all begins, I believe, with telling the full story about cancer, health, life, and death.
Photo credit: The author