If You Are A Mouse With Cancer, We Can Help

(How not to write a cancer story)

By Kathy Summers

    
Scientists can cure cancer--in a test tube. They can even cure it in a mouse. The problem is curing it in people. If you want to write an article with the headline Cancer Cure on the Horizon, it will probably sell big time. If you write, Cancer Cure Doesn't Work in Humans, it may not sell at all. Hence the many hyped and then retracted cancer cure stories--not to mention cancer scare stories--published year after year, even in respected newspapers. Through it all, cancer remains one of the most important stories in health.
    
If you want to write about cancer, the important thing to understand is that it will affect lives. It will stir emotions and create hope and the real danger that people will be seriously hurt. Even if you include all the necessary caveats somewhere in your story, the emphasis can be misleading. As one veteran writer explained, if the words CANCER CURE are in neon and the limitations and qualifiers are buried and boring, it's no different than when the Publisher's Clearinghouse says "YOU HAVE WON A MILLION DOLLARS! If we select your name out of a billion." That puts an extra burden on the writer (and the editor and the scientist).  
    
We've all seen cancer stories that rely on techniques to increase dramatic impact, for example, by scaring readers in the first paragraphs with doom and gloom statistics, then following up with the real point of the article, which is the new breakthrough treatment. This may seem like good storytelling, but just ask anybody dealing with terminal cancer and they'll tell you it can be gut wrenching. It's hard enough for people to have to go through all the ups and downs of cancer treatments without having their hopes and emotions toyed with, just so someone can get an article published or boost magazine sales or sell a product.
    
Misinterpreting statistics can also lead to false optimism. You can read (or, as another writer bravely confessed, write) a hundred cancer stories without realizing that the touted "five year survival rate" counts everyone alive five years out of treatment--regardless of whether they started out with no cancer, some cancer, or were in the miserable throes of end-stage cancer. The clock starts at diagnosis. That means earlier detection increases five-year survival numbers even though, in itself, it does nothing at all to improve people's long-term fate.
    
Suppose, for example, a diagnoses is made at stage two, and the person dies at exactly the same moment he would have if diagnosed later, let's say eight years after entering stage two. If treatment started at stage two, the person counts as a five-year survivor while he is in stage four. If diagnosis had happened at stage four, on the other hand, the person would have survived only two years and not have counted as a five-years survivor. The important thing in this example is that the treatment begun at stage two may have had no effect on actual longevity, despite what the statistics imply.  What sounds like new improved results may just be earlier detection, with no effective results from any particular treatment.
    
It also helps to understand what researchers mean by terms such as responding and extending survival. It may sound like it means returning to health, suffering less, some improved quality of life. In many cases, though, the researchers mean that some physiological measure has changed or that the patient died a few months later than expected, suffering all the while from both the disease and the unbearable toxicity of the treatments.
    
The public has a great need for clear and compassionate stories about cancer, but writing them can be tricky. More than one writer has produced a carefully planned cancer story--with precisely the right amount of promise and cautionary information--only to have the phone ringing in wild overreaction the day after publication. 
    
If you have a story about cancer that's worth telling, it's worth telling well. You can't second-guess how readers will react. But you can be aware of the extreme sensitivity of your subject, and pay attention to the following seven tips, learned the hard way by some very experienced, if not somewhat jaded, medical writers:

 Cancer Story Caveats

1. Treat subjects of life and death importance to potential readers with extra attention to accuracy.   
   

2. If uncertain about a quote, call the source back to verify. (Sure, they might weasel out of what they originally said, but you might also end up with an even better quote.)  
    

3. Avoid the words "breakthrough" and "cure." Keep things in perspective by including trends in past research so as not to raise false hopes or dash reasonable expectations.  
   

4. Know what the measures actually mean and how (and when) the results are expected to affect sufferers. If you're not sure, ask an impartial expert.    
    

5. Ask about conflicts of interest in the research studies -- they're rampant.  
   

6. Provide caveats as strong as (or stronger than) the new claims, even if you have to remind readers that what works for mice doesn't always work for people.  
   

7. Write the best story you can. After that it's out of your hands.

"I was gratified to be able to answer promptly,
and I did. I said I didn't know." -- Mark Twain