Saturday, October 9, 2010

A TV Physician Is Not Your “Doctor” Or “Coach”

Gary Schwitzer's <a href='http://keep-health-work.blogspot.com/' target='_blank' class='infotextkey'>Health</a>NewsReview Blog

A German physician wrote me about this, so while CNN may have an international reach, it’s not always with an adoring audience.


The physician was reacting to the weekend “Paging Dr. Gupta” program, which Dr. Gupta referred to once as “SG, MD.” The first thing that struck me was his introduction, in which he said:


“I’m your doctor. I’m also your coach.”


Later in the program he said:


“Think of this as your appointment. No waiting. No insurance necessary.”


I find this very troubling. He’s not my doctor. He’s not my coach. When I watch a “news” program, it’s NOT my medical appointment. It’s supposed to be news, not medical advice.


But that’s not what the German physician wrote to me about, so I kept watching (the segment in question appears about 5 minutes and 30 seconds deep, and after the??30-second commercial you have to watch to get there):



Gupta reacted to a viewer’s message on Twitter in which the tweep asked: “Does anyone know a ‘miracle’ treatment for ovarian cancer?”


Gupta’s answer began cautiously with a note about the word “miracle,” but he then transitioned into a description of a study described at the American Society of Clinical Oncology meeting last week about treatment of advanced ovarian cancer. Gupta said the results showed that adding the drug Avastin to standard chemotherapy “can slow the spread of this cancer pretty dramatically.” He also said that, “Cancer experts believe these results could change how doctors treat women with advanced ovarian cancer.”


Dramatically? Cancer experts believe this could change practice? Which cancer experts?


Not Dr. Len Lichtenfeld, who’s just across town from Gupta at the American Cancer Society, and who wrote about that same study, “Is It Right To Hype Ovarian Cancer Study?”:


“What appeared to be a very positive study in an abstract may not have been so positive after all. Patients, families and their physicians are now under the impression that a new advance has been made in this deadly disease, when that may not be the case. The positive press releases and news conferences were not balanced. Most of the media ignored the expert who raised legitimate concerns and cautions. But that information was only available to those who waited for the study to be presented and were in the audience at the time. Hopes have been falsely raised, when some caution is needed and appropriate.”

Lichtenfeld also pointed out the careful and cautious comments from a Canadian oncologist Dr. Elizabeth Eisenhauer:


“Given the cost issues, the side effect issues, and the unanswerable question as to why bevacizumab appeared to be beneficial as part of a maintenance program but not as a primary treatment, Dr. Eisenhauer concluded that more work needs to be done before this regimen can be considered as a standard treatment option for women with advanced ovarian cancer.”


Lichtenfeld himself concluded:


“…many experts and treating oncologists are going to be scratching their heads wondering what to do and whether or not to believe the results of the abstract, if they even know about the concerns such as those raised by Dr. Eisenhauer. More importantly, patients, families and friends are going to be wondering how a study that received such a positive response in the press could possibly not be the hope they had been waiting for, and had learned about through the media reports.”


Perhaps the news wasn’t as dramatic as Gupta announced, nor does it sound like cancer experts are poised to change their treatment immediately based on this abstract presented at a meeting. And it wasn’t just Lichtenfeld and Eisenhauer. I’ve already blogged about a Forbes piece that reported:


“Memorial Sloan-Kettering colon cancer specialist Leonard Saltz says that …new drugs like Avastin and Erbitux “have added very modest benefits. They increase survival a few months, but they increase the cost of care tremendously.”?? …researchers revealed that ovarian cancer patients who got Roche’s Avastin in addition to standard chemo lived 14 months before their tumors progressed, vs. 10 months for those who got standard therapy. But to get this modest improvement, patients had to remain on the Avastin drug for 15 months, adding to the potential expense, hassle and side effects. So far, there is no statistically significant survival difference between the two groups; because most patients are alive it may be too early to measure this. “We may never know” whether it extends survival, admits lead researcher Robert Burger of the Fox Chase Cancer Center.”

This is balance. This is perspective. This is analysis. Not what we got from a TV MD-journalist telling you he’s your doctor and your coach.


ADDENDUM: See science writer Paul Raeburn’s analysis on this same topic on the Knight Science Journalism Tracker.

                       

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