Dr Farah Rehman, Avon Clinical Research Fellow in the Gene Function Team.
While in my local supermarket a couple of days ago, I saw a magazine on the shelf entitled What Doctors Don’t Tell You. It was placed in the health section and featured a smiling young woman on the cover with the headline “The Big Cancer Cover Up – what’s really working” and “I said no to chemo and beat cancer”. As an oncologist I was intrigued to know what was in this magazine but, as I flicked through the glossy pages, I became more and more angry. Now I am not about to talk any more about this specific publication at the risk of being sued for libel like @SLSingh (I will leave the reader to make up their own mind about the validity of its claims but I recommend reading @mgtmccartney’s article in the British Medical Journaland interview on Radio 4 on the subject), but the feelings and themes it bought up made me think about it for some time afterwards.
It made me wonder why, on a newsstand where this magazine and others aimed mainly at young women purport to show the benefits of various things from “superfoods” to alternative therapies for almost every disease including cancer, is there no publication containing any actual science? Are the non-science trained public deemed too uninterested or stupid to be given accurate information about scientific topics? I would disagree. Every week in clinic I am bought articles from patients about a new cancer treatment or trial reported in the mainstream media, often with incomplete and sensationalist information that they hope will be applicable to their case and, when it is explained to them, they are more than capable of understanding the principles of what is being offered or tested. And not a week goes by without being asked if there is anything else they could/should be doing – these people could not be more interested in the research that is being carried out into cancer treatment and prevention. And for researchers, communicating successes and results is imperative not only for moving research forward but for future funding and collaborations.
Perhaps I should say here that I (and I hope that it is obvious), like most people treating and investigating cancer, am not against any treatment that will improve my patient’s symptoms or the course of their disease - but I insist that the same scientific rigour and testing is applied to any intervention, no matter what it is, and the problem is that many alternative treatments for cancer just do not stand up to simple cross examination.
Now I am not going to try here to de-bunk any intervention in particular – that work has been done in a systematic way by various individuals and organisations, notably @bengoldacre, Cancer Research UK and theCochrane Collaboration, but if we have a public that is hungry for the results of research efforts and scientists keen to get their message across, why does it seem that unproven or untested cancer treatments get more coverage and exposure than robust scientific information? Have we got a problem with how we communicate our science? Or is there just an inexorable rise in quackery, which, coupled with multiple digital formats like Twitter and Facebook distributing information at an unprecedented speed, means we cannot compete?
Of course, it’s not a level playing field – one of the benefits of selling an unproven story or treatment is that you don’t have to go through the time consuming and expensive hassle of actually proving that it works e.g. peer review and clinical trials. Those involved in rigorous science cannot expect to be able to deliver results in the time frames claimed by making claims that are too good to be true based on flimsy evidence.
But is it more than that? Are we missing an opportunity to market ourselves and our work by failing to keep up with what’s trendy or appealing? Is real science too boring, too difficult to understand or elitist? Are scientists earmarked as nutty professors? And oncologists as malign purveyors of poison? – one visit and you will be left bald and infertile!
Perhaps in a climate where much is made of natural remedies we would be better off marketing the plant derived chemotherapies paclitaxel and docetaxel as “Yew Tree Extract” and camptothecin as “Asian Happy Tree Concentrate” (both of which are factually accurate).
Some of the image problems in science and medicine are not helped by a lack of transparency such as the significant failures in the reporting of completed (often negative) clinical trials, with huge ethical and financial implications – a situation being challenged by the all trials initiative. There are also questions to be answered by the scientific community about whether all science should be published in an open access format – the issues surrounding this are currently being debated.
So what is the answer? Should we try to keep up to date not just with the peer-reviewed literature but also with whatever story is being peddled in the mainstream media? Should we make sure we read both Nature and theDaily Mail to keep abreast of current trends and hot topics? Should we sex-up and dumb-down what we say or over-state our conclusions and the implications of our research? Probably not… but what we definitely shouldn’t do is bury our heads in the sand and assume that it is not important what we say or how we say it. Or that just because we think we are doing robust science that it is obvious – it takes years to learn to effectively critique evidence so how can the public be expected to do that for every story out there?
We all have a role to play in making sure that the messages that get out are the correct ones. We want to ensure the public understands what we do and that progress is being made and that patients can make informed decisions based on a trusting relationship with us.
We also have to challenge inaccurate information and I for one welcome the opportunity to become more objective and to prove the effectiveness of what we do – that after all is the point of clinical research.
So although lab work and science don’t sell magazines in quite the same way as scaremongering and profiteering, at least we can try and get ourselves heard. After all, science is exciting and progress does happen – that’s why we do it.