One of the most common gripes I hear (and one that I often express) is that Medical news changes often. How often do we hear of a “breakthrough” only to be disputed the next week. It is confusing and it is difficult to know what news to believe and whether we should change a practice, a drug or a behavior. So, how do we approach this problem?
One of the first things I do is try and see if the news is based on solely one study. I also want to know if the risks, both short and long term, are described or understood in the article. It is my belief that changing a health habits based on just one study should be avoided. Always talk with your health care team if you have questions about a particular study, or even to just discuss the validity of the study. For me to change a health habit I want to see different studies performed at different institutions, or collaboration across the field.
Where the study was published should be evaluated. Has the study been peer reviewed and is it published in a large, respected Journal that lends greater credence to the conclusions. If the report is in a newspaper or on TV was it reported by an experienced and knowledgeable medical reporter? Does the reporter put the information into context with prior research? Is the report complete, or has the outlet edited it to save space (maybe editing important information)?
In the situations where there has been a clinical trial, what stage of a trial is being reported is important. The results from a phase I or phase II study often change when a phase III study is performed. Was the research on humans, in a Petri dish or animal only studies? Tissue studies, animal studies aren’t reliable substitutes for how a treatment works in people.
The most important facts I want to know is the rate of overall survival and does it improve. Depending upon the disease it can take a long time to learn if survival is extended, especially in advanced prostate cancer where survival even without treatment can be measured in years. Researchers may use a substitute measurement, such as PSA, tumor response (whether the tumor shrinks in response to treatment) and disease-free survival (the length of time after treatment during which a person survives with no sign of the disease). However, these substitute measurements are often do not translate into an actual improvement in overall survival, the gold standard we should be concerned about.
I also want to know who sponsored and paid for the research. I like to think that a commercial enterprise wouldn’t bend results, but honestly some do. Influencing the results could lead to a disastrous effect for you.
Always be cautious about words like “breakthrough” and “magic bullet “ as these are an immediate tip off of possible problems with the results.
Remember, it is always best to discuss a cancer news story with your health care team prior to changing any health behavior.
Joel T. Nowak, M.A., M.S.W.
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