Chatterbox: Hope or Hype?

Seems as if everybody’s beating on the New York Times for its May 3 front-page story on two new cancer drugs, a report that stimulated production of a spate of “hope or hype?” newsmagazine cover stories (as well as a rather feverish Chatterbox item, on 5/4). “Forget cancer. Is there a cure for hype?” asks a huffy editorial in this week’s New Yorker. “The placement! The headline!” bellows Sam Donaldson on ABC’s This Week. “Shameless Scam,” declares Liz Smith, plugging the New Yorker editorial. (“What does the New York Times have to say for itself in the matter of raising unrealistic expectations … where restraint would have been the better part of valor?”) The Los Angeles Times has cast aspersions on the ethics of its rival, and of the NYT’s reporter, Gina Kolata. Time complained that all the cancer coverage “only seemed to reinforce the impression that something really big had happened”–this in a 13-page cover package that reinforced the impression that something really big had happened.

Is it irresponsible to ask what, exactly, is the complaint here? The New Yorker leader, written by esteemed Slate contributor Atul Gawande, notes that there was no news “peg” for Kolata’s story–indeed, another NYT reporter, Nicholas Wade, had already written about the same two drugs back in November, on page A28. But so what? One constant complaint of responsible media critics is that important stories often don’t get the attention they deserve for lack of a news peg. Maybe it was the Times’ earlier decision to put the news on page A28–with Wade’s milquetoast conclusion that the drugs “may well prove relevant”– that was wrong, and maybe the Times realized this and decided to correct the mistake.

Certainly the subsequent media coverage–not just the volume of it, but the actual reporting about the relative promise of the two drugs, developed by Dr. Judah Folkman and his colleagues –suggest that the second decision was indeed the right one. Folkman’s drugs eradicate a variety of cancer types without apparent side effects. Yes they only do it in mice, so far, and it will take a while to find out if they work in humans. Yes, promising mouse cures have failed on humans before. Yes, similar, but seemingly less potent, drugs are further along in the pipeline. Yes, Folkman’s results had already been reported elsewhere, and yes, it’s really. really annoying when the NYT plucks some story that others have already reported and declares it important without acknowledging that others have already reported it, as if nothing actually happens until the NYT deigns to notice. But was this really a story that didn’t belong on the front page, even if it was only a potential cure for the often-fatal disease that afflicts about 45 percent of Americans (not to mention everyone else on the planet)? Would Gawande and Donaldson prefer a story about the highway bill or some hurricane?

Apparently yes. Gawande lumps the cancer-drug story in with the Viagra and Phen-phen fads, complaining that “desperate patients, newspaper clips in hand, clamor for the latest pill, so doctors make do with what’s in the news and what the drug-company detail men tell them.” Liz Smith also empathizes with doctors who have trouble dealing with the “crush” of callers–patients who, in the words of Dr. Philip DiScaia, a cancer doctor quoted in the L.A.Times’ anti-Kolata piece, “are desperate to find something that is an easy way out of a difficult situation.” The weaklings! Looking for the easy way out! They actually want to live!

Gawande may understandably want to preserve the orderly processes of science–no crush of callers, doctors armed with all the facts, a nice, staged process of testing drugs before their release. But a little perspective is in order. Here is Chatterbox’s: Cancer isn’t impotence, and Folkman’s drugs aren’t Viagra. Cancer is a life or death issue. People don’t want to die. When there is a good new treatment for them, they will want it, and they’re right to want it. Given this interest, and given advances in journalism and technology, they are going to find out about these treatments very quickly, pretty much right after the scientists who are performing the experiments. The medical system had better learn how to cope with this instantaneous, legitimate, global clamor for treatment, instead of complaining about journalists who fail to suppress or downplay the information that people want to have. If that means installing extra phones and operators, getting news to local practitioners sooner, and learning how to educate patients while speeding up the painfully slow process of drug testing and approval (which most of the reporters who sniped at Kolata seemed to take as an immutable given) so be it. Simply by drawing attention to the potential bottlenecks in testing drugs like Folkman’s, Kolata and the New York Times have performed a valuable public service.

By the way, another charge leveled at Kolata, especially by the L.A. Times–that she hyped the story after preparing a book proposal on the subject–collapsed on close inspection. Kolata did indeed prepare a book proposal, when agent John Brockman called her after her story ran. Subsequently she yanked her proposal from the market, apparently under pressure from NYT editors worried that her financial stake in the story might bias her. Two questions: will NYT editors now force all their other reporters to drop their book projects–like the promising book on welfare reform planned by Pulitzer-nominated welfare reporter Jason DeParle? (Can’t Times’ editors do their job and tamp down reportorial hype without squelching potentially good books?) And has Sam Donaldson–who said “People momentarily thought about book deals, and that’s irresponsible. That’s absolutely wrong!”–ever momentarily thought about a book deal himself? … Okay, that’s three questions. Sorry.