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作者：Zosia Chustecka  
出處：WebMD醫學新聞

　　March 26, 2010 — 一項於3月22日發表於內科醫學誌（Archives of Internal Medicine）的原著研究結論，新聞媒體對癌症照護的描述可能給病患對於癌症治療不適當、且過於樂觀的看法。
　　
　　這附帶，不真實的資訊可能誤導大眾對於英雄式治癒的企圖與臨終照護之間取捨的看法。
　　
　　在隨後的評論中，這些對於癌症不真實的新聞報導最糟糕的部分是，這會導致來自於病患不切實際的期待。
　　
　　主要作者、費城賓州大學臨床流行病學與生物統計中心的Jessica Fishman博士表示，我們的發現代表一些被遺漏的機會。
　　
　　她在一項訪談中表示，有關於癌症的新聞報導大部分討論到治療成功的案例，而非治療風險與負面結果，或是其他替代治療方法，例如臨終照護或是緩和醫療。
　　
　　相較於體驗真實的病患們，不平衡的報導可能給大眾一個對癌症治療更正面預後不切實際的樂觀期待。
　　
　　她附帶表示，蘭斯阿姆斯壯般的存活故事並不能反映出許多病患面對的事實。
　　
　　她解釋，除此之外，新聞媒體遺漏了「癌症照護一個重要的部分」，就是未談及臨終照護與緩和醫療，這些照護方式有許多已經被證實的好處且很少被使用。
　　
　　【分析新聞報導】
　　Fishman醫師與她的團隊分析了美國的癌症相關新聞，在5個國際性雜誌、8大領導性報紙上刊載的436篇新聞報導。
　　
　　他們表示，很少有有關於癌症的新聞報導談及死亡與臨終。這是令人驚訝的，因為這些病患中，有一半被診斷罹患可能無法存活的癌症。
　　
　　雖然死亡與其他負面事件經常是新聞媒體吸睛的號召，但卻非常少有關於癌症死亡的報導，這同樣令人感到驚訝。
　　
　　研究者們寫到，新聞經常以不幸與重要性劃上等號，對於死亡及其他負面事件投予不成比例的關注，他們附帶表示，科學家、媒體評論家，以及一般大眾批評新聞媒體僅關注死亡的做法。
　　
　　【需要「溫馨」的故事】
　　然而，一位新聞工作者表示，研究者過度看待「編輯部中重要的動態」了。馬里蘭銀泉的自由作家Merri Goozner碩士在隨後的評論中寫到，他同意媒體們長期以來有突顯負面新聞的傾向。
　　
　　但是他解釋，主編們與記者痛苦地察覺他們的產物幾乎經常強調戰爭、動亂、特別是最近的經濟脫序，因此，他們積極地尋找溫馨的故事來平衡。他附帶表示，健康照護，特別是癌症照護，提供了許多這樣的機會。
　　
　　最後的結果通常是商業廣告，他承認，引用許多來自美國媒體有關研究團隊興奮地談論癌症治療於老鼠模式的結果，他附帶表示，因為大部分與健康相關的故事並未繪製出一幅和諧的畫、省略掉其他替代選擇的詳細內容、傷害與好處之間的平衡，以及很少對科學證據品質進行評論。
　　
　　【喪失機會】
　　Fishman醫師強調，她的團隊研究的新聞報導鮮少提到臨終照護與緩和療法。我們感覺這是個嚴重的遺漏，因為這對病患與其家人們有許多廣為人知的好處。
　　
　　研究團隊寫到，具體來說，臨終計畫可以提供生命盡頭時的高品質照護，有著極高的病患與家人滿意度、減少費用、以及減少臨終時的痛苦。
　　
　　Fishman醫師附帶表示，當癌症並非總是可以治癒時，疼痛卻是可以治療的，但是這可能沒有正確地溝通。
　　
　　對於許多罹患癌症的病患而言，了解緩和與臨終照護是很重要的，因為這項資訊可以協助他們做出可以反映出其預後以及治療壞處與好處的決定。
　　
　　他們寫到，媒體常規地報導有關積極治療與存活的故事，想必可能是癌症相關新聞報導與大部分民眾有關。
　　
　　他們的結論是，為了同樣的原因，應該對替代療法投以相似的關注。
　　
　　研究者們表示已無相關資金上的往來。


News Media Portray "Inappropriately Optimistic View" of Cancer

By Zosia Chustecka
Medscape Medical News

March 26, 2010 — "Portrayals of cancer care in the news media may give patients an inappropriately optimistic view of cancer treatments, outcomes, and prognosis," concludes an original investigation published in the March?22 issue of the Archives of Internal Medicine.

"Unrealistic information may mislead the public about the trade-offs between attempts at heroic cures and hospice care," it adds.

The most troubling aspect of this unrealistic news coverage about cancer is that it leads to unrealistic expectations from patients, notes an accompanying commentary.

"Our findings suggest there are a few missed opportunities," said lead author Jessica Fishman, PhD, from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania in Philadelphia.

News reports about cancer mostly discuss treatment successes, but not the risks and negative consequences of treatment, or alternatives such as end-of-life hospice or palliative care, she said in an interview.

"This slanted presentation may give the public an unrealistically optimistic expectation that cancer treatment will lead to more positive outcomes than many patients will experience in reality," she said.

"The Lance Armstrong type of survival story doesn't reflect the reality faced by many patients," she added.

In addition, the news media are missing "an important part of cancer care" by not discussing end-of-life hospice and palliative care — "which has many proven benefits and is very underutilized," she explained.

Analysis of News Reports

Dr. Fishman and her team analyzed the reporting of cancer news in the United States by studying 436 articles that had appeared in 8 large-readership newspapers and 5 national magazines.

"Very few news reports about cancer discuss death and dying," they note.

This is surprising, becuase half of all patients who are diagnosed with cancer will not survive, they add.

It is also surprising that death from cancer is reported so infrequently, whereas deaths and other negative events are featured so prominently in news media.

"News often equates misfortune with significance, dedicating a disproportionately large share of coverage to mortality and other bad events," the researchers write, adding that "scientists, media critics, and the lay public repeatedly criticize the news for focusing on death."

Need for "Feel-Good" Stories

However, a journalist suggests that the investigators have overlooked an "important dynamic in newsrooms." Writing in the accompanying commentary, Merril Goozner, MS, a freelance writer based in Silver Spring, Maryland, agrees that the media has a "long-standing penchant for highlighting negative news."

They aggressively look for feel-good stories as a counterweight.

But he explains that "editors and reporters are painfully aware" that their products almost always emphasize war, mayhem, and especially lately, economic dislocation, and so "they aggressively look for feel-good stories as a counterweight." Healthcare, especially cancer care, offers numerous such opportunities, he adds.

The end result is often hype, he concedes, citing several examples from the American media of researchers talking excitedly about results with cancer treatments in mice. But cancer coverage is not unique in raising unrealistic expectations, he adds, because most health-related stories do not paint a balanced picture, omit details on alternative options and the balance between harm and benefits, and seldom comment on the quality of the scientific evidence.

Missed Opportunities

Dr. Fishman emphasized that the news reports that her team studied hardly mentioned end-of-life hospice and palliative care. "We feel this is a serious omission," she said, because there are numerous well-documented benefits for patients and family members.

"Specifically, hospice programs deliver high-quality care at the end of life, with excellent patient and family satisfaction, reduced costs, and decreased suffering at the end of life," the researchers write.

"While cancer cannot always be cured,?.?.?. pain can always be treated, and this may not be accurately communicated," Dr. Fishman added.

"For many patients with cancer, it is important to know about palliative and hospice care because this information can help them make decisions that realistically reflect their prognosis and the risks and benefits of treatment," the researchers write.

"The media routinely report about aggressive treatment and survival, presumably because cancer news coverage is relevant to a large proportion of the population," they note.

"For the same reason, similar attention should be devoted to the alternatives," they conclude.

The researchers have disclosed no relevant financial relationships.

Arch Intern Med. 2010;170:515-518, 518-520.