Cancer and the Media

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Cancer and the Media
Linda Cairns, European Institute of Oncology
Milan
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• Cancer, what is it ?
• Can you catch it?
• How do you spot it ?
• When are we going to cure it?

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Cancer is a disease of growth control.It is due
to altered genes.

• These genes can be
• a) switched on Accelerator genes
• b) broken Protective brake-block genes
• c) failed DNA Repair genes

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Cancer is a disease of growth control.It is due
to altered genes.

• These genes can be
• a) switched on Accelerator genes
• b) broken Protective brake-block genes
• c) failed DNA Repair genes

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TUMOUR SUPPRESSOR
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p53
"the guardian angel gene",
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Cancer is a disease of growth control.It is due
to altered genes.

• These genes can be
• a) switched on Accelerator genes
• b) broken Protective brake-block genes
• c) failed DNA Repair genes

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• DNA damage resulting in multiple broken
  chromosomes

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CAUSATION
Environment
Genes
Disease
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What causes cancer?

• Anything which damages genes
• A) DIET- Low fibre/high fat switches on
  Accelerators
• B) Tobacco smoke damages Brake blocks
• C) Viruses take out Repair kits
• D) Sunbeds (uv radiation) are like B) plus C)
• E) Some key genes arent present from birth

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What causes cancer?

• Anything which damages genes
• A) DIET- Low fibre/high fat switches on
  Accelerators
• B) Tobacco smoke damages Brake blocks
• C) Viruses take out Repair kits
• D) Sunbeds (uv radiation) are like B) plus C)
• E) Some key genes arent present from birth

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• Key points
• 1. Cigarette smoking causes 87 percent of lung
  cancer deaths and is responsible for most cancers
  of the larynx, oral cavity and pharynx,
  esophagus, and bladder.
• 2. Secondhand smoke is responsible for an
  estimated 3,000 lung cancer deaths among U.S.
  nonsmokers each year
• 3.Tobacco smoke contains thousands of chemical
  agents, including over 60 substances that are
  known to cause cancer

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• The tobacco industry promotes and sells a product
  they know to be lethal. Kenneth Clarke has been a
  supporter of the industry for over 30 years, and
  one of its leaders since 1998.

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What causes cancer?

• Anything which damages genes
• A) DIET- Low fibre/high fat switches on
  Accelerators
• B) Tobacco smoke damages Brake blocks
• C) Viruses take out Repair kits
• D) Sunbeds (uv radiation) are like B) plus C)
• E) Some key genes arent present from birth

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• Several viruses have been linked to certain types
  of cancer ?
• Epstein-Barr virus -Burkitt's lymphoma
• Hepatitis B and C viruses - liver cancer ?
• HTLV-I -T-cell leukemia. ?
• Papilloma viruses - cervical cancer.

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What causes cancer?

• Anything which damages genes
• A) DIET- Low fibre/high fat switches on
  Accelerators
• B) Tobacco smoke damages Brake blocks
• C) Viruses take out Repair kits
• D) Sunbeds (uv radiation) are like B) plus C)
• E) Some key genes arent present from birth

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Global Burden of Cancer

• Chance of American man developing cancer in his
  lifetime 1 in 2
• Chance of an American woman developing cancer in
  her lifetime 1 in 3
• Cancer kills more people each year than AIDS, TB,
  and Malaria put together

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Parkin JM et al. CA Cancer J Clin 2005 55
74-108 ACS, Inc., 2005.
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How do you diagnosis it?

• With difficulty! As its not painful
• Abnormal lumps and bumps
• Abnormal bleeding
• Change of bowel habit
• Loss of weight for no reason
• Change of voice quality

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Mammography negative
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MRI positive






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Whens the cure coming?

• WE cure 70 of all cancers in kids
• And 90 of some leukaemias
• 40 of men with cancer are cured
• 50 of women are cured
• But 120,000 people still die each year of Cancer
  in the UK.

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Personalized Cancer Treatment aims to consider
the genetic constitution of a patient and their
disease in the process of diagnosis, prognosis
and treatment.
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MONO-CLONAL ANTIBODIES
SMALL MOLECULES
NO CELL GROWTH
RECEPTOR TARGETED THERAPY IN CANCER
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RECEPTOR TARGETED THERAPY IN CANCER

• MONO-CLONAL ANTIBODIES WHICH INTERACT WITH THE
  OUTSIDE OF THE RECEPTOR
• CETUXIMAB
• TRASTUZUMAB
• BEVACIZUMAB
• SMALL MOLECULES WHICH INTERACT WITH THE INSIDE OF
  THE RECEPTOR
• IMATINIB (Gleevac)
• LAPATINIB
• GEFITINIB

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Eligibility for Trastuzumab Therapy

• HER2 status

Eligible for Trastuzumab
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Joint Analysis Disease-Free Survival
AC?TH ? H
87
AC?T
75

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N Events AC?T 1679 261 AC?TH 1672 134
HR0.48, 2P3x10-12
Years From Randomization
B31/N9831
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HOW DO WE COMMUNICATE THE BENEFITS AND RISKS OF
THE VARIOUS TREATMENTS FOR CANCER.
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Definitions- Media

• Newspapers- serious, popular, interest group
• TV- local, national
• Radio- local, national
• Internet standalone web-sites, or linked to
  other media

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The Real Issues

• Communicators skills
• Understanding research eg trials
• Sorting statistics
• Grasping risk
• Preparing media releases
• Controlling the end result

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Communicators skills

• Everyone thinks its easy
• Training works
• Doctors are bad
• Scientists are worse
• Advocates can be brilliant

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Sorting Statistics

• Keep it simple
• Choose easy endpoints eg mortality
• If using --say of what
• Dont touch p values or graphs
• Keep smiling

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Grasping Risk

• Grasping means understanding
• Risk- what is risk?
• How much risk is it ?
• With what can I compare it?
• What is the risk of standing under a tree?
• On a golf course,
• In a thunderstorm,
• In autumn!!!!

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Confusion

• Mr Jones,55,white reads of politician who gets Ca
  prostate.
• Runs Prostate and risk in Google
• 8410 hits! First is Harvard
• Fills in risk evaluation form age,height,diet,eth
  nicity,vasectomy
• Told Risk higher than average
• Consults primary care doctor

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More Confusion !

• Risk of what?
• Risk of Ca prostate is 40 in 1000 (in ten yrs)
• Risk of death from it is 2 in 1000(in ten yrs)
• So What?
• Risk of death from Ca colon is 4 in 1000,
• From Heart disease(smoker) 51 in 1000,
• (non smoker) 21 in 1000 (in ten years)

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Confusion cleared up!

• What mattered in the original calculation by
  Harvard?
• Age
• Nothing else!

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Preparing Media releases

• Keep it simple
• Say it in simple words
• Keep detail to an appendix
• Make 3 points maximum
• Dont forget your contact details

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Controlling the End Result

• Ask to see the finished text, or program
• Stand firm
• Insist on your 3 points
• Keep smiling

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Training Works

• Keep it simple
• Assume clear style
• Dont preach
• Dont fidget and fuss
• Eye contact is essential on TV
• So is a smile- four times better than words

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How can we transfer new, evidence-based findings
to a larger target audience, one that includes
health care providers, policy makers, and the
general public.
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