May 19, 2006

Herceptin, H5N1 and drugs trials

I was attempting to avoid the H5N1 bandwagon but it looks like I failed…

Many have complained recently about the coverage of the bird flu story in the media, saying that it has been sensationalist and potentially panic–inducing. This is clearly a difficult subject because whilst the chances of the virus mutating and becoming a transmissible human virus are relatively low, if this does actually happen the resultant pandemic could be terrifying. It depends on how you classify a potential crisis. The BBC has on its forum, as many have highlighted, a series of alarmist comments from members of the public (as well as, presumably, a swathe of others asking everyone to calm down). The BBC and newspapers have been criticised for their own coverage of the situation.

The opening paragraph from a recent New Scientist article read:

I have nothing against miracles, but whenever there's a big buzz about a new drug, it's a fair bet it'll be down to the usual suspects: vested interests, early research, and uncritical journalists.

I'm sure everyone will be aware of the hype surrounding the release, and subsequent variable availability, of the new breast cancer drug Herceptin. The media pronounced it a 'wonder drug', but how many people know the real truth about its successes? The tests carried out showed that Herceptin benefits only a small number of women – shrinking tumours in only 15% of cases – yet the early reports did not make this clear. The trial was carried out on women who had cancers that had been treated early. Emphasising a figure of a 52% reduction in recurrence in a group who already have a small chance of re–contracting the disease is misleading (even those who have no treatment after surgery have a recurrence maximum of 10% per year, dropping to 3% after 10 years). The test groups were also very small – only in the 10s – so the perceived advantages could have been down to pure chance. Yet this drug was described as a potential ‘cure’ by the 2006 President of the American Society of Clinical Oncology: a man who is also a paid consultant to Genentech, Herceptin’s US distributor.

Another important recent medical story was about the drugs trial that left six men critically ill. Many criticisms were voiced at the time criticising and even blaming the manufacturer of the drug. Yet when a follow–up story came out declaring that the manufacturer had followed all the required protocols and was thus not guilty of any negligence it didn't make the BBC News website front page, nor the Science and Nature front page. In fact, I had to do a search to find it.

Now, I don’t begrudge anyone access to a treatment that may save or help to sustain their lives: far from it. However, bearing in mind the huge variation between the hype and the reality in the case of Herceptin I can’t help but think that the injustice has been blown slightly out of proportion. Again with H5N1, there is a balance to be had between the potential risks. But is it the duty of the media to reflect these issues realistically and in a balanced manner? The newspapers need to sell and the TV companies need to maximise viewer ratings, and sensational stories will help with this. However, whereas newspapers are private companies, the BBC is publicly funded and has a Board of Governors who purport to act as ‘trustees of the public interest’. Is it in the public interest for these stories to be reported in a totally balanced manner or should we be expected to draw our own conclusions based on the true facts? How do you ensure a balanced coverage when many important stories may be reported many times, each time with a potentially different slant? Surely the purpose of a forum is to air the views of the public: should the BBC or any other company censor its fora to prevent potential hysteria or is this unfair?


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