It’s all talk part 2: If the news makes you sad, don’t watch it

The papers love a scare story, this much we know. Every week a different food is denounced as cancer-causing, and we are instructed to avoid it like the plague for the sake of preserving the health of ourselves and our children.  The data behind this kind of story is often quite wishy washy. In fact, some papers go so far as to report that the very same things that cause cancer can also protect us against it (here’s a comprehensive list of the every day objects, chemicals and foods that one particular newspaper claims will cause or prevent cancer, or both. And here it is in musical form).

Recently, in a new low for needless scaremongering, it was recommended that pregnant women avoid pretty much everything, from buying a cot to cleaning the house, if they wanted to ensure the good health of their unborn child. Ridiculous. But while the scare stories that come from non-news annoy me, one thing that gets me even more incensed is good news stories that have been manipulated, resulting in bad news. In these stories, a positive story is taken and twisted about until it becomes unrecognisable. The paper seemingly forgets what the real story is and slaps an attention-grabbing, negative headline on it.

What do I mean by this? Well, as an example, let’s say everyone suddenly realises that it’s bad to kill each other. World peace becomes a reality.  This is good news, right? Wrong. ‘UK economy takes massive hit as arms industry collapses!’ proclaim the headlines. Unless the readers of the newspaper can read between the lines, this is an easy sell as a bad news story.

This sort of manipulation seems to me to be particularly prevalent in science and health stories. As the health of the general population improves, with the advent of new and better medicines, the national papers run with any health story they can get which looks scary, ergo, sells more papers. As readers, we are being played. In reality, most of the health stories out there aren’t so bad. Here are two recent examples of good news stories, disguised as bad.

1/

“By the year 2020 half of the population will get cancer in their lives!” screamed the headlines in almost all the daily papers earlier this month. Scary stuff indeed. And it’s not a lie. Well, actually it is a lie, as the projection, drawn up by cancer charity Macmillan, puts it at more like 47% of the population, but still.  The articles then generally went on to talk about what a huge burden this would be for the NHS, with many quoting Ciarán Devane, the chief executive of Macmillan, who called it a ‘Herculean challenge’ for the NHS. So how is this a good news story?

Well, firstly, one of the main reasons that so many more people are getting cancer is because we are living longer. Cancer, generally speaking, is an age-related disease, caused by mutations in your genes that arise over time as cells divide and copy their DNA. The longer you live, the more time there is for mutations to accumulate. Not to be defeatist about it, but cancer is going to abound in the elderly for the foreseeable future, as we struggle to cure, never mind prevent it. This to me is good news. I would rather live 80 years and have a high chance of contracting cancer at the end of my life than have a life expectancy of 50, as people did at the turn of the 20th century.

Secondly, more people are surviving cancer.  Breast cancer, for example, killed almost 50% of people who contracted it in the early 1970s. Now, 85% of women who get breast cancer beat the disease.  Although many of the papers did accurately report that cancer is now eminently more survivable then it was even a decade ago, this was presented by almost all as a bad news story. Are they barking mad?

This is where the ‘Herculean challenge’ comes in. As more people survive cancer, there will be more people left with physical and emotional side effects from their ordeal. If these people are to get the care and attention they need after they are declared free of cancer, the NHS will have to alter its strategies for post-cancer care. This is true, and a fair enough point to make. Macmillan, who focus on providing emotional and financial care and support to people living with cancer, see first hand the failings of the NHS on this score, and naturally want to draw attention to the issue. As cancer rates rise, they too will be faced with  greater burden of care, after all.

Still, this is good news, people! We are edging closer to finding cures for many types of cancer that would have been 100% fatal until recently. I would have liked to have seen one headline celebrating that fact. ‘Macmillan study finds that huge numbers of us are living to an old enough age to get cancer in great swathes – and then surviving it!’. Doesn’t that have a nice ring to it?

2/

I was a bit alarmed on first hearing on BBC breakfast (as I tend to trust anything that Bill Turnbull tells me) the fact that ‘Surgery has ‘a growing death risk through the week”. Apparently, you’re significantly – a whopping 44% – more likely to die if you have surgery on a Friday than a Monday. A spokesperson from the Royal College of Surgeons came out to call the results ‘unacceptable’. Meanwhile, the Patients Association were also up in arms, revelling in the thrill of being able to shout ‘we told you so!’ while pulling faces and sticking out their tongues at the mean old doctors who just don’t care whether we live or die.  The study claimed that the likely reason for such a significant change in survival rate was that care was not as good over the weekend. Is this true? And how can it be good news?

BBC/BMJ

BBC/BMJ

Much like cancer, the first positive to take from this story is how low the rate of death during routine, non-emergency surgery is now. If you have planned surgery, there is more than 99% chance you will survive it, whatever day you go under the knife. This is amazing when you consider what you’re putting your body through. And the techniques and reliability of surgery have improved vastly over the last century. As an example, let’s take a kidney transplant operation. If you underwent this operation in 1950, there would be a 1/500 chance of death. If you have the operation today, that chance is 1/250 000. Pretty good news, wouldn’t you say?

Another important point to consider when looking at this story is whether the researchers who did this study took all the variables into account when drawing their conclusions. They suggest that the results must indicate that care is worse during the weekend, based on the fact that the first 48 hours after surgery are the most critical in determining survival. But are there any other explanations for this result? Maybe, for example, the most risky operations are performed on a Friday, a point made on the BBC’s Question Time in the wake of the story breaking. This would allow the surgeons to come and visit patients who appeared unwell over the weekend, whereas during the week they would likely be busy with more operations. This would be good news, in my opinion, because it points to a comforting level of common sense on the part of the hospitals that often seems to be rather lacking in big organisations.

Don’t get me wrong here. I don’t mean to suggest that the results are invalid, or that there isn’t a well-established concern about the level of care patients can expect to receive over the weekend. This is also well known to be true in August, by the way, when trainees take up new posts and newly qualified doctors join the workforce for the first time. But this sort of scaremongering doesn’t do any good. There are now concerns that the revelations will lead to longer waiting lists, as people demand to have their surgery during the first half of the week.

This really would be bad news, as longer waiting lists would mean a higher chance of people dying while they wait for their surgery. Or, since it also means that people are taking control and taking some responsibility for their own health, would it be good news?

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