Few media stories on cancer venture into issues of death, dying and end-of-life care—and outlets directed at African Americans are particularly unlikely to do so, a new study suggests.
Historically, African Americans with advanced cancer have been more likely than whites to opt for aggressive treatment, and less likely to want hospice care.
The goal of hospice care is to improve quality of life for terminally ill people, treating their pain and other physical and psychological symptoms. There's also evidence that hospice care, which is usually provided at home, does not speed death—and in some cases, may help people live longer than aggressive cancer treatment would.
But doctors often don't bring up options for end-of-life care—even those caring for people with advanced cancer, said Jessica M. Fishman, the lead researcher on the new study.
Since people often get medical information from the media, Fishman and her colleagues at the University of Pennsylvania in Philadelphia looked at whether there might be racial differences in how the media cover cancer care.
And they found that while few mainstream media stories talked about the downsides of aggressive cancer treatment, or about hospice care at all, African-American media were even less likely to do so.
The researchers analyzed 264 cancer-focused stories that ran in any of four urban newspapers with a mostly African-American readership, or any of four African-American magazines, including Ebony and Essence. They found that none of the stories discussed hospice care.
In addition, only 14 percent mentioned the adverse effects of cancer therapies, and just 4 percent noted that cancer treatment can fail to cure.
Fishman's team found that eight mainstream urban newspapers and national magazines like Time and Redbook did better, though not all that much.
A handful of stories (7 out of 396) talked about hospice or end-of-life care. Meanwhile, almost one-third gave some attention to the adverse effects of cancer therapy, while 14 percent mentioned that cancer treatment can fail.
"The news media rarely report on these issues," Fishman told Reuters Health. "And some groups may be even less informed than others. I think that's something the public should be concerned about."
It's not clear why African-American media were particularly unlikely to cover the negative sides of cancer treatment, or to cover hospice care at all.
And it's also not clear, Fishman said, that the lack of media coverage actually affects terminally ill cancer patients' decisions on treatment.
But she argued that patients, and the public in general, should get a more balanced portrayal of cancer in the media. "Lance Armstrong-like survival stories do not reflect the reality of many patients," Fishman said.
It's estimated that about half of Americans diagnosed with cancer will not survive the disease, Fishman and her colleagues note in the report. And African Americans tend to have higher death rates from cancer than other racial groups.
"I'd like to see the media not only offer people hope and hype, but some help as well," Fishman said.
People with cancer, she noted, may well find that they have to bring up the issue of end-of-life care with their doctors, who are not likely to raise the question themselves. "Make it really clear that you want that information," Fishman advised.
The bigger issue, she said, is that everyone needs to be more open about discussing death and dying. "We can put our heads in the sand about end-of-life care," she said, "or we can find out how to make things better for patients and their loved ones."