Why we should all read the "Daily Mail"
Most intelligent people caught reading the Daily Mail will have an explanation. “I found it on the train” or “They delivered the wrong paper this morning. I normally get The Times”. Truth be told, apart from the title, The Times is increasingly indistinguishable from the Daily Mail. But I digress. Ben Goldacre of “Bad Science” has a column in The Guardian, so you would think he reads The Guardian. And he probably does. But he reads the Daily Mail too. His excuse seems to be that “he has to” because he is a medical journalist. OK, Ben, I can go with that.
In discussing the effect of popular medical journalism he says:
A 2005 study in the Medical Journal of Australia looked at the impact of Kylie Minogue’s breasts on mammogram bookings, looking at appointments made before, during, and after the peak of publicity over her cancer. This period saw a 20-fold increase in news coverage of breast cancer and that, in turn, had a significant impact on health behaviour at a population level. Bookings rose by 40% during the 2 week peak, and six weeks later they were still up by a third. The increase among previously unscreened women in the 40-69 year age group was 101%. These surges were unprecedented. Ben Goldacre : Bad ScienceOf course, breast cancer is the most popular cancer of all, and Kylie Minogue is one of the most popular “A” list celebrities. Always best to have a fashionable, popular illness. Its treatment will be better resourced. It helps medical research funds enormously if a celebrity who suffers from the illness goes public.
We have managed to get some publicity about testicular cancer. Bob Champion was cured of it, and then went on to win the Grand National. You could make a film about something like that. Testicular cancer is, by and large, a young mans’ cancer and, caught early, it is curable. So the more publicity the better.
Celebrities and their agents don’t like botty, willy, wee-wee and poo cancers. The wonderful Sharon Osbourne has gone public about her bowel cancer, but many other celebrities have not. Roger Moore has been open about his prostate cancer. President Mitterand kept it quiet. Once he left office, Ronald Reagan talked openly of his Alzheimer’s disease though we may speculate about when it had begun to take hold. Harold Wilson left office voluntarily once he realized that his legendary memory and intellect was failing, but did not say why. John Wayne hated his lung cancer but did not hide it. Nor did Steve McQueen** (don’t those cigarette adverts he did seem sad).
How many celebrities can you name with bowel cancer? One or two? How many can you name with vulval cancer (surely one of the nastiest), or perianal cancer, or bladder cancer? I can’t think of any and yet, in my small list of 2000 patients, I have patients with all these diseases. It would help if more people went public. Think what Steven Fry has done for bi-polar depression. It is now a fashionable, almost desirable condition. I have had several patients who seem disappointed when I have told them that they “only” have “ordinary” depression.
We need high circulation newspapers to popularise (I use that word deliberately) less fashionable, more unpleasant illnesses.
++++++++++++
A reader tells me of a celebrity who has gone public about an "unfashionable" cancer. Do tell me of any others. It all helps.
** In fact Steve McQueen died of mesothelioma, a cancer of the lining of the lungs, caused almost certainly by exposure to asbestos, not to cigarettes. Apologies for that. We can enjoy his adverts then!
Farrah Fawcett : anal cancer
Farrah Fawcett : anal cancer
(anal cancer may be preventable by the new HPV immunisation - which again raises the question why in the UK and some other countries is it not being offered to boys.)
Hubert Humphrey : bladder cancer
Labels: Ben Goldacre, celebrities, Daily Mail, fashionable illness
34 Comments:
Farrah Fawcett has anal cancer-and she was pretty public about it. A celeb a bit before my time-but still, her age group are the ones getting this disease.
"Think what Steven Fry has done for bi-polar depression. It is now a fashionable, almost desirable condition. I have had several patients who seem disappointed when I have told them that they “only” have “ordinary” depression."
Anyone who 'desires' a diagnosis of bi-polar is clearly lacking any real insight into how much the illness can impact on your life.
It seems to me that when a celebrity endorses an illness; usually telling us of their miraculous recovery; the general public's perception of how serious or severe the illness can be is somewhat lessened
crazy nurse
"It seems to me that when a celebrity endorses an illness; usually telling us of their miraculous recovery; the general public's perception of how serious or severe the illness can be is somewhat lessened"
It also increases expectations sometimes unrealistically. One of our local breast surgeons told me several years ago that Linda McCartney's death made a significant difference to patient expectation as despite the best and quickest of care, she secumbed very quickly.
To be fair to the wonderful Stephen Fry I don't think he either glamorised or promised wonderful cures for bi-polar in his BBC series which was very interesting if "popular" rather than scientific.
As for your patients who now seem disappointed that they "only" have ordinary depression - perhaps that's a measure of how b awful "ordinary" depression is - not something to be trivialised either.
Not cancer but a list of famous depressed?
Regards Dr Shock
http://ectweb.blogspot.com/2007/11/11-famous-depressed-help-to-enfeeble.html
Wiki has a list of famous people with any type of cancer. I want to know if a list exists of famous doctors with cancer and/or depression.
Anon at 12.58 - I would be interested to read of a list if NHS Dr's with an ounce of common sense to be shared out at their practice meetings. Why is cancer the only illness deemed to be important? Cancers can be cured and so what about the famous with things like endometriosis , MS , Myesthenia Gravis , Parkinsons , Huntingdons , oesteoporosis , neuropathy etc which get little recogniition and no help in the community with Mr Average GP missing the signs and saying you have wait for it "ordianry depression" !!!
We could also do with the large number of people in the public eye with autistic spectrum disorders to come out of the closet. Wikipedia (Oh G-d, am I really quoting that as a reference), has numerous suggestions and at risk of putting Dr C in the dock for libel, I suggest PM Gordo, Bill Gates and the whole of the maths department at Cambridge University.
Anon at 1.32pm. Julia Bradbury of Watchdog fame had endometriosis, and was recently cured of it with laser surgery (privately I think). She is also connected to the Marie Curie Daffodil service.
1. Steve McQueen died of mesothelioma, not "lung cancer".
2. Hubert Humphry died of bladder cancer. He did not hide it.
I have had several patients who seem disappointed when I have told them that they “only” have “ordinary” depression.
Shouldn't that be a diagnosis for a psychiatrist to make? Especially since medications given for depression can do bad things to people with bipolar disorder. (This happened to me. GP thought I had depression, prescribed an SSRI despite previous bad reactions, rapid cycling ensued, followed by three days in hospital getting my wrist sewn back together.)
And to quote the NICE guidelines: "Cases of bipolar disorder often remain unrecognised (mainly misdiagnosed as unipolar depression), resulting in suboptimal treatment and an increase in the overall total healthcare costs."
"I have had several patients who seem disappointed when I have told them that they “only” have “ordinary” depression."
Well, it might have been that there's a load of other crap going on that they thought was mania, but is actually being caused by anxiety or something similar. And were hoping you'd given them the magic lithium and make it all go away rather than have to "manage" it with judicious doses of addictive anti-anxiety medication. I think most people are unaware of how inadequate the available treatments are or how much worse the prognosis is for bipolar as opposed to depression.
BTW yes I have a bipolar illness, and it took 10 years of episodes to get it diagnosed, as the mania isn't severe or classic (who the hell goes to the doctor when they are feeling good?). It was a great relief to be told finally that yes, all that other stuff wasn't my imagination, sleeping 3 hours a night for days on end wasn't normal and there was a reason why treatment for anxiety didn't work blah blah. I'm one of the lucky ones for whom the magic lithium pills really are magic, btw. I still don't own a credit card though, just in case.
Wiki has a list of famous people with any type of cancer. I want to know if a list exists of famous doctors with cancer and/or depression.
+++++++++
The BMJ obituaries now usually give the cause of death of doctors.
John
american md said...
1. Steve McQueen died of mesothelioma, not "lung cancer".
2. Hubert Humphry died of bladder cancer. He did not hide it.
Sunday, June 22, 2008 3:19:00 PM
++++++
Yes, thanks for that. Quite right. Have corrected the Steve McQueen entry. Didn't know about HH.
One of the many things I admire about Americans is that they are mostly far better than us anally retentive Brits about being upfront about illness.
John
Anon at 12.58 - I would be interested to read of a list if NHS Dr's with an ounce of common sense to be shared out at their practice meetings. Why is cancer the only illness deemed to be important? Cancers can be cured and so what about the famous with things like endometriosis , MS , Myesthenia Gravis , Parkinsons , Huntingdons , oesteoporosis , neuropathy etc which get little recogniition and no help in the community with Mr Average GP missing the signs and saying you have wait for it "ordianry depression" !!!
++++
Don't know what you had to start with the gratuitous snotty about doctors, but I suppose that is the way of the world now.
It's not doctors who only talk about cancer. I agree with you about that. It's the bloody meja.
John
Doctors are encouraged to talk about cancer. It's one of the things they are judged on for their QOF points. One day when the powers that be can work out how to justify collecting statistics on them the other illnesses you have sited will probably form part of some register or other. Whether that will help either the patients or the doctors, most of whom in my experience just want to get on with treating each patient as an individual, is of course another matter.
experimental chimp, are you suggesting that all cases of unipolar depression should be referred to a psychiatrist to rule out bipolar?
Given the high prevalence of unipolar depression, that seems a really good way to cripple our already stretched psychiatric services.
We should be able to trust most GPs to make a diagnosis of depression - yes, there will always be one or two who could do with a bit of an update, but most GPs have excellent knowledge of psychiatry.
DOI - I am a junior doctor and a patient with cyclothymia.
How about IBD as an unglam, unsexy disease. Most people confuse it with IBS, and the symptoms and treatment are not exactly socially acceptable". I'm the proud owner (at age 32) of a permanent ileostomy and I make damm sure tha everyone knows I have one as it's the only way to dispel the myth that only "old people" have them, and that they "smell" and that people can "tell you have one".
"We need high circulation newspapers to popularise (I use that word deliberately) less fashionable, more unpleasant illnesses."
They already do so. How about "National Bowel Cancer Awareness Week" that was splattered all over the popular press (Lynne Faulds-Wood being their champion), not to forget Jane Asher's well-publicised support for the Parkinson's Society? It makes me wonder whether it is doctors who determine which illnesses are popular or not, and I mean the likes of celebrity medics like Hilary Jones, Mike Smith and Mark Porter. Shouldn't they take the blame for not being even-handed when they write for the press or appear on TV?
"We need high circulation newspapers to popularise (I use that word deliberately) less fashionable, more unpleasant illnesses."They already do so. How about "National Bowel Cancer Awareness Week" that was splattered all over the popular press (Lynne Faulds-Wood being their champion),
the problem with Lynne Faulds-Wood et al is that she is a representative of but one of several bowel cancer charities; they need to amalgamate to get more clout.
not to forget Jane Asher's well-publicised support for the Parkinson's Society?
Sadly and surprisingly from someone so intelligent and for someone who it s the daughter of the late great Richard Asher, she uses her position to slag off doctors rather than promote PD
It makes me wonder whether it is doctors who determine which illnesses are popular or not, and I mean the likes of celebrity medics like Hilary Jones, Mike Smith and Mark Porter. Shouldn't they take the blame for not being even-handed when they write for the press or appear on TV?
These guys have all taken the meja shilling - think of Raj Plaigerist - and do not determine the agenda
John
"the problem with Lynne Faulds-Wood et al is that she is a representative of but one of several bowel cancer charities; they need to amalgamate to get more clout."
Well, despite this public awareness of bowel cancer is pretty good. What more clout do they need?
"Sadly and surprisingly from someone so intelligent and for someone who it s the daughter of the late great Richard Asher, she uses her position to slag off doctors rather than promote PD"
Don't like Jane Asher much either. She was a bit of a slag back in the 60s. Not sure who her father was, but she comes across as a bit of a nouveau riche type.
"These guys have all taken the meja shilling - think of Raj Plaigerist - and do not determine the agenda"
Well, who does determine the agenda?
Your life is so wonderful. Reading your article is a kind of enjoyment. Thank you.
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The actress Annette Funicello has MS, and has been open with her recent struggles with it.
No Terry Pratchett mention yet?
K
I'm surprised no one has yet mentioned Lance Armstrong, who had testicular cancer then went on to win the Tour de France seven times. I saw an interesting snippet in the cycling press last week suggesting that the cancer might somehow have favourably affected his body chemistry resulting in improved performance - he was a successful cyclist before his illness, but became world beating afterwards. (that reasoning may be complete rubbish of course)
I think bipolar is seen as a 'popular' illness in the media now, because so many 'celebrities' claim to have it and use it as a justification for their terrible behaviour.
In the public discussions about 'celebrities' and bipolar no-one seems to talk about common but embarrassing symptoms that many people with bipolar have e.g. being psychotic.
Completely off topic but thought Dr Crippen would like to know big pharma are starting to use pester power - advert on shockwave games for antihistamines sponsored by Nick Jr.
j
Anon at 1:32 I would be interested to read of a list if NHS Dr's with an ounce of common sense to be shared out at their practice meetings. Why is cancer the only illness deemed to be important? Cancers can be cured and so what about the famous with things like endometriosis , MS , Myesthenia Gravis , Parkinsons , Huntingdons , oesteoporosis , neuropathy etc which get little recogniition and no help in the community with Mr Average GP missing the signs and saying you have wait for it "ordianry depression" !!!
That's Dr Average GP to you!
Bob Monkhouse-prostatic Ca
off topic
http://www.theaustralian.news.com.au/story/0,25197,23905699-23289,00.html
Doc, I think boys in the UK won't be given the HPV jab because the UK has chosen the GSK vaccine (Cervarix) in preference to the Merck one (Gardasil).
AIUI The Merck vaccine has been approved for use in boys, whereas the GSK one hasn't (although you should probably check this out yourself).
Ruth - would mentally healthy people want to become celebrities in the first place?
Is anybody else genuinely perplexed as to how they went about creating these 'Bob Monkhouse from beyond the grave' adverts? They look pretty much seamless.
Good article.Especially the above.We end up with a justice system again, where many innocent people are locked up again on the basis of an anonymous witness who may have a grudge financial interest etc in cooperating with the Police or whoever wants the defendant put away.
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