The death of Farrah Fawcett, who succumbed to cancer Thursday, demonstrates the tricky relationship between cancer, hope, and the media. In February 2007, doctors declared her "cancer-free"; as recently as last month, they said she was "doing very well." But when a celebrity shares her battle with cancer, the information provided to the public is always partial and often misleading. Civilian cancer patients looking for information and inspiration from celebrity-cancer coverage of E! News, Us Weekly, People,and similar outlets should be cautious.
Fawcett, the Hollywood actress best noted for her role as one of three beautiful detectives in the 1970s television drama Charlie's Angels, received her diagnosis in September 2006. But it was not until early 2007, after she had completed treatment, that Ryan O' Neal, a longtime friend and father of her son, announced that Fawcett had anal cancer, a rare disease.
At the time, the news seemed remarkably good. One of Fawcett's physicians announced that she had had "a full and complete response to treatment," meaning that her prognosis was "excellent." The press was understandably pleased and even proud of her. "Once again," reported E! Online, "Charlie's Angel managed to kick butt—and, as it happens, cancer."
But Fawcett's treatment had consisted of not only surgery but radiotherapy and chemotherapy, suggesting that her disease was far advanced at the time of diagnosis. This made a cure less likely, though not necessarily impossible.
Why the contradictory information? Diagnoses of cancer routinely generate periods of what we might call "ritualized optimism." No matter what the reality is, surgeons announce they "got it all," and patients declare that they are cancer-free. It is hard to criticize these types of proclamations. Indeed, it is difficult to conceive of other ways one might describe the first weeks and months after being diagnosed with cancer. Even if patients themselves believe or suspect otherwise, they want to reassure family and friends that they are on the road to cure.
This phenomenon is especially true when the patients in question are celebrities. These days, it has become almost mandatory for famous people diagnosed with cancer to contact not only their doctor but their publicist. And such celebrities have a double burden. Not only must they battle their disease, but they must serve as inspirational role models for their concerned and admiring fans.
But as is indicated by Fawcett's case, such optimistic statements may be profoundly misleading to the public and, of more concern, to patients with the same or similar diseases. Although few cancer patients likely use celebrity cases to specifically dictate their treatment choices, many contact famous patients like Fawcett for both medical advice and inspiration.
Others post comments on the Internet that indicate a bond between celebrity and ordinary patient. When Fawcett announced her apparent cure in 2007, one writer wished that her mother, who had died of cancer, "had half of the courage and fight that Farrah has." These war metaphors, which pervade the coverage of celebrity cancer cases, perpetuate the false notion that survival is directly related to how hard the patient tries to live.
Fawcett's case had another component that potentially sent the wrong message to other patients. In addition to the traditional cancer treatment she was receiving in the United States, the actress traveled to Germany six times to receive a combination of natural supplements and immune treatments not approved by the U.S. Food and Drug Administration. These trips were chronicled in a moving documentary, Farrah's Story, that aired on NBC in mid-May. In seeking this type of therapy, Fawcett mirrored a choice made by actor Steve McQueen, who futilely traveled to Mexico in 1980 in search of a cure for his malignant mesothelioma. McQueen's Mexican doctors treated him with dozens of enzymes and vitamins, coffee enemas, and an anti-cancer drug called Laetrile, which was ultimately shown to be worthless.
Did the alternative treatments help Fawcett? It is unlikely. As Laurence R. Sands, a Florida surgeon who treats anal cancer patients, told WebMD, there is no scientific proof that such immune system stimulants work. Nevertheless, one of the German doctors involved in Fawcett's case claimed that the treatments had shrunk her tumors and substantially prolonged her life.
Once again, media coverage of Fawcett's case, while ostensibly providing useful information, ran the risk of sending the exact wrong message. Thousands of desperate end-stage cancer patients traveled to Mexico upon hearing Steve McQueen's story. The new destination may now become Germany.
As the expression goes, "Hope springs eternal." As a physician who treats cancer patients, I well understand the psychological importance of encouraging a positive outlook, at least initially. But when celebrity cancer patients, their doctors, or spokespeople make public statements that are clearly at odds with the facts, no good purpose is being served. Cancer patients should not have to spend their time trying to distinguish between fact and fiction. They have enough else to deal with.