Tuesday, May 14, 2013

Angelina Jolie's Fearless but Flawed Message

This article also appears in Medical Marketing & Media.

 A good chunk of humanity is talking about Angelina Jolie’s double mastectomy today. She penned a remarkable Op-Ed in The New York Times about her decision to have preventive surgery and breast reconstruction following the results of a genetic test. The variant of her BRCA1 gene gives her an 87% risk of breast cancer and 50% risk of ovarian cancer. (Clearly, she’ll need to confront the latter issue at some point and I wish her the very best.)

I join the millions who are happy to read that Ms. Jolie is making a fast recovery. Her story is another reminder of the need for education and outreach, and brave decisions. And, she points out the crucial issues of access, cost and preventive health care (though the discussion is one much broader than breast cancer). As sad and terrifying as her experience must be, however, she's fortunate to have deep emotional and financial support. It’s a stark reminder of health care haves and have-nots.

Unfortunately, her nod to "wonderful holistic doctors working on alternatives" is less helpful. Steve Jobs was famously regretful of his choice to pursue alternative therapies. He wished - too late - that "conventional" (science/evidence-based) therapies had started earlier. Instead, he tried dietary supplements, juices and acupuncture for nine months while his cancer spread. I’d hate to see Ms. Jolie provide a platform to physicians like Christiane Northrup, who has used Tarot cards to diagnose illness, or celebrities like Suzanne Somers, who apply, ingest and inject unapproved products in an attempt to stay young, and Jenny McCarthy, who uses the very unfortunate story of her son to create fear and confusion around vaccines.

Of course, people die even though they had the best of what science could offer. Cancer is a terrible, complicated array of diseases. And it's true that some people get better while on alternative therapies. Is there something to it? Quite possibly. We know that many modern medicines are derived from natural substances. But the cures you often hear about could be the result of other factors including poor initial diagnoses.

When it comes to managing one’s health or the health of one’s family, most people don’t have enough knowledge to evaluate a medical product claim or even formulate the right questions to ask a health care provider. This all makes the public an easy target for purveyors of alternative medicines and bogus devices.

So, while some push for greater access to health care, a parallel effort must be made to fund research and education. Dropping information – even crucial or compelling data – onto the heads of an unprepared public, or expecting a response to another “call to action,” is unproductive and unrealistic. We need a massive, sustained effort to enhance health and science literacy.

Between blog posts, I invite you to follow me on Twitter @pauloestreicher.

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