I had the privilege of sitting in on a Poynter seminar session about Covering Cancer yesterday. I listened to
bioethicist Dr. Art Caplan, certainly one of the world's most recognized experts in his field. (He is also on The Poynter Institute's
National Advisory Board.) I want to pass along a bunch of story ideas and coverage tips that I came away with:
Few Real "Breakthroughs"Be very skeptical of anything that claims to be a medical "breakthrough." When a discovery is made, it must be confirmed by other studies. So no single study makes a breakthrough.
Alternative Medicine
Caplan points out that just about all cancer patients are "swallowing something" on the side, besides their cancer medications.
"From licorice root to cactus," Caplan said, a lot of people are taking something. But Caplan said most do not tell their doctors that they are taking alternative medicines. If a doctor does not know, he/she might not discover drug interactions.
HPV (Human Papillomavirus) Vaccine
Why are so few young women/teens getting this new vaccine? (Here's the FDA's June announcement that it had granted a license for the vaccine.) Caplan says part of the issue is that it is a difficult story for journalists to frame.Is it a cancer vaccine or is it a vaccine against sexually transmitted diseases? The drug does seem to protect against genital warts, but it is not being marketed that way, Caplan says, because it is a difficult message for parents to hear when thinking about their young daughters.
When Planned Parenthood promotes the HPV vaccine it takes on the complexion of sexually transmitted disease prevention and parents might be resistant to it.
Biobanking
Caplan told participants in the Poynter seminar that Biobanking is going to capture a lot more attention in the future. Biobanks are repositories of human tissue, blood, bone, serum or DNA. These massive collections will allow researchers ready access to all sorts of samples to test and compare.
One biobanking project is to collect lots of cancer cells. The NIH Cancer Genome Project is trying to map which kinds of cancer cells grow at what rate.
When you have cancer cells taken out in a surgery now, researchers may want to take those cells and use them for research.
But Caplan says a significant ethics issues arise when researchers collect tissues without asking the patient's permission or with a vaguely-worded consent form. The patient may assume the tissues taken out in surgery are thrown away.
Cancer researchers are interested in heredity, but there may be issues of privacy (who else might know that patient has cancer if a name is attached to the tissue?)
In the future, cancer patients may want to be paid for the tissues they donate to biobanks. Caplan says hopsitals use surgical consent forms asking the patient for permission to use tissues for medical research. They also tell you that you are waiving your rights to compensation for the use of the tissue.
But not only sick patients may be approached. Cancer researchers may also want non-cancerous tissue to compare. How much permission should physicians and hospitals be required to secure before harvesting tissues or organs that might otherwise be thrown away after surgery?
Keep in mind that surgeons and for-profit companies are making money from these biobanked tissues. In short, somebody could be profiting by using your tissue for biobanking. Surgeons could be compensated for delivering cells or parts of organs they remove during surgery. Shouldn't the patient know about that deal?
Caplan says at some hospitals, umbilical cords are sold to outside vendors without the mother's knowledge. The cords can be used in other surgical procedures and research.
Here is a background paper on BioBanking ethics just published by Caplan. 
PDF Caplan paper
Here is another deep and detailed briefing paper to give you more about BioBanking.
About Vaccines and AutismCaplan said that, despite widespread fears that vaccines cause autism, the rumor is unfounded. The "stuff that may have had a connected to autism -- although I don't believe it -- has not been used in seven years." Caplan suggested that journalists should do more to alleviate the public's unfounded concerns about autism and vaccines. The Centers for Disease Control & Prevention says:
The weight of currently available scientific evidence does not support the hypothesis that vaccines cause autism. We recognize there is considerable public interest in this issue, and therefore support additional research regarding this hypothesis.
By the way, several states have CDC funded studies underway to learn more about the causes of autism including:
Alabama Arizona Arkansas Florida Missouri / Illinois New Jersey South Carolina Utah West Virginia Wisconsin
Vaccine Manufacturers
Caplan says most drug companies have gotten out of the vaccine business. Profits were low and liabilities were high. But new therapeutic vaccines against
shingles, colon cancer, melanoma and other diseases are coming down the road and could become big profit centers for drug companies. Caplan says many of these exciting new vaccines are only a few years off.
The vaccines of the future will be not just "preventative" but curative.
But the vaccines of the future (like HPV) will be expensive and genetically engineered, not grown in egg embryos as old vaccines were. The questions these drugs create in public policy areas are tremendous. Will drug plans be willing to pay for these new vaccines if they prevent even more expensive diseases?
We are always looking for your great ideas. Send Al a few sentences and hot links.
Editor's Note: Al's Morning Meeting is a compendium of ideas, edited story excerpts and other materials from a variety of Web sites, as well as original concepts and analysis. When the information comes directly from another source, it will be attributed and a link will be provided whenever possible. The column is fact-checked, but depends upon the accuracy and integrity of the original sources cited. Errors and inaccuracies found will be corrected.
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