The following is a minimally edited excerpt from The John R. Lee, M.D., Medical Letter, June 1999 issue. Dr. John R. Lee is a long time friend of FACT who has been a featured speaker at many of our Annual Cancer. Nutrition Conventions. A graduate of Harvard University and University of Minnesota Medical School and author of the groundbreaking books Natural Progesterone and What Your Doctor May Not Tell You About Menopause, Dr. Lee is an outspoken, in dependant voice in his field, as the following article illustrates.
Any news story has multiple interpretations. Different people interpret things differently. In politics this is called “spin-doctoring.” The same happens in medical news. Drugs promoted as “wonder drugs” often turn out to be quite insignificant or to have harmful side effects that outweigh their benefits. We have become used to these occurrences – remember Seldane and fenphen?
What we do not expect is that a TV news report will be an outright lie. But this is exactly what happened recently. This may seem shocking, but medical and health news is full of misleading information designed to convince you to buy one product over another. The conventional medical approach to hormone replacement therapy is based on spin-doctored reports on studies that promise women benefits that just don’t exist, or that gloss over serious side effects.
Let’s take a closer look at this phenomenon. I want you to be aware of how conventional medical gospel is created, not with scientific research or evidence-based medicine, but with well-funded and masterfully orchestrated spin-doctoring. Millions of dollars a year are spent in precisely the type of media manipulation that this story represents.
In April, TV news programs around the U.S. aired a clip reporting that a Journal of the American Medical Association (JAMA) study found that estrogen supplementation improved memory in menopausal women. In fact, the study found that estrogen supplementation increased brain activation patterns, but the authors clearly reported that “Estrogen did not affect actual performance of the memory tasks.” (emphasis added) Thus, the study merely confirmed what has been long known, namely that estrogen increases brain cell membrane excitability. But it did not show, contrary to the TV news report, that estrogen supplementation improved memory in menopausal women.
Strangely, the study was funded by two grants from the National Institute of Child Health and Human Development Wyeth-Ayerst chipped in with Premarin supplies and paid the cost of equilin (horse estrogen) assays, the results from which were never mentioned in the article. There’s a good chance they also indirectly funded the study. I wonder if anyone at the National Institute of Child Health and Human Development cared a whit that the study involved menopausal women, and had nothing to do with children?
THE MECHANICS OF MEDICAL SPIN DOCTORING
One might wonder how such a mistake is made on the TV news? Here’s how. The TV news stations receive a news release on the topic in the form of a well-produced video clip and a script all ready to go on the air for the station’s daily “Health News” segment. The clip may come from a parent network, from a news service, or a public relations company, and the TV station rarely questions the ultimate source, which is a drug company. Why should they? They are hungry for news which they have to churn out date or four times a day, and the opportunity to air a professional-looking video clip about a study published in a major medical journal saves much time, effort and money. Nobody at the station goes back and actually reads the study itself to check on the accuracy of the information, or consults with someone who has read the study and has the skills to interpret these news releases are simply parroted back to you, unquestioned and unexamined. This is not journalism; it is an indirect form of advertising.
What can be done about this now? The report has already intentionally misled millions of viewers, and has become conventional medical gospel more false evidence that estrogen helps with memory that will be regurgitated hundreds of times in future news reports and print articles. I imagine the drug company is quite pleased with itself great advertising at a relatively low cost. Once again, we understand how advertising and drug promotion leads physicians and thus medical practice by the nose.
NO SUCH THING AS UNBIASED REPORTING WHEN PRESS RELEASES ARE REGURGITATED
The same practices hold true in the print media. Just today I came across a story in the newspaper that Wyeth-Ayerst, the drug company that manufactured the “fen” half of the damaging diet pill combination fen-phen, hired people to ghost write stories about the drug combo that intentionally left out or played down descriptions of the side effects, even though they were well established at the time.
Magazines and newspapers are as story-hungry as TV is, so a “free” article ghost-written for a magazine, with a byline by an M.D. and probably some nice graphics, saves the cost of paying writers, researchers and photographers, and pleases a major advertiser. This is standard operating practice in the media. Too much of our media news and editorial content is generated by public relations companies who churn out spin doctored material. It looks good, it sounds good and best of all, it’s free.
Virtually every health segment in the print and television media has a commercial sponsor lurking somewhere in the background, most commonly hiding behind academic research. Spots that report on the negative effects of a drug are often sponsored by the manufacturers of competing drugs. Nutrition research is usually supplied by the industry that is favored by the research: vitamin companies, the dairy industry, the beef industry, the processed food industry, and so forth. Pure academic research with no strings attached does not truly exist anymore.
WHOM TO TRUST?
Because of all the strings attached to research, it’s difficult even to trust scientific studies. It’s all too common to engineer protocols and juggle statistics to produce a desired outcome. In fact, you can go on-line to Medline, the federal government’s National Library of Medicine database, and find reams of studies to back up almost any position in medicine you want to take. That’s why it’s important that we know who sponsors studies, that they be duplicated by others, that results be backed up by sound theory and with clinical hands-on experience, and that they be properly interpreted.
When you look for medical information to trust, try to find a source with little or nothing to gain financially by selling you a consumer product so the interpretation will be as free from bias as possible. Financial bias is why I steadfastly refuse to endorse any brand of progesterone cream or to make money from the sale of progesterone cream. I want readers to rest assured that I’m telling them about hormone balance because I think it will benefit them, not because I will profit from selling a hormone product.
One of my goals is to sift and sort through the flood of medical information out there and fill you in on what’s for real, what’s spin doctoring and when we should take a wait-and-see attitude.
AND THERE’S MORE
For years I’ve been trying to debunk the “eggs are bad for your heart” myth. Finally the Harvard Nurses’ Health Study has produced a look at 127,000 people over 14 years and compared their cardiovascular health to their egg consumption. Those who ate an egg a day did not have any higher risk of cardiovascular disease. This conclusion was inevitable because there was never any connection between eggs and heart disease to begin with!
The “eggs are bad for you because they’re high in cholesterol” myth has been perpetuated for years by the competing cereal industry based on absolutely no scientific evidence and lots of media manipulation. It’s a perfect example of how once something appears in print and on TV enough times it becomes the gospel whether or not there is any truth to it.
Decades later the tide is finally turning and eggs are getting the attention they deserve as one of nature’s health foods. There’s just no comparison between having a sugary cereal with milk and having an egg for breakfast. One is essentially junk food, and the other is a nutritional powerhouse. If you eat eggs from free range chickens you’ll be even further ahead because their fatty acid profiles are better.
In the July issue of The John R. Lee, M.D., Medical Letter, Dr. Lee included this follow-up:
Last month I wrote about medical spin-doctoring and about how companies use cleverly worded press releases and video clips to twist medical and scientific facts to suit their needs. Shortly after that issue came out, Journal of the American Medical Association (JAMA) published a study on hormone replacement therapy (HRT) and the risk of breast cancer, which illustrates that the same type of shenanigans go on with published studies. The headline reporting the study in the New York Times, for example, read, “A Study Downplays Estrogen Link to Breast Cancers,” and went on to state that the study “…offers some reassurance, finding little evidence to link hormone replacement with the most common types of breast cancer, known as ductal or lobular cancer.
The good news is supposed to be that HRT supposedly doesn’t raise the risk of the most common types of breast cancers, though it does significantly raise the risk of other less common types. However, the authors of the study never account for what type of estrogen the women took, how much they took, whether they were also taking a progestin, and what kind of progestin it was, whether they had their ovaries, if they had a hysterectomy, why and how individually sensitive they were to estrogen. The published data is inconsistent, saying that breast cancer risk is increased with short-term estrogen use in one graph, while the table that the graph was derived from says breast cancer risk is increased with long-term estrogen use. Some types of cancer are left out of the analysis, and others are inappropriately grouped so that the non-cancer, ductal carcinoma in situ (DCIS), which is not a cancer, is lumped in with real cancers.
SPIN DOCTORING CREATES CONFUSION
I have done a detailed technical analysis of this study, which you can read in the Subscribers Only area on my website (www.johnleemd.com). Meanwhile, in the same medical journal and many others, tamoxifen – estrogen blockers such as tamoxifen and raloxifene are being touted as preventive medicine for breast cancer, and young women at risk are urged to take it to prevent breast cancer. So, on the one hand we have studies (promoted by the drug companies that sell estrogen) claiming that estrogen does not cause breast cancer, and on the other hand women are being encouraged to take a drug that blocks estrogen in order to prevent breast cancer (promoted by the drug companies that sell estrogen blockers). Obviously both things can’t be medically correct. No wonder women are confused! (For details on hormones and cancer, see the April and May 1998 issues of this newsletter, and the chapters on cancer in What Your Doctor May Not Tell You About Premenopause.)
Despite all of this, I am not completely opposed to estrogen replacement therapy (ERT). I support it when it is clearly needed (most doctors don’t even measure hormone levels before prescribing it), when it is given in the proper physiologic dose (the usual prescribed dose is ten times too high), and when it is given with natural progesterone (women with a hysterectomy are told they don’t need the protection of a progestin or progesterone, but they do).