The representation of cancer in cinema: an approximate portrait

The Dr Maurie Markmanprofessor of oncology at Department of Medical Oncology and Therapeutic Research, Duarte, California, comments on a fairly original subject, that of the representation of cancer in cinema. An opportunity to better inform the general public? (below the transcript of his video blog originally published in English on Medscape.com).

TRANSCRIPTION

Growing up, we all — children, adolescents, adults — watched television series or films about medicine. The oldest among us remember the Dr Marcus Welby but also IS, Grey’s Anatomy and others. In a rather provocative study published in the JCO Oncology Practice (intitulée « Hollywood’s Take on Oncology :Portrayal of Cancer in Movies, 2010-2020 »)^[1]the authors examined 100 English-language films released over the past decade that featured cancer in their plots. They asked themselves relatively simple questions: how was cancer addressed? What types of tumors have been described? How did the disease progress?

The question is what the public “sees”. If you watch these films and you don’t have family or personal experience with cancer, what do you know about cancer? It may be that, despite the information campaigns of learned oncology societies, all you know is what you see in the movies…

Study results

What the researchers showed is really very interesting. Only a third of the films mentioned the type of cancer, so in two-thirds of the cases you simply knew that the protagonists had “cancer”.

Another very interesting phenomenon: what do you think was the most common type of cancer when it was defined? These were brain tumors. These are obviously very serious cancers, but if we talk about common cancers, brain cancer is not even in the top 10 most common cancers; yet it was most often found in these fictions.

A communication opportunity

The authors of this article wondered if this could be an opportunity for filmmakers. Certainly, in their scenario, they are trying to “sell a product, an idea”, but wouldn’t this be an opportunity to provide information on the reality of cancer? They might insist that smokers get lung cancer. In my opinion, they could talk about cervical cancer and say that if the HPV vaccination had been done, this might not have happened.

Researchers noted that the majority of cancers in these films were incurable, although this is not the reality today. Today, many cancers that were once not curable have become curable for a certain number of patients, not to mention that early detection allows for a very high cure rate. Why not try to send the message that we are having more and more therapeutic successes?

They also noted that there is very rarely, if ever, a conversation about multidisciplinary care, that in one way or another multiple doctors from multiple specialties are involved. This is a potentially very important message to get across.

In 12 of the films studied, the patient refused cancer care. Again, this happens, but it’s clearly a rare occurrence today. Maybe that’s not a very accurate representation of what’s going on. They acknowledged the fact that, obviously, we look back over the last ten years, and there were no patients receiving immunotherapy or targeted therapy. Of course, the goal is not to “sell cancer care,” but to be more specific about treatments wherever possible.

They also noted that there were very few, if any, comments on palliative care or hospice care.

The final point they made is that there was very little conversation in these films about what we now recognize as the financial distress of patients. This is unfortunately a reality that could perhaps be addressed in the future.

Again, this isn’t about telling Hollywood how to make their movies, it’s about telling the oncology community that if their patients or their patients’ families see these movies, they may not have an image very accurate of what is happening in the world of oncology today and that better education may be needed.

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