Times Insider
End-Stage Chemotherapy: Reporter’s Notebook
One of the many things we do in the Science department is keep apprised of significant studies that are about to be published. Major journals typically provide news media with two or three days’ notice of forthcoming studies so we have time to read and evaluate them, and talk with the authors and other experts so we can run an informed story when the journal publishes its study.
When deciding whether to cover new research, as I did last week when I wrote about a study suggesting that end-stage chemotherapy may make patients feel worse in their final days, we evaluate how solid the research and findings appear to be. We consider factors like study design and research methods, how many patients were involved, and whether the researchers controlled or adjusted for extraneous factors that might influence the results.
Along with editors — in the case of the end-stage chemotherapy article, with Hilary Stout — we also consider whether the findings are new and significant enough to warrant coverage. With a study on cancer, that means asking ourselves (and knowledgeable experts) whether the information might help patients, families or doctors make decisions.
Once we decide it’s worth doing a story, there are several next steps. Besides doing a detailed reading of the study, examining related cancer research and interviewing the researchers and unconnected experts, I’m always interested in talking with real people with relevant experiences. For the chemo story, I wanted to hear from people who chose late-stage chemotherapy or their family members. How did they make their decision? And how did chemotherapy appear to affect their quality of life in their final days?
These experiences can illustrate how the questions raised or answered by the research can play out in real life. It can be challenging to find patients or relatives willing to talk about a sensitive or painful subject, especially on a tight deadline – I had about 36 hours.
For this story, I reached out to different sources, including physicians, who agreed to ask patients or family members if they were interested in talking with me. Some were doctors I had spoken with in connection with previous stories and who, I hoped, trusted that we would understand the emotional and personal nature of these patients’ experiences and accurately and carefully reflect what they and their families had gone through.
I think it’s important too to point out the complexity and qualifiers that are almost always involved with research like this. For example, yes, the recent chemo study found that more people who had end-stage chemotherapy experienced a worse quality of life in their last week, according to people who knew them well. And more patients who did not choose chemotherapy enjoyed better quality of life. But that doesn’t mean that every patient in the study shared the majority’s experience. Some enjoyed a better quality of life in the last week, while some of the people who skipped chemo felt worse.
The doctors, patients and family members I interviewed helped explain why this is so: Cancer treatment is a highly personal decision. People have different goals and priorities. Some people in this very vulnerable stage want doctors to do everything possible, even if the odds are slim. Some, like a woman who wanted to see the birth of her first grandchild and was able to hold him on her last day, want to live long enough to reach personal milestones. Others would rather forgo the terrible discomfort and side effects of chemotherapy in their waning days.
It’s crucial, even in a quick story about study results, to make clear how big a role personal choice plays in a very difficult decision facing people suffering from cancer.
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