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How Movies Mislead You About Cancer

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Years ago, filmmakers realized they had a perfect villain that they could use any time—cancer. Cancer is real…but the way that it typically affects movie characters is often unrealistic.

If you saw The Bucket List, for instance, you’ll remember that the two main characters, played by Morgan Freeman and Jack Nicholson, had terminal lung cancer. But did they cough? Did they get chemo or radiation? No, they traveled around the world effortlessly! Symptoms and other everyday realities of having cancer were just too, well, real for this movie and a great many others.

Now, the flip side. While having cancer in movies generally is only a mild inconvenience, dying from it in movies is almost guaranteed. Surely you’ve noticed this—in fact, if you watch a lot of movies, I bet as soon as it’s revealed that a character has cancer, you think to yourself, “He’s dead!”

Movie characters with cancer die much more often than real people with cancer do—how convenient for a filmmaker who needs a character to go away! Take One True Thing, in which Meryl Streep’s character develops an unspecified form of cancer, takes morphine to ease her pain and (spoiler alert!) dies from a morphine overdose. Her death feeds a central plot point—the mystery of why and how she died. But…did it have to be cancer?

All of this makes for high drama, but it doesn’t give viewers a fair perspective on what cancer is truly like. So we were very interested when some Italian researchers decided to take a really close look at how movies deal with cancer in their plots…

TIME TO GET REAL

For the study, researchers tracked the role of cancer in 82 movies over the last 70 or so years. Their conclusion: Moviemakers are misleading audiences left and right. Researchers discovered that characters with cancer survived the disease in just 37% of the movies! But in reality, cancer survival rates are usually much higher—especially when the cancer is caught at an early stage.

For example, here are real-world five-year survival rates for common types of cancer that are higher than 37%…

  • Prostate cancer (unless advanced at diagnosis): 99.9%.
  • Breast cancer: stage I, 88%…stage II, 74% to 81%…stage III, 41% to 67%.
  • Colorectal cancer: stage I, 74%…stage IIA and IIB, 59% to 67%.
  • Kidney cancer: stage I, 81%…stage II, 74%…stage III, 53%.
  • Childhood leukemia: acute lymphoblastic leukemia, 85%…acute myelogenous leukemia, 60% to 70%.

Now, it’s critical to note that survival rates for some cancers can vary widely (depending on the type of tumor, where it’s located, the patient’s age, etc). Take brain cancer, for instance. A person between the ages of 55 and 64 who gets a glioblastoma has just a 4% chance of surviving, while someone between the ages of 45 and 54 who gets an ependymoma has a 91% chance of surviving.

Other cancers are just plain deadly, no matter what type you get, where it’s located or how old you are. For example, lung cancer caught in stage I has a 45% to 49% survival rate, but if it’s caught at stage II, III or IV, the survival rate is 30% or less. For pancreatic cancer, the odds are even worse—it’s 14% or less, even if it’s caught in stage I.

Filmmakers do have to be cut a little slack, because back in the day, cancer, in general, was more lethal. But with today’s advanced research and technology, a growing number of cancer patients are surviving. Maybe filmmakers should do a better job of keeping up with the times!

When we spoke with the study’s lead author, Luciano De Fiore, PhD, he said that he understands the attraction of using cancer as a plot point in a movie—cancer is inherently dramatic, and death is a big part of dramatic storytelling. But having cancer act mostly as a killer may mislead people about the facts and may exacerbate fear of the disease, he said.

In fairness, not every film gets it wrong. One film that provides a more nuanced and realistic view of cancer, for example, is 50/50, starring Joseph Gordon-Levitt and Seth Rogen. Levitt’s character is diagnosed with a rare form of spinal cancer, and you watch him struggle with his diagnosis throughout the movie—he is in denial at first…then he develops anger issues…and he is sad about losing his hair. You also watch him get chemotherapy and psychotherapy, and he eventually comes to terms with his diagnosis. Plus, his survival odds are higher than 37%—they’re…you guessed it…50/50. Despite the fact that (another spoiler!) he lives, the film is still gripping.

Other films that Dr. De Fiore applauded include Erin Brockovich, for highlighting how our environment can play a role in cancer, and The Rainmaker, for showcasing the economic implications of cancer therapies.

As health journalists who just want people to understand health better, we hope that more and more filmmakers will create movies like these, ones that are both dramatic and realistic. In the meantime, the next time you’re at the movie theater and a character utters the “C word,” take the almost inevitable result like you take your buttered popcorn—with a grain salt.

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Source: Luciano De Fiore, PhD, adjunct professor in the department of philosophical and epistemological studies at Sapienza University of Rome. His paper was presented recently at the European Society for Medical Oncology in Vienna, Austria. Date: December 17, 2012 Publication: Bottom Line Health Insider
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