Thermography

Review from the Office of the Ombudsman | English Services

Summary

The manager of a clinic in St. John's strongly objected to the representation of her facility on the thermography service it provided in a series of investigative reports from CBC St. John's. The review upholds the news team's work.

I write in response to your [Clare Barry] request for a review of the coverage of thermography and the Avalon Laser Health Clinic, which you manage. The coverage appeared on Here and Now, the St. John's evening newscast, and is available online.

The CBC St. John's investigation was part of more extensive coverage that appeared on The National and on other CBC platforms and programs. The material was presented as investigative pieces, and used some of the techniques associated with investigative journalism, including the use of hidden cameras. There were two main issues probed: the efficacy of thermography in the detection of breast cancer, and whether some service providers tout it as a substitute for mammography. Thermography has not been recognized as a screening tool in Canada, although in the United States, The Federal Drug Administration has cleared it for use as an “additional diagnostic tool for breast cancer screening and diagnosis.” After the CBC's broadcast the clinic in St. John's was advised by the Health Minister to stop providing the service. In the wake of the CBC broadcast, Health Canada sent out an advisory which began: “Health Canada is advising Canadians and health care practitioners that no thermography machines have been approved to screen for breast cancer in Canada.”

In your complaint you say it is not about “the video's coverage of thermography as a health care service.” Rather you say the piece leaves the false impression that Avalon Laser Health Clinic offered this service as a substitute for mammography. You also say there were some inaccuracies in the piece: one involving the story's statement that a promotional video on your website made similar claims to one objected to by the FDA in the United States, and the other involving your statement that mammograms emit radiation, and that increases the chance of breast cancer. You also feel CBC is in violation of its own policy by not correcting significant errors.

Your initial complaint went to Peter Gullage, Executive Producer of News. He rejected your request for corrections. “CBC believes that its story was correct and the methodology used in preparing it was appropriate, and therefore a correction is not in order.” He referred you to this office for review.

I have watched the piece, almost ten minutes long, several times. I am not left with the impression that it implied you were misleading your clients by telling them thermography is a substitute for mammography in breast cancer screening. In fact, one of the very first voices and faces seen is yours, saying that it is not and that your clinic would never make that claim. While you said it is not coverage of thermography as a health care service you are disputing, that is really what the piece is all about. Your clinic is one example of the hundred or so across the country who were offering the service. What the piece does explore is what your clinic claims about the efficacy of this screening technique and its ability to detect breast cancers earlier than mammography, and what scientists and physicians, as well as regulatory agencies, say about that.

CBC policy on Investigative Journalism states:

Investigative journalism is a specific genre of reporting which can lead to conclusions and, in some cases, strong editorial judgments. A journalistic investigation is usually based on a premise but we do not broadcast an investigative report until we have ensured that the facts and evidence support the conclusions and judgments.

To achieve fairness, we diligently attempt to present the point of view of the person or institution being investigated.

You agree that the strong editorial conclusions are not an issue here. It is the last paragraph that is the most pertinent based on your complaints. Your position is presented throughout the piece.

The tension and counterpoint is around the value of thermography and the claims you and your clinic make for it. The use of the hidden camera was appropriate in that it enabled the reporter to measure what you publicly stated in an interview against what a patient coming into the clinic would hear. Given there is controversy around the claims made for this technique, this is a valid use of this journalistic technique. Since some practitioners do make claims about the procedure versus mammography, it was valid to test what your clinic said. In repeated viewings of the story I did not find that it implied that your clinic was selling this treatment as a substitute for mammography — rather it was presented as a valuable tool for early detection.

You and your staff made repeated comparisons to mammography. For example, there is some emphasis on the fact that thermography does not emit radiation, and that mammograms do. You state in the piece: “There are women who do have mammograms every single year. Each time they do, they increase their chances of getting breast cancer.” The story shows parts of a video formerly on your web site that implies significant danger from radiation. Your statement is followed by one from Dr. Nancy Wadden, a radiologist and creator of the breast screening program in Newfoundland and Labrador. She says this is bad and incorrect advice. Juxtaposing her statement with yours is a standard technique. She is a recognized expert in her field and her view that concerns about the effects of radiation from mammography are misplaced is widely held in the profession. That is clearly what she is addressing. So your concern that there is an inaccuracy in this case is unfounded.

St. John's producer Kathy Porter affirms the video that was available from your web site was an edited version of the one objected to by the Food and Drug Administration in the United States. The video promotes thermography as a screening device able to screen for breast cancer at a much earlier stage than mammography. The FDA had two concerns — one was the claims about thermography as a replacement diagnostic for mammography. The other was that there is no scientific evidence to back the claim that thermography can detect cancers earlier than mammography.

The coverage of this issue on Here and Now and across CBC provided you, and other proponents of the technique, an opportunity to speak to its value. Based on extensive research, it laid out the case and led to a conclusion that strongly questioned the efficacy of the procedure. Apparently Canadian regulators agreed. Since the publication of this material, Health Canada put out an advisory telling Canadians no thermography machines have been cleared for breast cancer screening in this country. And two provinces, including yours, have issued cease and desist orders to clinics in their jurisdictions. I did not find that the piece falsely represented your clinic or its practices.

Esther Enkin
CBC Ombudsman