New movie portrays teen cancer unrealistically, expert says

A new movie, “The Fault in Our Stars” paints an unrealistic image of young patients with cancer, according to pediatric oncologist at the Loyola University Medical Center, Charles Hemenway, MD, PhD.

The movie, scheduled to hit theaters on June 6, is based on a teen book by John Green. The story is about two teens who fall in love; Augustus, who has osteosarcoma, and Hazel, who has thyroid cancer that has metastasized to her lungs.

Charles Hemenway

Hemenway said outcomes for most pediatric cancers are much better than the movie portrays, and the types of cancer the teens experience are very rare.

“For the most part these are things that we don’t typically encounter. It’s a dramatic fictional piece of work, so that’s fine — poetic license is up to the author, but it deviates from what we typically encounter,” Hemenway told HemOnc Today.

He went on to express concern that the story will send a frightening message to children, teens and their parents.

“I think the important thing to realize is that cancer in children is highly treatable and ultimately curable. Yes, we see sad outcomes in which children die, but this book tends to focus only on one side of it that’s not all that accurate. If you want to look at the big picture, outcomes are usually good,” he said. “It’s true that there are many sad stories in pediatric oncology but I think it’s perhaps not appropriate to focus exclusively on that.”

According to the American Cancer Society, roughly 2% of thyroid cancer cases occur in children and teens. Hemenway told HemOnc Today that it is largely treatable, even if it metastasizes, with long-term survival at about 95%. In a press release, Hemenway said osteosarcoma makes up about 5% of all pediatric cancers, and the long-term survival is about 65% to 70%. In the movie, Augustus undergoes an amputation and is thought to be cancer-free. Later, his cancer returns and spreads everywhere. Hemenway said osteosarcoma usually only spreads to the lungs if it returns, and that amputation is not always necessary.

Augustus and Hazel attend a support group in the story and meet another teenager named Isaac, who lost one eye to cancer and is going to have the second one removed. Hemenway said this is very unrealistic because the most common type of pediatric cancer is retinoblastoma. It typically occurs in babies and toddlers but only rarely in teens, he said. Further, he said it is possible to lose one eye to retinoblastoma, but the other eye would be monitored closely by physicians and any recurrence would be easily treated.

“For the three of them to all be in the same place with such rare forms of cancer is like lighting hitting three times. Fortunately, most pediatric cancer patients experience better outcomes,” Hemenway said.

The overall cure rate of pediatric cancer is about 70%, and Hemenway said pediatric cancers are “biologically different from adult cancers.” He added that children can usually tolerate higher doses of chemotherapy than adults can withstand.

In his experience, children are much more emotionally resilient than the movie portrays, he said. “My experience is that when kids are confronted with serious illnesses like this, they rise to the occasion and put the ‘Why me?’ behind them and get on with getting better.”

Resources for people who have questions and concerns about pediatric and teen cancer are available. Hemenway said the Children’s Oncology Group website and the NIH website section on childhood and adolescent cancer are good resources. – by Shirley Pulawski