Steve Hewlett’s Journey with Advanced Oesophageal Cancer: A Case Study

Oesophageal cancer (OC) is typically diagnosed at the later stages of the disease due to its vague symptoms. Over 9000 people in the UK are annually diagnosed with the cancer and the survival rate is only 12% (Cancer Research UK, 2013-2017), therefore it is vital that people are diagnosed at the earlier stages of the disease for increased chances of survival. OC has been an under-represented cancer in the media for raising public awareness of symptoms when compared other cancers such as breast or prostate.

In March 2016, Steve Hewlett, a British journalist and broadcaster, was diagnosed with late-stage OC at the age of 58. Shortly after learning of his diagnosis, he made the decision to share his cancer journey with listeners on BBC Radio 4 (the PM Show). A total of 21 interviews took place on air with radio presenter Eddie Mair. Steve also released dairy entries, as well as taking part in other media interviews. A range of guests were invited to speak on the PM Show including: family members, health professionals and the occasional listeners who phoned in to express their interest and appreciation for Steve’s reporting.

The aim of this research was to examine Steve Hewlett’s cancer journey (pre-diagnosis to end-of-life stages) as depicted in the media, with the exploration of techniques used to share health information and personal experiences with his audiences. This provided a unique and in-depth perspective of OC as a journey.

Case study (CS) methodology was used, which encompassed the use of multiple sources such as radio interviews, television interviews, newspaper and diary entries. These were supported by the validation technique of triangulation to check for consistencies in reporting experiences and perceptions throughout the different contexts and reporting mediums. All data was pre-existing (ranging from 2016-2017) and publicly available on the internet. Audio and video interviews were transcribed verbatim and analysed with thematic analysis, underpinned by an interpretivist researcher stance.

Five main themes were developed that chronologically mirrored the journey: Unexpected Diagnosis: My luck’s run out; The Active Patient: On the phone to the drug manufacturers; Buying Time with a Lucky Break; and Death and Dying: I could pop off at any time. Findings showed that Steve’s communication to listeners had multiple purposes. Purposes included: teaching the public about OC signs and symptoms (raising awareness), explaining NHS referral and treatment processes (how to get the best care possible), sharing experiences and the options available in private treatment and, costs associated with this and lastly, breaking social barriers for men’s health and identity when diagnosed with cancer. In addition to factual reporting and personal narrative, metaphor was also used to enhance health communication.

The combination of personal and journalistic stories about OC showed the various and creative ways of Steve’s reporting. These included metaphors, health frames and narratives that may be available to audiences when interacting with journalist cancer stories to make sense of certain cancer experiences and the healthcare system. The combination of personal and journalistic reporting about OC showed the multiple methods of Steve’s reporting, which included modelling and potentially showing ways to take responsibility for one’s own health such as enquiring about delayed referrals; demonstrating shared decision-making process; coping and navigating one’s self through the journey using helpful information sources, ultimately exemplifying a way of becoming an informed and potentially ‘expert’ patient. To fully understand audience perceptions of the impact or usefulness of journalist cancer stories, further research is required.