Yesterday I editorialized about an article I chose to run about nutrition and cancer.  Not because it wasn’t good–it was–but because it was most likely written by a paid staffer representing someone with an undisclosed financial interest.

Here is what I wrote:

This is an example of how individuals and groups are exchanging information on the internet, in part to push their own agendas.

The host’s site, Real Food Rocks!, was created by a woman named Bridget.  I have never met her or spoken to her.  But by reading her profile, I see that Bridget is a certified nutritionist with a Masters of Science in Nutrition in Washington State.

For whatever reason–possibly because she has just started the site–Bridget chose to run an article written by someone who is paid by a company with a professional interest in mesothelioma.

I don’t think that this is necessarily bad.  But what about Bridget’s interests?  Like most professionals these days, she is interested in attracting new clients.  By including interesting features about nutrition on her site, she helps achieve that goal.  Again, no problem there.

As someone who carefully writes and crafts my own posts, especially on my other daily blog,, I might shake my head a bit over Bridget taking the easy way out and using content contributed by a special interest group…

But what about my interests?  YES!  I want to help my fellow cancer patients and caregivers.  But I feature a large link on the left side of my homepage, encouraging you to enter our My Cancer Store to purchase books about cancer that I and others have written.

You may be surprised to learn what I really think about all of this.  Tune in tomorrow and let me explain.

After posting my opinions, I shared this comment with my readers on our My Cancer Store facebook homepage:

I understand that this two part series is a bit nuanced.  But keep this in mind:  THERE IS NOTHING WRONG WITH HAVING A PERSONAL OR FINANCIAL INTEREST IN WHAT GETS POSTED ON BLOGS AND/OR WEBSITES.  Mine have a bit of that too, right?  I promote my books and use My Cancer Store to help sell them.  I hope my readers trust my intentions.  (YOU SHOULD!)  But this type of thing is happening more and more, so I wanted to write about it to help all of us “read between the lines” and realize content can be designed to manipulate how we thing and what we do.  For better or worse, welcome to the 21st Century!

I need to find ways to get my three books–two about multiple myeloma and one bone marrow/stem cell transplants–into the hands of patients and caregivers that need them.  The money we collect from book sales allow us to donate books to those who can’t afford them, and to gear-up for the next book release (Book number four is on the way!)  I also run a few Google ads buried down below my content, and that helps a little bit, too.

So in this case, no harm, no foul.  But I believe disclosure is important.  It is important because the agenda of the writer–and/or the site editor–can affect what information the patient sees and why.

In most cases this doesn’t make much difference.  But sometimes it can.  Several weeks ago, I was contacted by Jasmine McCarthy with an organization called Drug Watch, asking me if I would run an article about diabetes and the dangers of diabetics developing bladder cancer.

After reading the article (which like the article I ran yesterday, I felt is also quite good) I had a feeling their was a “hidden agenda” there.  See if you agree:

Bladder Cancer and Type 2 Diabetes

Type 2 diabetes patients often use oral medications to help control their blood sugar. One of these medications, Actos (pioglitazone), is quite effective, but can cause cancerous tumors to grow in the bladder.

Prevalence of Bladder Cancer

Taking the lives of an estimated 15,000 people each year, a diagnosis of bladder cancer is devastating. The FDA warns about Actos and bladder cancer. This is bad news for diabetes patients because they have found that using Actos for more than a year increases the risk of bladder cancer by up to 80 percent.

Despite the fact that other drugs for treating diabetes are available, 10 million people throughout the world have been prescribed Actos.

Thousands of people have been filing Actos lawsuits against Takeda, the manufacturer of Actos, after either being diagnosed with or losing a loved one to bladder cancer.

Bladder Cancer and Diabetes

Even without taking Actos, diabetes patients are already at risk for bladder cancer—especially men.

The American Cancer Society and the American Diabetes Association compared research, finding that people with diabetes are 40 percent more likely to get bladder cancer.

Type 2 diabetes also increases the risk of cancer of the liver, pancreas, endometrium, and the colon/rectum.

Common risk factors for both diabetes and cancer are aging, sex, obesity, physical activity, diet, alcohol and smoking. And now type 2 diabetes patients can add another risk factor to their list: Actos.

Trials Reveal Risk of Bladder Cancer

From the beginning test stages, Actos showed adverse effects, as laboratory rats tested with Actos developed more tumors than rats tested with a placebo.

Studies by the French Medicines Agency, the Kaiser Permanente Northern California (KPNC) diabetes registry, and the British Medical Journal all confirm that people who use Actos for longer than a year are at an increased risk of getting bladder cancer.

More than a decade after Actos hit the world market, study results finally elicited a response from drug-regulating agencies.

In 2011, Germany and France responded to results quickly, stopping sales of the drug altogether.

The United States continue to stock pharmacy shelves with Actos. The Food and Drug Administration has responded by adding a bladder cancer warning to the drug label. The warning relays the risk of bladder cancer, but not the gravity of the diagnosis, which can totally disrupt life.

Diagnosis of Bladder Cancer

Bladder cancer patients often have to quit jobs because of the serious side effects. Feeling pain while urinating and increased frequency of needing to urinate are just some of the side effects patients may experience.

Bladder cancer can spread to close areas like the prostate, rectum, uterus, ureter or vagina; and to the pelvis, bones, lungs or liver.

Treatment options include surgery, chemotherapy and radiation, but survival is contingent upon early diagnosis.

Doctors perform various tests to determine whether patients have bladder cancer, including biopsy, cystoscopy, urinalysis, abdominal CT scan, intravenous pyelogram, pelvic CT scan, urinalysis or urine cytology.

While some patients respond well to treatment, others do not. Within the first five years of diagnosis, the survival rate is high. However, those who beat the cancer may have to undergo drastic changes, like adjusting to using a urostomy bag, once the bladder is removed.

Discontinuing use of Actos — with a doctor’s permission — can decrease your chances of developing bladder cancer.

Alanna Ritchie writes about prescription drugs and medical devices for

After reading the article, I emailed Jasmine back and she was very forthcoming with disclosure information.  Here is what she said:

Hello Pat,

Our organization receives our funding from a law-firm (The Peterson Firm), but our website is a completely separate entity, and every service our website provides is completely free.

We do not refer people from the website to any law-firms unless they specifically request it.


Fair enough.  But couldn’t you tell from the way the article was written that there was an agenda there?  It read to me a bit like the scary ads you see on TV, asking you to contact a law firm if you had your feet fall-off after taking drug X, Y or Z.

All of that said, there is value here.  I clicked-on the link in the second paragraph, The FDA warns about Actos and bladder cancerFascinating.  Once there, it was clear this was a site designed to attract patients who had problems develop after using Actos.

There was a lot of great information there.  I wasn’t aware that Actos is possibly the causal agent in so many cases of bladder cancer!

I’m constantly writing about and evaluating secondary cancer risk for those of us taking chemotherapy.  I personally have experienced the issue, having developed melanoma as a result of my compromised immune system from using chemo meds for years to help battle my bone marrow cancer, multiple myeloma.

But I haven’t paid much attention to drugs which may cause cancer in the first place.  This was a real eye opener for me.

I just wish Drug Watch would have been open and disclosed more about their interests up-front. 

And speaking of full disclosure, I do some consulting work for Millennium Pharmaceuticals, which was acquired by Takada a few years back.  The company also pays my expenses to travel around the country and share my story with cancer support groups. 

There are two take-away messages here.  The first is to pay attention to where a particular article or post comes from–and if there is an agenda there that might color or slant the information that you’re reading.

And the second?  If I had diabetes, I’m not sure that I would be using Actos!  Check with your doctor about that, OK?

And thank you, Jennifer, for helping to open our eyes to this potentially dangerous information.  Sorry if I beat you guys up a bit!  But in the future, please disclose your intentions up-front.  I don’t think it weakens the message–I believe it strengthens it. 

Feel good and keep smiling!  Pat

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