Confronting a Rising Tide of Cancer Misinformation

The man sitting across from me in clinic was only 58, but he had been smoking two packs per day since his teenage years and was exposed to potential environmental hazards in his job in construction. He had come into the emergency department with acute chest pain, thinking that he was experiencing a heart attack. Instead, his scans revealed a large mass in the upper lobe of his right lung, with enlarged lymph nodes in his thorax. A biopsy of the lung mass confirmed that he had small cell lung cancer.

In oncology, these clinical situations demand urgency. Small cell lung cancer is an aggressive diagnosis, so it’s critical to move quickly. The next steps in this type of care are to complete staging by ordering more scans, such as a PET scan of his body and an MRI scan of his brain, and to create a treatment plan in collaboration with colleagues from surgery or radiation oncology. Patients with limited stage disease may not need systemic drug therapy, only local control with surgery and/or radiation. Despite the fact that my actual role is to provide systemic drug therapy, I take on the task of quarterbacking their journey to ensure that they make it through without getting lost in a fragmented and complex medical system. The clock matters. Each delay risks the cancer growing beyond the window where curative treatment is possible.

In the midst of that urgency, I was surprised when the patient asked us to pause. He wanted to consider what I was telling him and think over his options. He had seen a video on social media about ivermectin and fenbendazole. These antiparasitic drugs, often used to treat livestock, took off in popularity after the actor Mel Gibson appeared on The Joe Rogan Experience and touted the experiences of several friends who were supposedly cured of their stage IV cancer after taking them. My patient shared that multiple members of his church had “come back” from their cancer after trying such alternative treatments. He also wasn’t sure about Big Pharma and its profit-seeking motives. He felt like I was hurrying him. I read in his face a mixture of emotions: fear, confusion, resentment, suspicion.

In that moment, I felt the collision between the way I was trained — on papers, on guidelines, on expert reviews — and the social reality of practicing medicine today. Everything I knew about staging, prognosis, trials, and evidence mattered less than whether I could earn my patient’s trust enough to start treatment on time.

The new reality

I know well that patients are not monolithic. During my training at Harvard Medical School and Memorial Sloan Kettering Cancer Center, many of my patients were highly educated and well-resourced, coming to appointments armed with binders of medical articles; lists of trials pulled from ClinicalTrials.gov; and sometimes even spreadsheets of their lab values, symptoms, and vital signs over time. These patients asked hard questions, but their skepticism was directed at whether they were getting the best cutting-edge treatment. They were not challenging the very premise of FDA-approved systemic drug therapy, nor did they question the motives of their physicians or the pharmaceutical and biotech industries.

In my current practice in exurban Tennessee, I often encounter a different set of realities. Many of my patients live paycheck to paycheck, and I’m not infrequently asked to postpone a treatment date to the first of the next month, after a patient gets paid. Sometimes patients decline a referral to a specialist surgeon in Nashville because they cannot afford the gas money to make the trip. There are varying levels of health literacy and social support. At the moment, I am pondering what to do with a patient who needs a bone marrow biopsy but requested sedation due to a phobia of needles and does not have anyone to call on to serve as his designated driver home.

Through these vulnerabilities seeps misinformation. When someone in the community or an online personality promises cures that feel more natural, affordable, and empowering, it is easy to understand the appeal. By contrast, the treatments I offer — infusions, radiation, surgery — are intimidating, disruptive, and toxic. If you already feel left out of a health system that seems distant, confusing, and expensive, why not place your trust in the person on YouTube who seems to get it?

I find it fascinating that the rise of misinformation and distrust appears to have coincided with the advent of artificial intelligence tools, which are considered to be particularly potent for flattening the information divide between physician and patient. But while ChatGPT and other chatbots are empowering a certain subset of patient-customers, others are worse off today than they have ever been — mired in conspiracy theories and pure quackery, despite living within striking distance of the most sophisticated science and medicine in all of human history.

Confronting this landscape has reshaped my work as a physician. My education gave me fluency in scientific jargon — overall survival, progression-free survival — but delved less into the importance of mastering narratives, which are as much cultural as they are scientific. Recently, several colleagues and I discussed how much this wave of misinformation is contributing to burnout: The impulse for doctors is to ask, Why can’t you just trust me? While my instinct is to correct mistaken beliefs with facts, the only viable response is to lift the lid and uncover the emotions underneath. The deeper and truer task is to build trust, to acknowledge fears, and to make medicine feel like something more than an impersonal machine.

Everything I knew about staging, prognosis, trials, and evidence mattered less than whether I could earn my patient’s trust enough to start treatment on time.

For my patient with new lung cancer, we spent extra time together, which squeezed the rest of my morning schedule but was needed. We aligned on a plan — I would continue with the workup and start him on treatment. He would take ivermectin in addition to whatever regimen I recommended. I’ll note that not every contretemps can be resolved so harmoniously — and in this case, there does remain a worry of some kind of drug-drug interaction or liver toxicity. But this alignment felt like the best negotiated outcome that I could reach with him. The experience left me reflecting on how fragile these decisions can be, and how easily misinformation could have changed the outcome.

I also strongly believe in implementing systemic solutions rather than relying on physicians to shoulder the responsibility of serving as all things — physician, counselor, guide — for the patient. On my non-clinic days, I serve as a senior medical director at Thyme Care, a cancer navigation company. We staff teams of nurses, social workers, and community health workers, all organized in pods and led by a medical director, to partner with patients in navigating their diagnosis, treatment, and eventual survivorship. These teams offer what the influencers on TikTok often promise but cannot truly deliver: time, continuity, compassion, and practical help. In an era where misinformation thrives on isolation and mistrust, this kind of true partnership can make patients feel less adrift and more in control of their decisions.

This is the practice of oncology in 2025: evidence and empathy, urgency and uncertainty, trial data and TikTok. The questions patients ask me about vitamin infusions and raw food diets are, at their core, about trust. My job is not only to treat their cancer but also to answer those questions in a way that they realize that decisions are mutual and respectful and that the power and potential of medicine are theirs to claim.

Samyukta Mullangi, MD ’15, is an oncologist at Tennessee Oncology and a senior medical director at Thyme Care, a value-based cancer care enablement company.