We live in what is called the Information Age - a time when human beings have unprecedented access to knowledge and data, thanks to the revolutionary advances in information technology. Yet, as in the mythological tale of the cosmic ocean's churning, the quest yields amruth, the elixir of immortality, and also kalakooda, the deadly poison. The same deluge that brings waves of knowledge also unleashes torrents of misinformation and outright falsehoods. Alongside the extraordinary benefits of this knowledge explosion, humanity now faces the grave threat of being engulfed by dangerous, pervasive misinformation.

Dr M. V. Pillai, the globally known Malayali oncologist, made a startling revelation some time ago in a public address. He said that more than half of the 10 prominent Keralites he knew personally and who had been diagnosed with cancer had almost given up conventional treatments to opt for scientifically unproven “alternative” medicines and methods. Dr Pillai’s revelation had come well before a controversy in February 2023, when some relatives of the former Chief Minister, Oommen Chandy, approached Chief Minister Pinarayi Vijayan urging him to ensure the Congress leader received the best possible medical care. They alleged that the Congress veteran was being subjected to faith healing for his throat cancer. However, this was swiftly and strongly denied by Chandy himself and his son, Chandy Oommen, who maintained he was under the care of top oncologists. Chandy passed away in June that year.

Even if we take the departed leader’s and his son’s statement at face value, one undeniable reality remains: there is a sharp rise in the number of people around us turning to unproven “natural treatments,” miracle cures, and exotic diets to manage serious illnesses. If this trend is gaining ground even among the elite in Kerala—a state celebrated for its high literacy and health awareness - what might be the situation elsewhere? Or could it be that Kerala’s very literacy and high media penetration are partly to blame, making its people more susceptible to the overwhelming flood of information unleashed by social media, where misinformation and falsehoods abound?

Recall the panic some time ago created by anti-vaccine campaigners on social media fuming against pentavalent vaccines being given to children, saying it would make them autistic! Videos of this campaign during the outbreak of Nipah and the coronavirus also went viral in the state, culminating even in the arrest of one of them for offering fake treatment for COVID. Highly risky “home births” are on the rise in certain parts of Kerala among even educated persons, fuelled by social media campaigns calling for “natural births” and against C-sections in a state credited with having 100% institutional deliveries. This April, a 35-year-old mother in Malappuram died due to severe post-partum haemorrhage after giving birth to her fifth baby at her home, ironically on the day the World Health Organisation launched a campaign against preventable maternal and newborn deaths. The woman’s husband was an active social media campaigner of faith healing and miracle treatments.

In 2017, doctors in the Kozhikode Government Medical Hospital expressed grave apprehensions about the cancerous growth of fake medical practitioners. According to them, the most affected are child patients whose parents drop modern medicines in favour of herbal medicines after their initial treatment and in the process endanger their children’s lives, even when the survival rate rose from 20% in the 1960s to 90% now. However, the number of child patients has been rising, with at least one new case seeking treatment every week. The doctors revealed that a six-year-old girl had died after moving out of the hospital in the final stage of treatment under pressure from agents of proponents of “alternative treatments”.

Not just Kerala or India but even the developed world is also badly affected by the spread of misinformation and quackery through social media. This June, the world's largest cancer conference in Chicago, the annual meeting of the American Society of Clinical Oncology (ASCO), said that cancer misinformation had “acutely worsened in the past decade”. The UK newspaper, The Guardian, reported that, according to doctors at the ASCO conference, cancer patients were “snubbing proven treatments in favour of quackery such as coffee enemas and raw juice diets, and some were dying needlessly or seeing tumours spread as a result”. They pointed out that with more people being diagnosed amid a growing and ageing global population, misleading false information about cancer has become a significant public health concern.

Some doctors at the conference pointed out that with the preponderance of social media, doctors are losing out in the field of communication. There are also contradictory views among the doctors, which make people lose trust in them. “We are losing the battle for communication. We need to regain the battlefield”, said one doctor. A breast surgeon said, “Every day I get messages from scared women who want to know if they need to stop eating dairy, soy, or flaxseeds. Do they need to stop wearing underwired bras, or using deodorants? Is it true that juicing can cure cancer? What about miracle supplement cures like mushrooms and CBD?” According to her, doctors should engage more with patients online. “But we can’t say anything sexy or exciting - we can’t promise a cure. The drugs we give have side effects, and some people still die”.

Exploitative and unethical practices and profiteering by the big pharma companies, private mega hospitals, coupled with the exorbitant rise in the expenditure for cancer care, etc., are also driving desperate patients to unproven methods. The 2013 Supreme Court's landmark judgement in the case of Novartis vs. Union of India over the cancer drug, Glivec, dismissed Novartis’s patent claim, enabled generic production and made the drug more affordable. According to the 75th round of the National Sample Survey (NSS) Social Economic Survey (2017-18), the average cancer treatment cost in private hospitals was ₹41,000 compared to ₹18,000 in government hospitals. As many as 50% of cancer patients in India suffer financial difficulties, as one-third of households with a cancer patient spend over half of their annual expenditure on the person’s treatment. In 2021, Lancet Oncology pointed to financial toxicity in cancer care in India, which leads to an exodus from evidence-based care.

A recent poll by Macmillan found that 59% of the population in the UK -over 30 million people- believe myths or misconceptions about cancer. A study by Italy’s University of Bologna found that 90% of cancer-related videos on YouTube and TikTok contain incorrect information. A report says that experts say patients were being “sucked in by social media influencers’ claims that low-carb diets can battle cancer, recommendations for unproven drugs, and a belief that deodorants, mobile phones or even negative thoughts can cause a relapse. A research published by JMIR Infodemiology identified 310 paid advertisements from 11 alternative cancer clinics on Meta (Facebook, Instagram or Messenger) marketing alternative or “natural” treatment approaches, care and interventions. The study has also recommended that Meta should introduce a mandatory, human-led authorisation process that is not reliant upon artificial intelligence for medical-related advertisers before giving advertising permissions. It calls for further research to focus on the conflict of interest between social media platforms and public health.

Though it is primarily to be blamed for the present deluge of misinformation, social media is here to stay and grow in its influence. Notwithstanding the flip sides, the enormous opportunities it provides to improve our lives are unprecedented. The job is to take the amruth and dump the Kalakooda by making the best use of social media to deliver positive results. Unquestionably, social media has emerged as the most powerful tool in promoting and educating about health. A recent study in the USA says that although there was a global decline in early cancer screenings since COVID-19, social media trends have significantly promoted screenings among young adults who are increasingly being diagnosed with the ailment in recent times. A JMIR Cancer study found that positive psychology interventions delivered via social media were were well-received among young adults who also use it to connect with cancer peers for support.