The following transcript is computer generated

Mike Dilke: Hi, I’m Mike Dilke and you’re listening to the Relax Back UK show, the show that explores all kinds of health topics relevant to you, your family, and your friends. Each week, I talk to expert guests from a range of backgrounds to inform and entertain you. So please do join the Relax Back UK family and stay tuned.
Thank you for joining me on this week’s Relax Back UK show. The topic this week is all about diet and health misinformation, particularly when it relates to cancer advice and being online.
Alex Ruani: We tend to assign more credibility when we see something that has millions of reactions. That engagement does not mean evidence. It doesn’t mean that something is evidence-based. And that’s a fine line for the brain to distinguish.
Mike Dilke: I speak with Alex Ruani from University College London and we cover how misinformation spreads, why it spreads so fast, and how to protect yourself from it. So please do join me for a great show. Thank you.
I spoke to Alex Ruani about health misinformation, in particular about cancer misinformation online. I started by asking her where she is doing her research.
Alex Ruani: Oh yes, well I’ve been at UCL for nearly a decade now, looking at misinformation—how it originates and how it spreads. More recently I’ve been looking into the risk. What could go wrong when we fall for something that may not be accurate or is misleading? None of us like to be duped or exploited, so how can we build those cognitive defenses to protect ourselves from misleadingness?
Mike Dilke: There’s an awful lot to chat about. But what I’m hoping is that we can home in a little bit on some of the things that you see online about cancer and the people that might be spreading this stuff. There are an awful lot of people spreading information which is incorrect, slightly wrong, or sometimes just downright dangerous. The numbers appear to be huge. If you spend any time looking online, you see lots of people doing this.
Alex Ruani: Absolutely. The prevalence of online misinformation in relation to cancer will potentially vary depending on the platform you’re looking at, the circles, and the influencers talking about it. It’s such a personal topic. My mom is a cancer survivor. She had two very large tumors in her colon, one the size of an orange and the other the size of a grapefruit. The amount of information that was sent to her from other cancer patients in the groups that she was taking part in was enormous, because everybody wants to help. It doesn’t usually come from a place of malice. She would then send these claims to me and I would say, “Mommy, if you follow this, it will make things a lot worse. Please be safe.” At one point she started just to send everything to me so I could help alert others in her group about some of the things being said.
You may have seen some of the research recently conducted by the World Cancer Research Fund on misinformation. What we’re seeing now is extremely concerning because this information that we find online is now spilling over offline. Nearly half of frontline NHS staff see inaccurate or misleading information about nutrition or supplements being raised at least once a week. If you look at midwives or nurses, that number goes up to above 50%.
Mike Dilke: These numbers are enormous. Let’s look at the source of some of this stuff. It’s picked up online from various people that like to post information. Why would people post this stuff? Are these people just trying to peddle bizarre ideas to get hits and followers on social media so they can make money?
Alex Ruani: There is the influencer economy. Some of the most pervasive harmful misinformation in relation to cancer cures and prevention does come from these disproportionately amplified accounts. Some of them have a very high anti-medicine sentiment, operating in a way that confirms our fears. They are very welcoming and you build a parasocial relationship with them. But it’s not just these influencers to blame. If you look at their history, maybe when they started out, they were not as extreme or as controversial as we see now. They are learning how to play the algorithm. The algorithm rewards content that is emotionally charged, extreme, and agitates or makes you feel rage against the system or doctors.
I’m not saying that the NHS or healthcare in general is perfect, but that is exploited as part of the narrative. The algorithm picks that up and somebody who maybe had a few thousand followers can have millions a year later. However, when you look at the super-spreaders of misinformation, they tend to be a very small number of accounts. These loud, agitated voices rarely represent the silent majority. Most of us are doubtful or don’t fall for those things. Is it the algorithm to blame, the influencer, or both?
Mike Dilke: Do these people have no morals? Do they just want to make money and don’t care if people take their advice and die? Or do they really think they’re right? What’s going on here?
Alex Ruani: That’s a good question. Some of these influencers may have started from a very genuine place, truly believing that what they were doing was good. But as the incentives keep coming and they sell more products, some of them may have realized they crossed an ethical line. Not everyone is aware they are crossing that line. The commercial incentives and the revenue being generated can put ethics on the side. Others may be completely unethical from the get-go. Usually, many of them believe what they are saying, or they may have said it so many times that they start believing themselves.
These are still a minority of individuals and accounts that are disproportionately amplified. They should not be amplified in the first place. In the olden days, if somebody had a fringe view, they would go to Speaker’s Corner in Hyde Park and give a rant for a few minutes.
Mike Dilke: You can still do that actually. I might go there this afternoon.
Alex Ruani: Exactly. Now they take a lot of space in our social media feeds. Our brain cannot discern between actual consensus versus likes, shares, and views. We tend to assign more credibility when we see something that has millions of reactions. That engagement does not mean something is evidence-based. That’s a fine line for the brain to distinguish.
Mike Dilke: There are rules to stop people inciting hatred because that can lead to real problems in society. This stuff can lead to even greater problems. Where does this stand legally? Surely something needs to be done to stop this? Whose responsibility is it?
Alex Ruani: Legally speaking, right now we have Ofcom in the UK. Ofcom began regulating online spaces in 2023. They ask social media platforms, search engines, and AI chatbots to provide risk assessments. These companies, like TikTok and Instagram, have their own policies. Because of the freedom of expression, the government cannot censor speech or moderate content, but they can ask platforms to follow their own policies. However, these policies are not always followed. For example, TikTok has policies against food crime, yet you can still find posts selling the “Miracle Mineral Solution,” which is a bleach-based mixture that claims to cure cancer. I went in yesterday and those posts are still there with people asking for the dose and where to order it. Platforms are regulated, but the compliance under the Online Safety Act is not 100% there yet.
Ofcom can regulate how platforms assess and mitigate systemic risks, such as algorithmic risks and recommendations. Hopefully, we can tackle the harmful misinformation problem. I’m somebody who cares about the harm. If I follow a recommendation like taking colloidal silver drops or Miracle Mineral Solution to cure cancer, what’s the harm? Ingesting bleach is harmful. That’s where I mostly focus.
Mike Dilke: We will come on to more of that, but for now, we should park the topic of control versus freedom of speech. Let’s move on to the demand for this stuff. There is a massive market for weird and wonderful cures. Why is that happening and is it getting worse? Is it worse in places like the USA where many people are uninsured?
Alex Ruani: The prevalence of misinformation varies across countries. At the moment, over 80% of online misinformation is on social media platforms globally. The detox market is valued at around $76 billion globally.
Mike Dilke: I’ve got some detox in my own body for free; I’ve got a couple of kidneys.
Alex Ruani: I know. Detox teas and “deworming” involve consuming dangerous substances that allegedly cleanse the body from parasites. If you actually had parasites in your body, you would be in the hospital. The body is good at dealing with these things, and parasite infections are serious. The supplements market was valued at over $500 billion last year. These are products like lollipops, gummies, powders, and tablets.
Mike Dilke: If you take a tube ride in London, it’s not uncommon for three out of five adverts in a section to be for supplements.
Alex Ruani: We’re bombarded by supplement information. That $500 billion is for the regulated market, but you also have the dark supplement market where you are sold things like colloidal silver drops. There was a case of a man hospitalized with metal layering in his colon from consuming those. These are not innocent remedies; they can do more harm than the thing you were trying to address. The dark market for supplements is very scary because it is difficult for consumers to navigate.
Mike Dilke: Is the demand growing because we’re getting more health-conscious or because people don’t necessarily trust their doctor or the NHS anymore?
Alex Ruani: There are lots of explanations. Since the pandemic, we are more health-conscious and more people have turned to supplements and detoxes. Many people are seeking alternative solutions. Becoming a medical doctor involves over a decade of very intensive training. Although the education in the UK is good, it doesn’t necessarily focus on nutrition and lifestyle as much as we would like.
There is also research on “medical silencing” or “medical gaslighting.” In the past, we would not always trust the patient’s experiences or believe they were reliable narrators of their own pain. When concerns are silenced or explained as being “just in the head,” trust is eroded. If you’re disappointed with a doctor, get a second opinion. Influencers come in because they are excellent communicators. Your doctor only has 10 minutes, versus a two-hour podcast where you can connect with everything being said.
Mike Dilke: What does this actually mean for NHS staff on the frontline?
Alex Ruani: Data from the World Cancer Research Fund shows that half of frontline NHS staff face misleading nutrition and supplement misinformation on a weekly basis. Even more shocking is that 40% of frontline staff said they are not confident that the advice they see online is correct. They don’t know how to navigate that or where to find evidence-based advice. That is very concerning. It’s about helping healthcare professionals learn how to navigate the information environment so they can help their patients.
Mike Dilke: Can’t they just tell them to look at the NHS website?
Alex Ruani: CHARISMATIC influencers are often more exciting than the NHS website. Evidence-based communication is not always as emotionally connecting. Medical professionals need to become really good communicators of sound evidence to help their audiences navigate information and discern what is harmful.
Mike Dilke: If someone has cancer and is undergoing treatment, can they follow advice from influencers at the same time?
Alex Ruani: That’s a “yes and no” answer. Being diagnosed with cancer is daunting and scary. Just having facts about the treatment doesn’t always feel comforting enough. It is very common to look for people who went through the same experience to find hope. The sad part is that some people lie, like the Australian influencer Belle Gibson who faked her cancer and built a successful app.
Mike Dilke: Do you think she helped people in spite of being untruthful, or did she speed people to their deaths?
Alex Ruani: She was trying to peddle products and accumulated a lot of cash, which was unethical. She claimed that plant-based eating, supplements, and coffee enemas helped her, but it was all fake. A cancer is considered curable when there is an 80% or higher chance of survival with evidence-based treatment. Researchers looked at one million cancer patients and found that the risk of dying doubled for those who abandoned evidence-based treatment in favor of alternative therapies like herbal supplements and alkaline eating.
Alternatives can reduce your chances of survival. It’s about informed decisions. You should know the statistics: if you undergo treatment you have an 80% chance of surviving, but if you do an alternative method, your chances of dying may double.
Mike Dilke: It’s not ethical to do the third test, which is “do nothing.”
Alex Ruani: Chemotherapy is toxic and enduring it is challenging and painful. But at the end of the tunnel, the cancer may be gone. If the odds are against you, first get all the science-based advice you can from the NHS, and then support that with complementary approaches to support your body’s defenses.
Mike Dilke: There was a press release with advice on looking at information using the acronym TRUST. Are you familiar with that?
Alex Ruani: Yes, I helped refine it with the team at the World Cancer Research Fund. We wanted to come up with something that didn’t tell the audience what to believe, but encouraged them to feel more confident in their ability to discern what could be harmful. The TRUST test is a way to filter claims:
• T: Too good to be true? Does it promise unrealistic results or quick fixes?
• R: Research Fact? Does it trace back to scientific evidence rather than personal stories?
• U: Understood? Has the person explained the dangers and risks, or were harms downplayed?
• S: Source Quality? Does it come from a trusted organization or scientific source? What do other experts say?
• T: Think before you share. If you don’t trust it, don’t pass it on.
This is about empowering everyone listening to discern what could be harmful.
Mike Dilke: That’s a good list, because we are bombarded with this stuff. If people have cancer and do related searches, the algorithms will just gang up on them. Finally, what are some good, trustworthy sources of information?
Alex Ruani: The World Cancer Research Fund has worked with dietitians, doctors, and researchers to develop accessible and fun resources. Their website, wcrf.org, has recipes and information on lifestyle factors like diet, smoking, and alcohol. They have a database of 12,000 scientific papers and their research shows that 40% of all cancers are preventable through lifestyle and diet. They are not denying the role of nutrition; they are integrating lifestyle medicine into cancer prevention and treatment.
Mike Dilke: Alex, thank you so much for taking the time to chat.
Alex Ruani: My pleasure, Mike. Thank you so much.
Mike Dilke: Thank you very much to my guest this week, Alex Ruani from UCL. We were talking about cancer misinformation. Thank you for listening and have a healthy week until next week.
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3. Summary
In this episode of the Relaxback UK show, host Mike Dilke sits down with Alex Ruani from University College London (UCL) to discuss the dangerous rise of health and diet misinformation online, specifically concerning cancer advice. Ruani, a researcher at UCL and a collaborator with the World Cancer Research Fund, highlights how misinformation is no longer just an online nuisance; it is actively spilling over into clinical settings, with nearly half of frontline NHS staff encountering misleading patient information on a weekly basis.
The conversation explores the “influencer economy,” where social media algorithms reward emotionally charged, extreme content rather than evidence-based facts. This creates a “parasocial relationship” where vulnerable patients trust charismatic influencers over medical professionals. Ruani notes that while many influencers may start with genuine intentions, they often drift toward unethical practices or become victims of their own echo chambers. The financial stakes are massive, with the global “detox” market worth $76 billion and the supplement industry exceeding $500 billion annually.
A primary concern is the “dark market” for alternative cures. Ruani references the tragic trend of patients abandoning conventional treatments for unproven methods like “Miracle Mineral Solution” (a bleach-based product) or alkaline diets. Research indicates that patients opting for alternative therapies over evidence-based medicine double their risk of death. The lack of nutritional and communication training for doctors often drives patients toward influencers who have the time to connect with them emotionally, even if their advice is harmful.
To combat this, Ruani introduces the TRUST test:
• T: Is it Too good to be true?
• R: Is it based on Research facts?
• U: Are the risks Understood?
• S: Is the Source quality high?
• T: Think before you share.
The show concludes by recommending wcrf.org as a reliable source for science-based lifestyle and cancer prevention advice.