A case study in the kinds of problems to expect from this increasingly popular marketing tactic, On a recent Friday evening, we had the good fortune to find ourselves at a performance of Margaret Edson's Tony Award-winning play W;t (pronounced wit). play lived up to its accolades. In an Oncology Unit of an unnamed research hospital, Vivian Bearing, an academician and scholar of John Donne's poetry, has become a research subject as she lives out her final days with stage-IV ovarian cancer. We left the theater in tears, chilled by the stark depiction of metastatic cancer's pain and the ability of a clinical trial to detract from a dying woman's humanity. Thumbing through the playbill in the minutes before the play began, however, we stopped at a full-page advertisement taken out by a biotechnology company for its commercial BRCA1 and BRCA2 genetic test. Our eyes were drawn first to the head-and-shoulders photograph of a woman holding her hand across her chest, the left side of her woeful countenance in shadow. She is worried about recurrent breast if the text around her picture is any indication. Yet the proper genetic test, we also learn, could dispel her fear and provide hope. That the advertisement was placed by a for-profit biotechnology company is indicated only with a subtle reference to the company's name within its website address, printed at the bottom of the page. advertisement is problematic on three counts: it is manipulative, it is misleading, and it is misguiding. It is manipulative because it targets a vulnerable audience, there to witness Dr. Bearing's isolated and vividly painful death from cancer. With the dread of cancer hanging in the air, readers will be easily beguiled by the advertisement's prophetic headline, The only thing worse than hearing you have cancer is hearing it (with the words hearing, cancer, twice in bold and enlarged lettering). advertisement is misleading because it promotes a product with incomplete and at times incorrect information. Its central claim is the familiar mantra that knowledge is power. But information must be both accurate and pertinent to be empowering. This advertisement is not tailored, as it ought to be, to the small number of women who fall within the high-risk categories for BRCA1- or BRCA2-related cancer. Nor does it recognize that test results often lack certainty and that prevention options are of debatable utility. Nor does it appropriately qualify its claims about the availability of legal protections against health insurance discrimination for women who undergo testing. advertisement misguides women by suggesting that they contact the company directly about its BRCA1/2 genetic test rather than talk to their health care providers about genetic testing, their personal risk of breast and the potential usefulness of the test. We are entering an era in which ever more genetic tests will be integrated into clinical practice. We can expect a concomitant increase in direct-to-consumer marketing for these tests. This advertisement--one of the first, as far as we know, to directly target potential consumers of genetic testing--provides an example of how the value of genetic tests can be misrepresented. It also provides an example of what we need to be on guard against. Overstatement and Misrepresentation advertisement opens with the suggestion that women can and should want to learn about their risk for breast cancer: If you could discover your risk for a second breast cancer or for ovarian would you? Chances are, you would ... Such is the promise of [this test]. It reads your genetic code to determine whether you possess the altered ... genes that dramatically increase your risk of breast and ovarian cancer. Knowing your family history is neither enough, nor is it always accurate. [This test] is. This way of framing BRCA1/2 testing is overly broad, since it is only smaller groups of women for whom BRCA1/2 mutations may be of concern. …