I made this post a few years ago, and I’m updating it now because my family back home in the Seattle-Tacoma area has a tradition: every year they join the Relay for Life to raise money for cancer research, in honor of my sister-in-law, Karen Myers, who died of melanoma. That’s my family listed there, doing good. If anyone wants to chip in to help out, that would be nice — I’m planning to donate to my mother’s page, since I like her best, but they’re all nice people and it’s a great cause. Or if you’d prefer to donate to the one who’ll probably expend the most energy running around the track, Alex Hahn is the littlest ball of fire.
This is my sister-in-law, Karen Myers — mother to 3, shy but always cheerful, and with a wonderful laugh that you were sure to hear any time you were with her. You would have liked her if you’d known her…unfortunately, she was slowly eaten alive by an implacable melanoma several years ago. It doesn’t matter what kind of person you are; lots of good people — and you probably have known some yourself — are killed by cancer every year.
About 20 years ago, I was funded by a cancer training grant which required me to experience a fair amount of clinical training in oncology. It is not one of my happiest memories. What I saw were lots of dying people, in pain, with treatments that caused more pain — or were palliative because the patient was expected to die. Pediatric oncology was the worst, because they were dying children. I’m afraid my training convinced me to run screaming from anything clinical.
So last week, I met Beth Villavicencio, who told me she was a pediatric oncologist. The first words out of my mouth were something like, “That’s funny — you don’t look depressed or suicidal.” And she wasn’t. She looked awfully happy for someone who works with critically ill kids … so she turned me around 180°. She wasn’t miserable, because people bring dying kids to her and she saves them — she has a job where she is literally taking people who would be dying otherwise and she makes them healthy again with excellent success rates, which sounds like something that would make anyone cheerful.
How does she do that? With science. She sent me a whole stack of references on the amazing progress that has been made over the last several decades, thanks to clinical trials and evidence based medicine. Here’s one picture that says it all.
Those are survivorship curves for acute lymphoblastic leukemia. When the lines are plunging downwards, that means kids are dying like flies; when the lines flatten out horizontally, that means no kids are dying. Each line has a date for when the survival was measured. Look at the mid-1960s, the yellow line: 90% of the kids diagnosed with ALL would die within five years. But then look at the other curves — in the 1970s, 64% would die; in the early 80s, about half; in the late 80s, about 30%; in the 90s, about 20%; and now, about 10%. What’s going on?
We haven’t been evolving ALL-resistant kids. The medicine has been getting better. Every percentage point that those lines are pushed upwards is the outcome of hard work and clinical testing of new drugs and protocols and therapies and diagnostic tools. That’s impressive. This is how we progress.
You will sometimes hear people claim that the answer is found in the natural healing power of the body, and that doctors don’t really do anything but let nature do all the work (or worse, that treatments for cancer poison people and hinder nature’s healing power). They may also say that children are just especially tough and healthy, so pediatric cancers are relatively easy…but look at the data. When doctors don’t have effective treatments and don’t intervene, we get those yellow lines from the 1960s. We get 90%+ survival when doctors can exercise their hard-earned knowledge.
You want happy stories? Read this account of one of Beth’s patients.
It’s not just children’s cancers, either. If we want to cure adult cancers, like the melanoma that killed Karen, don’t look to magic, or wishful thinking, or ancient shamanistic wisdom, or prayer — we’ve had those for millennia, and they do nothing. What we need is more research, more doctors, more clinical trials, and more money. Unfortunately, this is what the money looks like.
It’s been drying up. Researchers are spending more time struggling to get basic funding and less time doing the work that saves lives, and more often than not, they aren’t getting funded. Often, too, the researchers who are getting screwed are the new researchers, the ones who don’t have established labs right now, which means we are short-sightedly demolishing our future research infrastructure. Good luck with that, America!
So what can we do?
We must push our politicians to invest in science, and to do so sensibly. It seems that the news nowadays is full of politicians wasting their efforts on naturopathy, homeopathy, “alternative” medicine, creationism, and other pointless exercises in pandering to useless ideological feel-good nonsense. Don’t put up with it! This is your life and health on the line, and the life and health of people you love — why are they frittering away your future on quackery? Apply the electoral pressure.
Ideally, we’d have strong, well-funded federal agencies managing the money; think of places like NIH and NSF as repositories of informed experts who disburse money rationally (usually) to address specific, important questions by qualified scientists. The first priority should be to bolster these institutions.
Alternatively, we can recruit more private donations. This has the danger that the money is more likely to go to politically prominent causes (although, to be realistic, NIH and NSF do the same thing), but in these lean times it’s what research needs. Think of it as like insurance — no, it’s better than insurance. You could sock away money and have a million dollars on hand when a catastrophic illness strikes, but it will do you no good if the doctors don’t have the tools to treat you at any cost; invest now to make it more likely that effective treatments will be available when you need them.
Donate to the American Cancer Society. One common event is the Relay for Life, a way for people to get together as a community and raise money for cancer research. Look for Relay events locally — they’re all across the country — organize one yourself, or you can donate to my family’s cause, the Relay for Life for Karen Myers, which is organized by her daughter, Rachael.
Get out there and support something that works!