A Modest Wish

Oncologists have many wishes. Their pockets are crammed with them. They lie awake in the early morning, while trees outside their window slowly shed gray shadows left behind by the fleeing night, wondering who among the many people walking the earth today will not live to see twilight return, and they quietly make wishes.

An old cliché states that doctors don't really want cancer to be cured, because then they would be out of a job. As for me, nothing could be farther from the truth. Every day I pray for someone to unlock the crucial secret of the aberrant cell's immortality, so that it can be exploited to the detriment of its unnatural reign over us. Who among us would not be thrilled to live long enough to see the end of cancer? I can't think of a happier way to become unemployed.

Oncologists wish for cancer to be cured, but realize the final victory is still a distant parade, too far off to hear even the loudest cheers. We therefore dream of quieter triumphs, of advances in prevention and treatment that will make a difference in the lives of patients now, or if not now soon, or if not soon hopefully before we hold our stethoscope for the last time. The promise of new therapies that are less distressful and have fewer side effects has led me to a new wish, a modest wish, but one that I believe is worth sharing:

I hope for the day when cancer patients say to their doctor, "I'm not worried. I have friends and relatives who have taken treatment and they all told me it isn't that bad - not like in the old days like, say 2006."

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Being selfish, I pray for my personal cure. Personally, I do pretty well under the chemo and Neulasta except for the bone numbing fatigue.

Doc, a great essay, as usual.

As the PhD counterpart to my oncologist wife, I, too, would like nothing more than to hang up my pipets when cancers are cured and spend my time working on other challenges like diabetes, obesity, and infectious diseases.

A common misconception is that there will be a single cure for all cancers when, in fact, multiple molecular defects often exist among even a single type of cancer. We're getting smarter, with expression profiling and such, of knowing which cancer subtype will respond to which treatment. Give the treatment to the patient whose cancer will respond, and not to those who will simply just have side effects. We are slowly moving in that direction.

The other big challenge is that few folks realize just how similar cancer cells are to normal cells. Of the 25,000 or so proteins in a human cell, only about 30 to 200 are abnormally regulated (or their genes mutated/deleted) in cancer. A lot of those abnormal proteins talk to normal proteins and the majority of the drugs we have today have a very low therapeutic index, that is, a low ability to distinguish between cancer cells and normal cells.

But, it is also amazing to me just how many cancer survivors there are, living with their disease like a chronic illness, such as hypertension. However, I still see and hear of very young people losing the battle to cancer and there remain some cancers where we have completely failed patients and have made very little inroads.

"I can't think of a happier way to become unemployed."

When that day comes, PharmGirl and I will be high-fiving you on the unemployment line.

"I hope for the day when cancer patients say to their doctor, 'I'm not worried. I have friends and relatives who have taken treatment and they all told me it isn't that bad.'"

Wishes can come true, Doc. I and several of my advanced breast cancer friends have uttered those very words, many times. As long as I'm uttering, I'm living.

Think about this argument for a minute please. "If there was a cure for cancer oncologist would be out of a job". Not likely, it means that they would have something to cure your cancer with. I could go to my doctor and not make him feel guilty because he has to poison me or give me the bad news. People who don't think doctors want a cure for cancer are cynical and uninformed.