By: Matthew Harper
No surprise: PBS’ “Cancer: The Emperor of All Maladies” is exactly the documentary one wishes every person who has ever been captivated by a breathless news report about cancer research would watch first. No surprise, because the book, by oncologist and researcher Siddhartha Mukherjee, was exactly the same thing in written form.
It’s a pity both are so long – the book is a doorstop, and the documentary series takes six hours to watch. But here’s a quick insight, from the first two-hour chunk that aired last night, that I wish everyone remembered every time they get news about cancer, including when they read my stories.
There have always been magic bullets. And they’ve never been quite magic enough.
That goes for aminopterin, the Lederle drug that, in the hands of the legendary Sidney Farber, produced the first remission in children with leukemia in 1947. The documentary gets across how pyrrhic that victory was by interviewing a man who, as a small boy, watched his twin brother, who’d responded to the aminopterin, carted away by men in an ambulance for the last time.
And it goes for the brilliant and terrible 1965 realization by National Cancer Institute oncologists Emil Freireich and Emil Frei that giving four toxic drugs at once was the way to treat childhood leukemia. It worked, saving at first a third of patients. The strategy was so toxic at first that Farber would never embrace it.
Built into these advances is an inevitable cycle of hope (as we first realize we’re making progress) and disappointment (as we realize that new treatments have their own costs and that none are perfect). Over time, the progress is real, and amazing: today, childhood leukemia is curable 90% of the time.
Having this simple story in the back of your mind is maybe the most useful fact you can have when looking at new advances, like Novartis ’ Gleevec, which has turned a form of adult leukemia into a chronic disease, or the drug Imbruvica, which led to a 75% reduction in mortality in patients with chronic lymphocytic leukemia; its maker was recently bought by AbbVie ABBV +0.52% in a $21 billion deal.
And it is eerie to think about the similarities between what happened with childhood leukemia in the 60s and what is happening now: a new treatment for the 10% of kids who fail combination chemotherapy involves taking out their white blood cells, genetically modifying them, and re-injecting them so they bloom and kill off the cancer cells. Results so far are amazing, and companies including Novartis, Juno Therapeutics, and Kite Pharma are all talking about moving beyond blood cancer to solid tumors like breast and lung cancer. Will this turn out to be as difficult as it has been with Freireich and Frei’s insight about chemotherapy? Will it take forty years?
“To imagine that we will find a simple solution to this, I think, doesn’t do service to the true complexity of the problem,” Mukherjee says in the documentary. “Cancer is part of our genetic inheritance. We will always have cancer amidst us, within us, amongst us.”
There are four more hours of cancer film to go, airing tonight and tomorrow night.
Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.