A Most Thoughtful Essay
Occasionally I come across something (thank you, Barbara) which is more than thoughtful and well-written, something that shares a different kind of possible understanding about cancer and cancer treatment. This essay from The New York Times is one of those rarities.
I found it especially insightful and remarkable as it addresses some of the usually unspoken realities of clinical trials. It takes a much broader perspective than that taken by the FDA or most of the rest of us. Instead, it addresses healing and wisdom and compassion and hope.
Here is the start and a link to read more. Please take a few minutes to read it. And then save it so you can read it again.
A Failure to Heal
By SIDDHARTHA MUKHERJEE
What happens when a clinical trial fails? This year, the Food and Drug Administration approved some 40 new medicines to treat human illnesses, including 13 for cancer, three for heart and blood diseases and one for Parkinson’s. We can argue about which of these drugs represent transformative advances (a new medicine for breast cancer, tested on women with relapsed or refractory disease, increased survival by just a few months; a drug for a type of leukemia had a more lasting impact), but we know, roughly, the chain of events that unfolds when a trial is positive. The drug is approved for human use; “post approval marketing” is deployed to commercialize the treatments; slick ads materialize on TV; fortunes are built. Yet the vastly more common experience in the life of a clinical scientist is failure: A pivotal trial does not meet its expected outcome. What happens then?
A few years ago, I was a lead investigator in a study for a drug for blood cancer. Let’s call the medicine O. The compound, designed to kill leukemia cells, had shown efficacy on cancer cells in Petri dishes. The trial was backed by a small company with just a handful of employees, many of whom had invested their lives, and their life savings, in the company.
The first patient to enroll was a 60-something woman whom my colleagues and I had been treating with other medicines. Unfortunately, all the other drugs had stopped working. Her illness caused her bone marrow — the body’s nursery for the genesis of blood cells — to malfunction, and so her blood counts would collapse every two weeks. She would be back at the hospital, awaiting a blood transfusion. The repeated transfusions, in turn, provoked immune responses, making it hard to find amatch for her. She would wait for hours, or even days, before we could find a subtype of blood that would not be rejected by her