Why cancer is way harder than a “moon shot”.
Cancer changes a person’s life in profound ways. It changes their families’ lives in equal measure. I felt this change over the course of four years when my younger sister — a wildly talented, incredibly intelligent, and loving mother — was diagnosed with pancreatic neuroendocrine carcinoma. I felt it again when my father underwent an “awake” craniotomy for unknown type of brain tumor (which resulted in a metastatic melanoma diagnosis) and follow up radiostatic surgery treatment and genetic testing.
I felt it again when, this year, I was diagnosed with an early form of breast cancer.
Biology is messy.
Physics and math, the laws of thermodynamics and differential calculus, are a bit more straightforward. Caveat: Watching a brilliant mathematician or physicist explain their favorite theorems or principles on a [chalk/white] board is a bit messy.
But the foundation principles governing these areas, and the predictability of their execution in the real world, is very different from biology.
When people are on the receiving end of a cancer diagnosis, regardless of the intensity or grade of that disease, the first crippling thoughts center around shock, disbelief, treatment options for a cure, and even denial.
…her doctors didn’t seem to have a good reason to choose one treatment over another.
The journey of options is vast and overwhelming for some, but starts to become agonizing, when in 2016, we (and I do include myself in that) hear that those involved in our care sometimes don’t have good reasons to choose one treatment over another. [And, if you’re fortunate, you do have health care professionals who admit as much.]
That was the case for Dr. Shirley Pepke. She had a recurrence of her cancer, after completing a surgery and first-line standard chemotherapy treatment for ovarian cancer Stage IIIC. But for her treatment options the second time, her doctors didn’t seem to have a good reason to choose one over another.
“When women recur, they have to ultimately make a choice of what their therapy will be, and it’s really like throwing darts at a dart board,” said Pepke.
Shirley is a physicist, computational biologist, genetics and cancer researcher, so she intimately understands the power of precision medicine and its influence for treating cancer. She leveraged her smarts and her network to get to work on finding a more targeted form of therapy than the dart board approach she was being offered. Ultimately, she went against her oncologist’s recommendation of standard chemotherapy, and a year after her newly [self] prescribed treatment plan, she has no evidence of the cancer.
Shirley is one of very few people with the ability to make such options available for her care and treatment — and then see it work.
This is what is both aggravating and exciting. Learning that such a therapy exists, or was specifically designed, and worked is exciting. That you have to be a genetics-computational biologist-physicist and have the network to make it a possibility is aggravating.
I wonder if this is what it felt like before you could buy Benadryl OTC.
In the meantime, the business of understanding cancer biology and immunotherapy for cancer, depends on very messy and extremely variable processes rooted in biology and chemistry. The technological innovations (comparatively) that will and are required to better serve individual cancer patients’ needs are just easier to build and use. It’s the governing principles of biology that make finding therapies, if not cures, damn near harder than shooting, and landing, Neil and Buzz on the moon.
For those living with cancer, especially those with rare or incurable forms, personalized therapies and medicines can’t come fast enough. And, given the nature of the challenge, I believe arriving there will be an accomplishment much more significant than putting a man on the moon. Quickly following any such discoveries will be our ability and willingness (cause it will require both) to make it accessible to many.
A “moon shot” metaphor, then, feels inferior to the nature of what scientists are working on to cure cancer.
