The New York Times recently published a fascinating and mainly hopeful guest essay by Kate Pickert dubbed “Is a Revolution in Cancer Treatment Within Reach?,” (See https://www.nytimes.com/2023/06/16/opinion/cancer-treatment-disparities.html (June 16, 2023)).  In it, Ms. Pickert describes nothing less than a paradigm shift in cancer treatment away from a long-held medical assumption “that many early-stage cancer patients could be cured, but metastatic disease was almost always incurable.”  Under an older treatment model, early-stage cancer patients were likely to be subjected to invasive surgeries or heavy doses of powerful chemotherapy drugs because, it was believed, these extreme treatments offered the best hopes for keeping cancer from spreading.

Today, however, many of cancer’s victims enjoy additional months, indeed years, of life, all thanks to the emergence of new classes of drugs. Modern immunotherapy drugs and antibody-drug conjugates (ADCs) are replacing traditional chemotherapy and radiation-based treatments as the standard of care. As the name implies, immunotherapy drugs exploit the patient’s own immune system to beat cancer.  Antibody-drug conjugates provide a therapy that combines antibodies that target cancer cells with strong chemotherapy drugs.

Today, according to Ms. Pickert, some cancer patients simply switch from one medication to another if their specific treatment regime either fails to work or stops working.  She writes that for the most fortunate such patients, “cancer is more like a chronic disease than a one-time catastrophic event.”

Obviously, this is terrific news.  At the same time, she observes that, “[c]ures or long-term survival for certain types of the disease — like pancreatic cancer and glioblastoma … are still stubbornly out of reach.” (My italics.)  Further, according to Ms. Pickert, “the mortality rate [for these cancers] has barely budged in the past 30 years.”

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My old and dear friend, Bob, was a charter member of our imaginary rock group — the Frazier Thomas Band.  Indeed, we enjoy a long friendship, which goes back to our high school days.

It was maybe six or seven years ago when Bob developed an inoperable lung cancer. His situation seemed dire. Next, he was among the first lung cancer patients to receive a novel and still experimental immunotherapy regime as part of a clinical study. The treatment destroyed all traces of the tumor in his lungs, a seemingly miraculous result and one almost too good to be true.  Unfortunately, more recently my good friend has been diagnosed with glioblastoma, a deadly form of brain cancer that can occur when lung cancer metastasizes.

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As I’ve mentioned here over the years, my dear wife, Lee, suffered from numerous and serious medical issues throughout the course of her life, almost from birth. In her adult years, these issues would include several types of cancer. I suppose it’s just the hand she got dealt, yet I still marvel how Lee was able to take each development in stride and remain in good spirits nearly to the end.

Old line chemotherapy created special problems for Lee that I witnessed firsthand. For example, she was unable to metabolize certain chemo drugs. As these drugs would build up in her system, she would get so sick her doctors had to suspend her cancer treatment. This occurred one time while she was battling breast cancer. In this case she barely qualified for a clinical study involving a chemo pill that could be taken orally. We always assumed that she had been part of the group that got the actual drug, rather than a placebo, because, thankfully, she never had any recurrence of breast cancer. For the next couple of years, Lee enjoyed a basically normal, healthy life.  We collectively could exhale.

Then, a few years later, after she developed colon cancer, Lee was ineligible for prevailing standard of care treatment, which utilized the same chemo drug that made her so sick during her successful fight against breast cancer. Remarkably, the substitute chemo regime for colon cancer her doctors employed was even more harmful. This time Lee’s chemo treatment nearly killed her, and my unshakeable view is that Lee never fully recovered from this episode.  The recuperation took a full four months spanning the latter portion of one Spring and an entire Summer. Finally, just as Lee seemed to be approaching full strength once again, she was diagnosed with the deadly pancreatic cancer that took her from me in just a matter of months.

I cannot forget Lee’s desperation after her doctor finally acknowledged she had but scant weeks or months (in fact, it was mere days) left to live. Lee was not quite ready to quietly die.  With aid from two close friends, she scoured the internet for any clinical study that might provide the slightest glimmer of hope. Alas, a lifetime of serious medical problems basically had eliminated her from being considered an acceptable study candidate. I believe this is when Lee finally became resigned to impending death. I find Ms. Pickert’s report that, ”[m]ore than 800 pancreatic cancer clinical trials are now recruiting patients across the country” to be ironic, to say the least.

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Would I be wrong to begrudge those lucky patients for whom “cancer is more like a chronic disease than a one-time catastrophic event”?  Lee never had access to the varied array of treatment options that cancer patients seem to enjoy nowadays; she was afforded none of the benefits. As much as I would like to think that I am a  magnanimous fellow, I wonder how strong my jealousy and resentment would be if these promising new therapies were currently available to the victims of pancreatic cancer.