I often start talks I give on cancer research with a discussion of the war on cancer. To be honest, I have a very mixed relationship with this metaphor.
The concept of the war on cancer was first popularized in 1971 by President Richard Nixon and used in a more nuanced manner more recently by Vice President Biden. This metaphor emphasizes how working together against a formidable foe will improve our lives and those of future generations. It speaks to the need for immense dedication, focus, sacrifice and persistence to achieve a noble goal. The war on cancer implies a need for teamwork by multiple sectors of society, including civilly minded citizens, government, academia and the private sector. It also implies there is an identifiable enemy, and that total victory is possible. This last point is where the metaphor of the war on cancer starts to break down. In 1971 our knowledge of cancer was quite primitive. We thought of cancer as a single disease where a single approach to victory was possible. We now know that cancer is not a single disease but multiple diseases. Indeed, every cancer is unique and personalized approaches are required for success. In other words, in the war on cancer, there is no single and simple way to target and defeat the enemy.
Last month I gave a presentation on cancer medicine and cancer research to a sophisticated group of non-scientists and was asked to predict what cancer medicine would look like in 25 years. This made me think back on a talk I gave in the late 1990s on that very topic. Thankfully, I no longer have the slides I used for that talk! I do recall a couple of items that were a focus of that presentation – one where I missed the mark and another where I was more on target.
Cancer, as in many complex problems, can best be approached by looking at it from every angle, i.e. in three dimensions. We do this literally through reconstructing images such as CT scans, confocal microscope pictures or computerized molecular modeling. We also do this figuratively through the 3Ds of discovery, development and dissemination.
My three offspring have each chosen their own path in life.
Aaron, my older son, is a stage actor. Miriam, my daughter, is in her last year of medical school here at the University of Iowa. Nathan, my younger son, is a wild land fire fighter working on a helicopter fire attack crew in Idaho.***
My wife and I continue to do our best to support each of our children as they find their own path. This includes providing guidance and support for the day-to-day challenges and decisions they face, as well as helping them think about the long-term and how they can best reach the goals they have set for themselves.
Every day, we each make choices. Some choices are pretty obvious and require little discussion or thought; for others, individual preference plays a major role with different people making different choices based on different perspectives.
A personal example involves a trip my wife and I plan to take to a warm, seaside location in January. One choice is whether we will use sunscreen. This is a “no-brainer.” Another choice is whether we should go scuba diving. I love scuba diving and jump at every chance I get to spend time swimming with the colorful fish of the underwater world. My wife makes a very different calculation. Factors that impact on her decision include being in cold water, breathing through a small rubber tube, and the thought of being in the water with potentially nasty creatures. When it comes to sunscreen – the choice is obvious. When it comes to scuba diving, we each made our own calculation based on our own perspective. Continue reading →