Tag Archives: cancer prevention

Grateful non-patients

One of the great privileges of my job is talking to grateful patients and their families. It is hard to imagine anything more rewarding than hearing a heart-felt thank you from a patient impacted by cancer who has returned to a healthy, happy and productive life due to progress made possible by the research being conducted at Holden and delivery of state-of-the-art cancer care. Such conversations help many of us keep going despite the many challenges we face working in such a difficult field. In addition, support from grateful patients and their families provides us with philanthropic resources that are vital to accelerating progress in areas as diverse as pilot research projects, recruitment of new faculty, education for oncology nurses and patient amenities. Such grateful patients are vital partners in our efforts to reduce the burden of cancer even further.

Well, on second thought, I said “it is hard to imagine anything more rewarding,” when in truth I can imagine something more rewarding. That would be knowing that our efforts had prevented cancer from occurring in the first place. Solid research indicates reducing use of tobacco, encouraging healthy diet and exercise, increasing rates of HPV vaccination, limiting both natural and artificial exposure to harmful UV rays, testing and mitigating radon exposure and helping patients obtain screening for both pre-cancerous lesions and early cancers all contribute to reducing the burden of cancer by preventing it from occurring in the first place.

Cancer prevention and cancer therapy are alike in that we have considerable progress in both areas, yet there is much more we need to do. However, cancer prevention and cancer therapy are very different in that cancer prevention is unlikely to lead to grateful patients saying thank you. Individuals whose cervical cancer was prevented by the HPV vaccine or lung cancer avoided because they paid attention to anti-smoking messages they heard as teenagers are not cancer patients and go about their lives without ever knowing the impact cancer prevention efforts had on their lives. You and I, as well as our loved ones, may well have benefited from such cancer prevention efforts.

So, next time you think about our past, current and future efforts to reduce the burden of cancer, think about the vital role cancer prevention plays in that effort. If you see a scientist, physician or public health worker dedicated to cancer prevention, give them a big thank you. You never know whether you owe them a huge debt of gratitude. Those of us who are fortunate enough to not have been diagnosed with cancer should consider ourselves “grateful non-patients” who, due to cancer prevention efforts, did not develop cancer in the first place. Finally, support for ongoing cancer prevention efforts from both grateful patients and grateful non-patients is needed to assure we succeed in tipping the balance towards more grateful non-patients in the years ahead. It truly is hard to imagine anything more rewarding than that.

The War Metaphor

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.

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Cancer medicine in 2043

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.

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Approaching cancer in 3D

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.

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Valued and different

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.

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Scuba and screening

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