The Secret Life of Cancer

My startling interview with a well-known molecular biologist about what cancer is, really. Click here for the full interview. An excerpt:

I’m a faithful reader of the New York Times Science Section, cover to cover, because I want to know about things, not be caught flatfooted. Somehow it seems necessary for survival to know about quarks and bosons, the social structure of ants, scientific explanations of the smile, and the sexual life of grapes. I had a fling with books explaining how to endure being stranded in snow (make an igloo) and identify edible weeds in the park. What does this say about me? I never kept any extra food in the house beyond what was fresh in the fridge until after 9/11 when I laid in some canned beets and tomato sauce and a gallon jug of water. The tomato sauce exploded and the water leaked, so clearly I am batting zero as a survivalist. Perhaps knowing things about the world lets me feel that nothing can surprise me, jump out of the dark corners beyond my peripheral vision. Illness is like that. Two months ago I saw spots and flashes in my right eye and was told I had a partially detached retina. Why? No reason. Out of the blue. Once I was allowed to read again after the repair, I read a lot about retinas. But what do we really learn about how illnesses and the body work from reading popular science? Recently, I had a long conversation with a prominent scientist at Harvard, the molecular biologist Michael R. Freeman, who explained to me what cancer was. It wasn’t anything I expected, even after years of reading science stories. It was as if he had opened a door into an alternate universe. Below is a transcript of part of our conversation…

One Response to “The Secret Life of Cancer”

  1. MF: Well, we know a lot about tumor biology now. I started graduate school in the early 1980s and there’s no comparison between now and then. We have a vast reservoir of knowledge now. We have a much greater ability to identify promising drugs than we did ten years ago. The goal I think of most cancer researchers is to get to the point where cancer becomes a chronic disease and it’s managed with medical therapy. I think that’s what people are shooting for.

    IMO, this is the most ominous –as well as the most telling– part of that conversation.
    It just isn’t in the interest of the big-pharma to prevent or cure it; that would be a lousy model of cash flow. But, once you have reduced it into a ‘chronic disease’ managed through medical therapy you’ve struck a gold mine you can milk for decades to come.

    MF: That part of it is very disappointing. The rate-limiting step is the means by which drugs that look promising in the laboratory can be tested in humans. This is very expensive. To move one drug through phase 1, 2 and 3 clinical trials can cost upwards of a billion dollars. The only way that can be paid for is through companies, and companies can decide to proceed with that investment or not. There are many situations where you have promising drugs and they’re not ever moved into clinical situations and tested in real patients because the cost is too high. Pharmaceutical companies have to make strategic decisions based on the bottom line, and a lot of that is divorced from science.

    It’s situations like these that I believe state intervention is a must. I wish the US had something like DARPA that undertakes big research for humanitarian purposes for a change.

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