Upbeat About Cancer?
—David Waldstreicher, Editor
Professor of Pharmacology, School of Medicine
According to Mike Sirover, Professor of Pharmacology in the Medical School, the general public is not especially well served if they go into a bookstore like Borders looking for information about his specialty, cancer treatment. “There are books about prostate cancer, breast cancer, colon cancer,” he notes, but they are complex, extremely detailed and specific. They don’t account for the predisposition to fear cancer as a death warrant, and so they don’t provide a helpful or accurate road map through the challenges of cancer therapy.
The fact is that tremendous strides have been made in treating cancer during the three and a half decades Sirover has been working in the field. But early detection, and a willingness to stick with therapies, is critical to the higher cure rates—and here doctors have been finding that patients are resistant. One in five colon cancer patients stopped treatment, according to one study. Fifty percent of ovarian cancer patients ceased therapies due to side effects.
The side effects are real, and often daunting—but as Sirover writes in his new book Surviving Cancer: A Light of Hope at the End of the Tunnel, “it’s not your parents’ cancer therapy.” Radiation, for example, can target very small areas now, successfully – however, the patient may need treatment every day for twenty eight days in a row. The large amounts of money that have been poured into cancer research since President Nixon declared a “war on cancer” in 1971 have actually changed the medical landscape: cancer “need not be the death sentence we think it is…. For every Teddy Kennedy [who died of brain cancer] there are about 25 post-menopausal women who get breast cancer, 98% of whom survive if the tumor is localized and 84% survive if it’s regional. The cure rate for childhood leukemia is now over 80%.” True to his upbeat style, Dr. Sirover sees a positive message here as well: “People say government doesn’t work. Here, it works.”
I’m old enough to be aware of the change. Both of my maternal grandparents died, rather quickly, of cancer. Yet now I know more survivors than friends and family lost to cancer. What, then, accounts for the persisting fear? Why, as Mike asks in his first chapter, “do we fear cancer and not heart disease?”
I asked Mike how he accounts for this discrepancy. He attributes much of it to human nature: the tendency to focus on the glass half empty. He also notes the debilitating nature of the disease, and its invisibility in its early stages, which makes it an unknown, mysterious force for patients. The historical scholarship of James T. Patterson, in The Dread Disease: Cancer and Modern American Culture (1987), seems to confirm that there has always been a particularly wide gap between the thinking of the experts and the populace on this topic, to the extent that cancer has sometimes been a site of especially intense skepticism about medicine itself.
All the more reason why cancer therapy needs to be explained in layman’s terms. Surviving Cancer seeks to answer the questions that come up as a result of contemporary treatments. Using everyday, even folksy comparisons (did you know that chemotherapy is like boxing?), he explains what happens and doesn’t happen. Therapies may not act only on cancer cells, for example. They may kill most but not all of the cancer cells, so that there is a special danger in not completing therapy. Over the counter anti-cancer agents like St. John’s Wort may actually have particularly severe side effects in cancer patients that actually weaken the body in its fight against the disease.
What was it like to try to translate research findings, and the points made in teaching doctors, dentists, and podiatrists, into an accessible, short volume? Interestingly, Mike decided early on to publish the book himself with XLibris. This has enabled him to take a longer term approach to the project. The book is on Amazon.com, and has a web page (www.survivingcancertoday.net); he is starting to give public talks and get very positive feedback. A cancer surgeon at Harvard Medical School has purchased the book to distribute to his patients. Given the positive feedback, Sirover is now considering whether to approach a trade publisher with a proposal for a revised edition.
I asked Mike how writing Surviving Cancer compared to his usual academic practices. (He has published dozens of papers and heads an NIH Scientific Advisory Committee on Cancer Prevention that evaluates grant applications in his field.) He compared it to flying solo. But the book is very much shaped by his experience teaching the subject of cancer therapy. When writing it, he tried to imagine himself sitting across from a cancer patient, anticipating and responding to questions. He approached the project less as a scientist who does research on cells than as an educator.
The result is an extremely accessible and, yes, even upbeat book about a topic so often considered to be depressing. Reading it, I understood much more about a topic I thought I knew something, even enough, about.
To find out more about Surviving Cancer: A Light of Hope at the
End of the Tunnel, by Dr. Michael Sirover, browse to: