The Cancer Treatment Revolution

David G. Nathan

Description

Praise for The Cancer Treatment Revolution

"A wonderful journey through modern medical science, told with warmth and insight, brought to life through the stories of people confronting cancer. This book will inspire and educate both laymen and caregivers."
—Jerome Groopman, M.D., author of The Measure of Our Days and The Anatomy of Hope and Recanati, Professor, Harvard Medical School

"This is probably the best book on cancer that exists--beautifully written and unfailingly interesting, conveying a clear sense of hope for cancer patients and survivors. Cancer treatment has come a long way but not without intense struggles and passions, which David Nathan narrates from the inside as one of the leading players. He explains cancer more clearly than anyone else, and his portraits of great cancer doctors are sharp and unforgettable, a contribution to history."
—Richard Preston, author of The Hot Zone and The Demon in the Freezer

"No one is better positioned to tell the tale of the cancer treatment revolution of the last half century than David Nathan. A brilliant physician-scientist, he has been present at the cusps of history in this life-and-death field. The story he tells here is fascinating, and his book is captivating."
—Atul Gawande, M.D., author of Complications: A Surgeon's Notes on an Imperfect Science and Better: A Surgeon's Notes on Performance and Assistant Professor of Surgery, Harvard Medical School

"David Nathan is a true storyteller. In The Cancer Treatment Revolution, he tells stories that bridge cancer patients and cancer research as few others could. These gripping tales will be appreciated by those who live with cancer and those who strive to create new therapies."
—Thomas Cech, Ph.D., recipient of the 1989 Nobel Prize in Chemistry and President of the Howard Hughes Medical Institute

"David Nathan, one of the nation's preeminent clinician-scientists, tells the stories of three cancer patients, revealing compelling human facets--the dedication of the remarkable teams that care for these patients and, even more, the bravery and fortitude of the patients and their families."
—Harold Varmus, M.D., recipient of the 1989 Nobel Prize in Medicine, President of the Memorial Sloan-Kettering Cancer Center, and former director of the National Institutes of Health

"Engaged by the compelling triumphs and tragedies of patients whose normal lives are inevitably altered by a life-threatening cancer, the reader of The Cancer Treatment Revolution will easily appreciate the impact of the new cancer diagnostics and therapies compared to even relatively recent cancer treatments."
—Karen Antman, M.D., Dean, Boston University School of Medicine

"This personal, highly readable account by one of the leaders of the cancer treatment revolution explains how the revolution has come about and how it will change the future."
—Sir Paul Nurse, Ph.D., President of Rockefeller University and recipient of the 2001 Nobel Prize in Medicine
Acknowledgments.

Prologue.

Introduction: The Nature of the Beast.

Mario's Story.

ONE: The First Hours.

TWO: The Plan.

THREE: Leukemia and Cancer Chemotherapy.

FOUR: The Final Treatment Plan for Mario.

FIVE: The Risk of Chemotherapy Resistance.

SIX: Three Critical Smart Drugs: Nursing Care, Psychology, and Social Work.

SEVEN: Mario’s Future.

Joan's Story.

EIGHT: A Pleasant Summer Day.

NINE: Bad News.

TEN: An Initial Plan.

ELEVEN: The Surgical Plan.

TWELVE: The Medical Plan.

THIRTEEN: The Baton Is Passed.

FOURTEEN: The Consequences of Therapy.

FIFTEEN: The Future of Epithelial Cancer Therapy.

Ken's Story.

SIXTEEN: The Explosion.

SEVENTEEN: Cancerous Hens and Constipated Mice.

EIGHTEEN: Triumph and Tragedy.

NINETEEN: The Search for More Smart Drugs.

Glossary.

Bibliography.

Index.

Sujets

• Santé et bien-être
• Santé du quotidien
• Santé au quotidien
• Santé au quotidien
• Cancer
• Fitness
• Health
• David G. Nathan
• Diseases

Informations

• Publié par: Turner Publishing Company
• Date de parution: 18 mai 2009
• Nombre de lectures: 0
• EAN13: 9780470491966
• Langue: English

Extrait

The Cancer Treatment Revolution
The Cancer Treatment Revolution
How Smart Drugs and Other New Therapies Are Renewing Our Hope and Changing the Face of Medicine
David G. Nathan
Copyright © 2007 by David G. Nathan. All rights reserved
Published by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
Wiley Bicentennial Logo: Richard J. Pacifico
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone], or on the web at www.copyright.com . Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, [phone], fax [phone], or online at http://www.wiley.com/go/permissions .
The information contained in this book is not intended to serve as a replacement for professional medical advice. Any use of the information in this book is at the reader’s discretion. The author and the publisher specifically disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this book. A health care professional should be consulted regarding your specific situation.
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Library of Congress Cataloging-in-Publication Data:
Nathan, David G., date.
The cancer treatment revolution : how smart drugs and other new therapies are renewing our hope and changing the face of medicine / David G. Nathan.
p. cm.
Includes bibliographical references and index.
ISBN 978-0-471-94654-0 (cloth)
1. Cancer—Patients. 2. Cancer—Treatment—Popular works. I. Title.
RC263.N38 2007
616.99'4—dc22
2006024621
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
To Jean and the wonderful family she gave me
Contents
Acknowledgments
Prologue
Introduction: The Nature of the Beast
Mario’s Story
ONE: The First Hours
TWO: The Plan
THREE: Leukemia and Cancer Chemotherapy
FOUR: The Final Treatment Plan for Mario
FIVE: The Risk of Chemotherapy Resistance
SIX: Three Critical Smart Drugs: Nursing Care, Psychology, and Social Work
SEVEN: Mario’s Future
Joan’s Story
EIGHT: A Pleasant Summer Day
NINE: Bad News
TEN: An Initial Plan
ELEVEN: The Surgical Plan
TWELVE: The Medical Plan
THIRTEEN: The Baton Is Passed
FOURTEEN: The Consequences of Therapy
FIFTEEN: The Future of Epithelial Cancer Therapy
Ken’s Story
SIXTEEN: The Explosion
SEVENTEEN: Cancerous Hens and Constipated Mice
EIGHTEEN: Triumph and Tragedy
NINETEEN: The Search for More Smart Drugs
Glossary
Bibliography
Index
Acknowledgments
I am in debt to the many supporters and colleagues who made this book possible. From the beginning of the project, I received the encouragement, wisdom, and skill of my wonderful agent, Jill Kneerim, and of the president of the Dana-Farber Cancer Institute, Edward J. Benz, Jr., M.D. Initial editing advice came from Steven Marcus. Laura Van Dam became my private editor during the final year of completion of the manuscript. She did a masterful job even while battling her own serious illness. The manuscript was ultimately dissected and improved by Tom Miller, Juliet Grames, and Kimberly Monroe-Hill at Wiley.
The construction of this book required over a score of transcribed interviews with patients and with colleagues who have contributed far more to cancer care and research than I. These and other significant editing expenses were defrayed by generous grants from the Richard and Susan Smith Family Foundation and the Goldhirsh Foundation.
The first draft of the book was assembled during a delightful five-week residence at the Villa Serbelloni of the Rockefeller Foundation in Bellagio, Italy, in the fall of 2003. I am grateful to the foundation and to colleagues who supported my application for the residency. These were Joseph Goldstein, M.D., Phillip Sharp, Ph.D., and Harold Varmus, M.D.
Several colleagues, family members, and friends willingly read sections of this book and gave me excellent critiques. They included Ann Barnet, M.D., the late Richard J. Barnet, Nathaniel I. Berlin, M.D., Sissela and Derek Bok, Thomas Brand, Deborah Charness, George Demetri, M.D., Mimi Dow, Frank H. Gardner, M.D., Judy Holding, Philip Kantoff, M.D., Steven Karp, David Livingston, M.D., Robert Mayer, M.D., Linda Nathan, C. O. North, Ann Partridge, M.D., Orah Platt, M.D., Kornelia Polyak, M.D., Ph.D., Dorothy Puhy, and Jane Weeks, M.D. I have tried to incorporate their suggestions and thank them for their efforts. I am particularly thankful to Samuel J. Cohen for his contributions to the suggested reading list and to David E. Fisher, M.D., and Loren Walensky, M.D., who scanned parts of the manuscript for scientific accuracy. If errors remain, they are mine.
The practical task of assembly of this book fell in order to Janet Cameron, Toby Church, Bernadine B. Kirkland, and Cathy Lantigua. Without their combined effort, the manuscript would still be in tatters.
My wonderful wife, Jean F. Nathan, devoted hour after hour to poring over chapters, forcing rewrites, and asking all the right questions. For this and fifty-five years of helping me in every possible way, I thank her from the bottom of my heart.
Finally, I want to thank the caretakers, cancer researchers, and patients who inspired this book and made it possible. I have vaguely wanted to write about “smart” drugs in cancer for several years. But the story would be as dull as a textbook were it not about real patients and about the physicians, nurses, basic scientists, and support staff who surround them. Mario’s family, Joan, and Ken were particularly generous of their time. They did so because they, like the clinicians, nurses, staff members, and researchers, want to help others through the strait gate of cancer. Having suffered, they hope to relieve suffering for others. It is an honor to share their stories and the stories of their caretakers and cancer researchers with my readers.
Prologue
Ken nearly died one night in 1999. He was forty-eight years old and had been treated repeatedly with blood transfusions for unexplained anemia, but never for a minute did he think he was close to death. He was working every day and enjoying life. Then came the night all hell broke loose. He awoke suddenly with terrible abdominal pain and went into shock. If fast-moving EMTs and a savvy surgeon at his community hospital had not realized that Ken required immediate abdominal surgery, he would not have survived the night.
The operation revealed a grapefruit-size tumor attached to his small intestine. Some of the tumor cells had grown into his bowel, leaving a huge hole in his intestine. That night, the contents of Ken’s gut had poured into his abdomen and caused terrible inflammation and shock. Worse, the tumor cells had scattered all over his belly. He was doomed to have multiple cancers grow in his abdomen.
A few weeks later, Ken and his wife, Peggy, learned he had a form of cancer that would result in an utterly unmanageable situation when the distributed tumor cells began to grow. He had no traditional treatment options, since the cancer—gastrointestinal stromal tumor, most often called GIST—stubbornly resists radiation and chemotherapy. And its complete surgical removal was impossible. But Peggy did not give up hope. She went on the Internet and found that George Demetri, an oncologist at the Dana-Farber Cancer Institute in Boston, was just a few months away from starting a clinical trial with the first so-called smart drug treatment for tumors like Ken’s.
One of the leading physicians interested in GIST, Demetri had learned that a mutation in a single gene in one of the billions of cells in an otherwise healthy body causes the disease. The altered gene, called an oncogene, creates proteins that figuratively shout at cells to divide constantly—that is, to become cancerous. The oncologist also found out that the pharmaceutical company Novartis had developed a drug that should be able to halt the mutated gene’s actions by blocking the shouting protein’s function, thus killing the cancer. What’s more, the drug wasn’t supposed to seriously damage any other system in the body. When hundreds of GIST cells that had spread in Ken’s abdomen began to grow, Demetri started treating him with the drug. The tumors vanished.
Ken’s story illustrates the radically new era on the horizon of cancer therapy—using drugs that are “smart” in that they precisely block the defective genetic pathways that cause and promote cancer. These new compounds destroy cancer cells yet cause minimal damage to normal cells.
The revolution in cancer genetics is giving new hope to everyone, from clinicians and medical researchers to patients and their loved ones. Pharmaceutical companies are quickly developing smart drugs. A few medicines have already passed required testing phases and have entered general oncology clinics for broad use. Within two decades—perhaps even one—a high proportion of cancer patients will receive such treatment. We are already beating back many kinds of aggressive cancers with smart drugs, and we will defeat even more