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First, I want to thank those readers who generously helped me reach my goal of fundraising for the annual Movember effort to increase awareness and support research into prostate cancer and men’s health. If you are so inclined and want to make a last minute contribution, you may do so here: https://mobro.co/michaelglode?mc=1 My itchy, scraggly moustache is destined to come off tomorrow!
Second, it has been an incredible journey since my internship to watch the evolution of our understanding of cancer. In 1972, when my mother called to tell me (a young medical intern) she “had a little lump in her breast” – it turned out to be not-so-little, and she fought the disease for another 4 years before succumbing – we had little we could do other than surgery and in some cases radiation. Even adjuvant chemotherapy (the CMF treatment) had not been published yet. During the next decade, remarkable strides were made in finding new drugs, most notably cisplatin, that allowed cures of previously lethal diseases – especially testis cancer.
Then, while on sabbatical in Helsinki in 1986, I found an article to present at our journal club that I thought would revolutionize medicine. The PCR reaction opened the door to rapid DNA sequencing. When I returned to my lab in Denver, my PhD colleague, Ian Maxwell had already started to use the technique with his own jury-rigged thermal cycler, but it would be 3 or 4 more years until a medical student in his/her 3rd year clinical rotation would be able to tell me what PCR stood for. Recognizing there would be a generation of physicians who “missed out” on what would be the revolution, I was able to help start a catch-up course in Aspen, Molecular Biology in Clinical Oncology, that is still ongoing. As a “fly on the wall” I was able to listen to the world leaders in molecular oncology (including this year’s Nobel Prize winner, Bill Kaelin) describe their research that unlocked the mysteries of how cancer works. Fly-fishing with some of them on the Frying Pan was a bonus to be cherished!
As the cancer story unfolded, I was able to participate in many clinical trials, bringing new treatments that emerged to my patients. Thanks to the brilliant writing of Siddhartha Mukherjee, author of “The Emperor of all Maladies“, it became possible for my patients to begin to understand the nagging question, “how did this happen to me?” And now, this week, a brilliant article summarizing all we know about the genes and mutations that cause cancer has appeared in the New England Journal. I invite you to read that (it’s free online) if you want to join me in peering over the horizon to the future of cancer medicine. It is both overwhelming and humbling.
The privilege of living through the last half of the 20th century and into the 21st is one of the most amazing journeys one could ask of a human lifetime. As I ponder it, looking out on the snow I will get to ski on next week and enjoying my grandchildren and family, I am truly thankful to have been here. Happy Thanksgiving to all!
7 responses to “Thanksgiving for an oncologist”
Thank you for writing this always informative blog, Dr. Glode. I just want to point out that access to the referenced NEJM article requires a one-time registration which then allows you to access 3 free articles per month.
Happy Thanksgiving to you and your family!
Thanks Len. I noticed that, but it’s well worth the registration, and I think NEJM doesn’t bother people much with spam email. Who knows, maybe there will be some other articles people will find interesting – it’s the premier medical journal in any case, and nice they are providing increased access. My wife (also a physician) and I signed up for lifetime subscription in 1972 – best $500 investment I ever made. 🙂
Right back at you , happy Thanksgiving and thank you for making it all possible for me to enjoy one more Thanksgiving with my family! ❤️❤️❤️❤️❤️❤️❤️❤️❤️❤️❤️ Sent from Billy. Dittmar
Happy Thanksgiving to you and your family Dr. Glode.
As you consider blog topics you might want to address in 2020 I am sure many of your followers will have subjects they would like you to consider. A few that I might suggest deal with “ where are we” in terms of resource allocation on cancer research and treatment. The Prostate Cancer space is a small but clear prism through which one can examine the issues. In prostate cancer , huge amounts of money are still being spent on the well known role of the androgen receptor axis which everyone knows is the low hanging fruit . The new anti androgens are still competing to delay hormone refraction which at best is a time limited exercise. Once castrate and metastatic men are on their way out. Manipulating the androgen receptor buys time but with variable side effects which for many are significant. Once a drug is FDA approved and covered by Medicare, the pharmaceutical companies receive a wealth transfer from the taxpayers to extend a life suffering from an incurable disease. The article you cited above demonstrates the huge complexity of cancer that cries out for investment. Our health care system lead by for- profit companies seems happy to develop patentable medicines that simply extend life no matter the side effects. Do you believe the pharmaceutical companies want to actually cure cancer? Do you believe that as our population lives longer because of the huge changes in cardiac care, and more “ get” cancer, Medicare will go broke? Would you support a system where Medicare recipients are capped on lifetime benefits which would result in many getting a death warrant so long as the non spent funds would be used to fund a “ cure” ? You are qualified to address these questions because of your time spent in research, patient care, and importantly have an ‘“ ethical sense” of how all of this might be mediated .
Others will have some topic ideas for you but mine will keep you engaged for 2020 !
Thanks for your wisdom no matter the topic you might address.!
Wow – great list of topics. Not sure I’m qualified to opine on the complicated issues of cost/benefit, but there are some really great articles coming out and I’ll try to take a swing at it sometime. Thanks for the suggestions!
Another great reflection on the state of cancer care and we are all thankful for researchers like you. I feel fortunate to be the beneficiary of advanced cancer care. The genetics of tumors and targeted therapy are such a dramatic change in a very short time. Reminds me of the short decade ago without cellphones.
I am Thankful today for you and others who care for us.
Thank you for a lifetime of hard work and service for all of us.
And Happy Thanksgiving.