Wednesday, 23 May 2018

The real survival rates to cancer - Part 1 of 3

It is very difficult for anyone detached from the reality of clinical trials and the research developed by the biggest pharmaceutical companies to have access to secretive data pharmaceutical companies hold on their pipeline products (even when they become fully marketed ones).  We don't necessarily have to initiate or feed any kind of global conspiracy theory. There is huge investment in researching a pharmaceutical product destined to battle diseases as serious as cancer is. Such investment must be claimed back when the product reaches the market and becomes fully or partly available to hospitals, patients, for compassionate use, etc. Not always the different governments support pharmaceutical research to the same extent as governments claim taxation on these companies or impose price cuts/subsidiary support when the products are given market authorisation. 

It is not my job to analyse the soul of said companies as it is not my job to scrutinise the role of governments in the market authorisation and governmental participation process. But for such a global, relevant and recurrent disease that is ever so present in our day-to-day lives (every single one of us has to some extent come across a friend/relative/acquaintance affected by its ramifications) the BIG C is an obscure scenario. Whenever we are forced to bereave upon such frailty, our human side becomes a lot more mechanical, I suppose; a lot more statistical. The positive ones will hold onto the minimum numbers and foresee survival, the negative ones will probably see the opposite side of the mirror. I'm not here to judge, but I tend to be a positive one, and I would want everybody to be positive on their experience with such terrifying disease.

Hence, the idea of "celebrating" about 75 years of the first use of chemotherapy agents in a cancer patient [1] made perfect sense to me. A celebration based on survival, on the numbers that we are to increase but still attribute hope, regardless of how small they can be. 

We are then obliged to mention JD, as he was known back at the Yale Medical Center in 1941 when he was diagnosed with lymphosarcoma (a cancer of lymphocites). The expected treatment would be a combination of radiation and surgical resection. A fast-spreading disease branched through JD's body and the cervical tumours he had been screened for suddenly were unresponsive to radiation and spread to his armpit. His fate was about to be drawn if it wasn't for WWI's nitrogen mustard gas and its associated leukopenia (reduction of white blood cells - leukocytes - in the blood) inducing a low count on those exposed to it.

Well cancer, in very basic terms, isn't but a fast and abnormal multiplication of cells. Therefore, any substance that could attack those sub-systems prone to quick cellular production (hair, immune system, etc) could represent a potential pharmaceutical agent if shown to have reduced toxicity against humans. That wasn't the case for mustard gas, but at least the motto for what would become a very interesting research phase was given the go-ahead flag. And nowadays the common plebeian response to cancer is an immediate word -  chemotherapy. However, statistics are still quite hidden beneath the veil of frailty and business approach that both people (affected by their dramas) and pharmaceutical companies (profiting from the human drama) tend to either ignore, restrict, keep or cherry-pick.

I decided that for this post I'd refer only 1 article, the one by Panos Christakis (see below). The reason being the fact that it is a great article that can do wonders for your need for historical feed on how chemotherapy emerged from the shadows of Word War I. How life typically emerges from death and vice-versa, in a strange synergy of an uninterrupted circle. As if life and death weren't; and all we have is a continuum. The referred article deserves your uttermost attention as I believe it to be a great piece of work that instruct us on the chronological process of bringing a clinical and pharmacological product/procedure to life from the unexpected.

Before I leave you today with the premise to what is to be expected with the upcoming two additional posts - namely, the numbers on cancer survival rates (scientifically published), I'd like to share with you an additional motto for me to produce this trilogy of posts. It has to do with my past experience as an interpreter working in the NHS when I came across a cancer patient for the first time. No personal details will obviously be mentioned, but on the next post I will open with this extremely intense experience I lived and how it affected me tremendously... emotionally... and spiritually.

[1] Christakis, P. (2011). "The Birth of Chemotherapy at Yale". Yale Journal of Biology and Medicine, 84(2), pp. 169-172.

1st image kindly taken from The Irish Times [].

2nd image kindly taken from Haiku Deck [].

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