The end of cancer is within reach. If you can’t believe this bold assertion when it’s made by someone with the fame and reputation of a Brian Druker, what can you believe?
Druker is director of the OHSU Cancer Institute in Portland, and a superstar in cancer research. He developed Gleevec, a targeted therapy designed for patients with chronic myeloid leukemia, the diagnosis of which used to be a death sentence. Gleevec can fairly be called a miracle drug, as people with CML who take it have a 95% survival rate. All cancer patients should be so lucky.
I went to Druker’s lecture last month at the elegant Newmark Theater in downtown Portland because I wanted to hear why Druker was so optimistic about progress in cancer research. I read what appears in the lay press pretty closely, and will even check the medical literature occasionally when melanoma is involved. Nothing I read seems to justify OHSU’s very public conviction that cancer will soon be ended. It strikes me as an obvious PR play.
When I arrived at the Newmark to pick up a ticket, I realized I may have underdressed for the affair. I was in blue jeans and wearing my gortex jacket and a baseball cap, while much of the crowd appeared to be older men in nice suits with very pulled-together wives on their arms. I felt like a slovenly Michael Moore on Wall Street. Inexplicably, when I went to buy my ticket, the women pushed a comp ticket my direction and said, “It’s your lucky day.” No charge! With this ticket I was able to sit in the second row from the stage, amongst all the guests of honor called out by the host. The auditorium, which was packed, smelled like the fragrance counter at Macy’s.
What became obvious almost immediately, but which was not apparent in the ads I had seen in the newspaper, was that this was a pep rally for cancer research. There was no direct financial appeal, but clearly OHSU was giving Druker a big stage to soften up a friendly, well-heeled crowd. Overall, the university is in serious financial straits, so when someone like Nike’s Phil Knight comes along and writes OHSU a check for $100 million, as he did this year, it raises hopes that lightning like that can be bottled. There probably wasn’t a doctor or businessman in that auditorium who mows his own lawn. These potential donors were just dying to be seduced.
Druker gave his audience an entertaining walk through the germ theory of disease, and left the clear impression that cancer can be conquered just as infectious disease was by getting at root causes. Targeted therapy is the latest great hope in cancer research, with lab coats all over the world working feverishly to duplicate Gleevec’s ability to kill cancer cells while leaving normal cells alone. God bless them. There’s fame and fortune for whoever gets there next. It doesn’t take too many stories of hospice patients gulping some pills and jumping to their feet to convince some people that a Gleevec-type response is also possible with other forms of cancer.
If only it were that easy.
Sitting next to me in the auditorium that night was a young man dressed even more casually than I was, and who works in Druker’s lab. (He also happens to know my daughter, but that’s a story for another day.) Breaking down CML was easy, he said, compared to the challenges faced in mastering other forms of cancer, and Druker “got lucky” in that the mechanism that causes CML was relatively easy to identify—and it still took him more than 20 years. The gene sequencing alone that’s needed to specify all the broken parts in most cancers is a Herculean task. Compared to infectious diseases like tuberculosis, cancer is devilishly difficult to understand and to treat successfully. The amount of money that’s been spent in this effort to date is staggering, as I’ve written previously.
Druker, on the other hand, believes the cancer research enterprise is woefully underfunded. The $5 billion a year that is spent breaks down to $3000 per patient. He’d like to see funding increase by an order of magnitude. In other words, he’d like to do for cancer research what Nike did for sports apparel: Just cure it. He received a standing ovation when he told his audience that we need more funding “to capture this opportunity to keep patients alive and thriving.”
My purpose in reporting on this curious, hoity-toity evening in Portland is not to cast aspersions on Druker’s character nor to slander cancer research. I’m a gnat on an elephant’s rump when I question whether the end of cancer is, indeed, within reach. I don’t believe it is, and I think there are some largely unexamined assumptions about why this should be a priority of American medicine. The spectacle of seeing a man of Druker’s intelligence and passion peddling hope for cancer patients, and pitching for dollars, needs to be commented upon. It strikes me as a con job. There’s so much more here than meets the eye.