Saturday, March 18, 2017

Kicking cancer's ass

"Kicking cancer's ass." I'm sure most of you have heard the expression. After Cara was diagnosed, people would talk about how she was going to "kick cancer's ass." It's kind of a weird expression. As if cancer is some sentient being, and as if simply by fighting hard enough, someone with cancer can defeat it.

Of course, that's not true. Cara didn't die because she didn't fight hard enough. How hard you fight has very little to do with whether or not cancer will kill you. (Which isn't to say that how hard Cara fought was not a very beautiful and meaningful thing. It was! It will continue to inspire me for the rest of my life.) Cara died because of simple biology. Out-of-control Darwinian evolution of a small mass of cells in her body that eventually spread to become something much larger and more destructive. For reasons we are not near fully understanding, the response to treatment of those malignant cells, even those that we've identified through the tremendous, decades-long work of countless scientists and doctors as having the same driver mutations, varies widely from person to person. Some people have much better luck than Cara did. It's not because she didn't fight as hard to "kick cancer's ass."

I've also seen people use the expression when they talk about participating in charity events (especially those involving strenuous athletic pursuits) to raise money for the struggle against cancer. Events like the Pan Ohio Hope Ride, a four-day, 328-mile bike ride to raise money for the American Cancer Society. 

The Pan Ohio Hope Ride's Facebook profile picture - a picture of my dear friend Shelli Snyder!

Another such charity event (although one requiring much less exertion on the part of its participants) that is very near and dear to my heart is Breathe Deep Cleveland, a 5k fun run and walk to benefit lung cancer awareness and research funding that Cara founded before she passed away.

These events are great. The battle against cancer is one in which we need all the help we can get. Every dollar raised has the potential to positively affect someone's life.

We've come a long, long way in our understanding of this horrible disease. We know vastly more about the underlying biology than we did a hundred, fifty, or even (especially when it comes to certain specific genetic abnormalities) ten years ago. This helps us devise better treatments. It also helps us better understand the underlying causes - why people get cancer in the first place. There's a whole lot we still don't know, but we've made great strides in the fight against cancer.

Sadly, today, in this country, there is a concerted effort underway to reverse much of that progress.

Republicans in Congress are trying to pass the "American Health Care Act" - their replacement for the Affordable Care Act. The Congressional Budget Office has estimated that this act would result in a whopping 24 million Americans losing health insurance compared to current law. Don't trust that number? Think it's "fake news"? The White House estimated an even bigger loss - 26 million.

It's pretty simple - if you get cancer, and you have health insurance, your odds are going to be a lot better than if you don't. If you can afford medical treatment, your outcomes will tend to be better than if you can't. If Cara didn't have health insurance when she was diagnosed, she would have died a lot sooner. The same is true for many terminal cancer patients. And there are many other cancer patients who have had their lives saved by medical treatments. If the AHCA passes, there are going to be a lot more people who have to make the horrifying choice between bankrupting their families or giving up on their treatments.

There's more.

The White House recently released their budget proposal, which cuts funding to most of the government programs that are vital in our shared efforts to (I have to say it) Make America Great. Two items in particular are especially relevant to the fight against cancer. A nearly 20% cut is proposed in the budget to the NIH, which provides an enormous amount of the funding for medical research in this country.

Without NIH-funded research efforts, I can say without any doubt that Cara would have died much sooner after her cancer diagnosis than she did. It was because I saw firsthand the benefits of cancer research that I decided to enter the field myself after obtaining my PhD in Biology.

The other highly pertinent and disturbing item in the proposed budget?  A greater than 30% cut to the EPA.

That is something that should horrify everyone who breathes air and drinks water.

(That is, everyone. Duh.)

Although there's still a lot we don't understand, we've come a long way in our knowledge of what causes people to get cancer. Probably the most widely recognized such causative link is that between cigarette smoking and lung cancer. Of course, it's not a one-to-one link; Cara didn't smoke. But we all know that years of smoking increase the chances someone will get cancer. That's because the toxins in cigarette smoke damage DNA in cells and make it more likely that those cells' genetic programs will go awry and lead to uncontrolled malignant growth.

Cigarette smoke is far from the only toxin that can do such damage.

In China, rates of lung (and other) cancer have skyrocketed. This is a direct result of rapid industrialization without the protections the EPA affords us here leading to a dramatic increase in pollution. In less than a decade, rates of lung cancer in Beijing rose more than fifty percent. We've all seen the images of the horrendously smoggy Chinese capital city.

Without government-mandated environmental protections, things would look much the same in major American cities.

But surely, you might say, even with a 30% cut to the EPA, we won't let things get that bad here. And that might be true. Still, it's a simple equation. More exposure to environmental toxins = higher rates of cancer. That's just a fact.

In the war between humanity and cancer, Donald Trump has staked his position firmly on the pro-cancer side. And any Republican elected officials who support these budgetary and health care proposals have likewise staked their positions just as firmly on the pro-cancer side.

Doing charity events like the Pan Ohio Hope Ride and Breathe Deep Cleveland is great. We have a good time with friends and we raise money for a good cause. But as much as that makes us feel good about ourselves, the sad reality is that Donald Trump and the Republican Party are setting out to do far more harm in the fight to save people's lives from cancer than all the good that will be done by all of the participants in all of those charity events.

Right now, if we want to kick cancer's ass, we have to kick Donald Trump's ass.

1 comment:

  1. Great post, Jeff. I don't think most people understand how long (and expensive) the road to medical advancement is and how important the government contribution to research is along with private and non-profit sources like ACS. We need EPA and NIH for disease prevention and treatment!

    Those 20 months Cara had were priceless, and everyone deserves that chance and much more.