One of the things I enjoy most about what I do is the frequent unpredictability of my day. I frequently say that when I wake up in the morning, I never know what the day will hold, or what city I will be sleeping in that night.
Today is no exception.
I am currently attending a meeting of our national board of directors in Austin, Texas.
Yesterday, I was approached by one of my Texas colleagues and asked if I could help out with some legislation currently before the Texas state senate this morning.
The bill (HJR90), which would authorize $3 billion for cancer prevention and research ($300 million a year for the next ten years) had passed the Texas House of Representatives, and was currently “in process” in the state Senate. It had run into some roadblocks, and there was a hearing pending for Friday afternoon. If it passes the legislature, it goes to the Texas voters as a constitutional amendment authorizing the funding for this momentous effort.
I indicated I would be glad to help out, and then received a phone call indicating that I would be participating in a news conference in the morning. The lead attraction: Lance Armstrong, a Texan and someone who had committed himself to support this legislation and get it passed.
The press conference occurred as scheduled, showcasing the legislation and the many legislators and others who had made their own personal commitments to helping fund the cancer research that will help us continue our efforts to prevent and treat cancer over the next decade.
I have heard Lance speak last year at the annual meeting of the American Society of Clinical Oncology, and I have seen him several times on various television shows that deal with the issues of cancer and cancer survivorship. I have never had the opportunity to meet him in person.
He is obviously an articulate and passionate spokesperson on these topics, and his commitment to supporting cancer research and survivorship efforts is legendary.
His story is well known, but nothing prepares you to see him up close and personal, take a measure of his commitment and his intensity, and understand that this is obviously a very personal and very important mission for him.
So what do you say when you have a brief quiet moment with one of the most recognized and admired people in the country, if not the world?
You think about him as a person, and from my perspective, the battle that he fought to overcome a disease that could have led to a different outcome.
But that moment also brought back another memory for me, one that was much more personal and much more intense. It is a memory of the way things were, and a memory of what can be. It is a memory of a miracle.
When I started my cancer training in 1972, I was at a National Cancer Institute facility in Baltimore.
We did cutting edge research in cancer, both in the lab and in the clinic. We treated patients with lymphoma, leukemia, sarcoma and some solid tumors such as lung cancer and colorectal cancer.
We also treated (usually) young men with testicular cancer, the type of cancer that afflicted Lance Armstrong.
We had little to offer these young men. If they had a certain type of testicular cancer called seminoma, we at least had a shot of helping them live. But for the other types of testicular cancer, there wasn’t much to offer.
The memory that came to my mind this morning was of a young man who had one of the non-seminomatous types of testicular cancer. This young man had widespread disease, and it wasn’t responsive to chemotherapy. The disease was spreading rapidly—which was frequently the case with these types of cancers.
I remember being the physician on call in the intensive care unit one Sunday, spending hours by this young man’s bedside, trying to do something—anything—to save his life.
But there was nothing we could do. The disease would progress, and all the supportive care, the ventilators, the antibiotics, the medications, the chemotherapy would make no difference.
The young man eventually died, as would several others that year who had the same type of cancer. It was heartbreaking, and maybe a bit more so because many of us who cared for him could relate to him in some way given the fact that we were young men as well.
And then there was a research report. It described a new drug called cis-platinum. The drug was discovered because someone in a laboratory noted that bacteria died when exposed to an electric current from a platinum electrode.
The researchers took that observation and worked with it. They found that the platinum compound was responsible for what happened, and then they learned that it worked as a cancer treatment drug in animal systems.
And, then, they learned that the drug they produced was exquisitely effective in the treatment of testicular cancer.
Suddenly, young men who would have died were living. We treated some of those young men, and followed the clinical research that was developing around the country with close interest.
Each year, the news became better and better as we learned how to use the drug most effectively. Patients who would have died a quick, difficult death were suddenly living and thriving.
Suddenly, we had survivors.
Lance Armstrong is a survivor. He is a survivor because someone in a laboratory made an observation and developed it into a more robust treatment. He is a survivor because of one moment in research.
That is what I discussed with Lance this morning, the memory of what was and what is. The memory of that young man in that bed in a small, simple ICU in Baltimore where all of our efforts couldn’t make a difference.
Lance Armstrong is a special person. He is a survivor. There are also millions of other survivors in this country, whom he represents every time he speaks. Millions of survivors, some of whom are here today because some researcher somewhere had the ability to make an observation that made a difference.
The Texas legislation is a bold step in support of advancing the dream that we will be able to further diminish the suffering and burden of cancer in this country. The American Cancer Society vigorously supports the efforts of the many special people and legislators in this great state who are making an effort to make a difference. As I write this, I am sitting in the gallery of the Texas state senate, waiting to see if the legislators will move this legislation to a committee hearing and a vote.
As a physician, however, you can never forget that moment of a miracle. My young patient didn’t have a chance for a miracle; Lance Armstrong is a miracle.
And, as many of us know, there are many miracles around us.
Hopefully, by emphasizing our investment in prevention and research, there will be many more.
PS: It's 8:30 PM in Austin, and we have just left the committee hearing. The bill passed out of committee, and now goes on to the Texas Senate. If it passes there with a 2/3 vote, it will go on to the citizens of Texas to vote for the funding.
This is truly a momentous bill and a momentous commitment by the legislators of this state to fund cancer research.