A friend sent me a link to this book review of The Emperor of All Maladies by Siddhartha Mukherjee, over at Slate.
"...this is not a metaphor," he writes in The Emperor of All Maladies, an ambitious scientific, political, and cultural history of the disease. "Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves."...Maybe we must ultimately accept cancer, to some degree, as the "inherent outer limit of our survival"—an inevitable offshoot of growth and aging that we might learn to hold at bay but can never truly eradicate...It could be that cancer, "the scrappy, fecund, invasive, adaptable twin to our scrappy, fecund, invasive, adaptable cells and genes, is impossible to disconnect from our bodies," Mukherjee writes grimly.
Ha ha, the joke's on you, St. Kern! The cancer we shall always have with us!
Well, that's depressing.
But hey! Scientists are tough and scrappy! Targeted therapies are the future! St. Kern is lashing your backs because cancer patients need their individualized targeted therapies and your whiney-ass titty baby crying selves who wanna go home and rest once in awhile are prolonging their misery! Sack up and work around the clock for the cure!
It's hard to see how these prices [tens of thousands of dollars for targeted therapies] might come down when the market consists of patients increasingly fragmented not only by type of cancer but even by types of mutation. The answer to how well we manage at outsmarting our awful twin surely depends on our scientific maps and metaphors, but it may well have as much, or more, to do with money.
Indeed. Money for expensive therapies, in a health insurance climate where access to even basic health and dental care is something that millions of U.S. citizens cannot count on - where's that money going to come from?
And money to pay the researchers who must develop these new targeted therapies - oh wait, we don't need that. Under the St. Kern model, we just exploit the labor force we have till their effective hourly wage is less than minimum wage. Might as well take away what few benefits they have, too, since they won't have any time to be using them. Bonus - another cost savings that can be plowed back into lab supplies!
As with any custom work of art or craftsmanship throughout history, these artistically hand-crafted treatments will be supported and enjoyed by those who truly deserve them (and can prove it by tossing more money at the treatment than the peons can dream of ever having in their short and worthless lives.)
Fortunately for the St. Kerns of the world, owning serfs is not only back in style, but the lucky few who call the shots have freed themselves of any of the old social pretense that they should be modest about having serfs. Including the serfs who work for St. Kern.
Now now, we *need* those lab supply budgets to fund SNP chips to characterize each cancer cell! That's the approach taken in a recent research paper from Kern's lab, anyway.
That said, Kern focuses partially on pancreatic cancer. I can't blame him for *trying* that approach. It is a very tough nut to crack. It's got a 5 year 95% mortality rate. They're throwing the nastiest chemos at it. They're throwing radiation at it. They're throwing surgery at it. They're throwing *acupuncture* at treating the pain. They're throwing the cheap messy drugs at it (e.g. chloroquine as an adjuvant). They're throwing newer messy drugs at it (e.g. HDAC inhibitors). They're throwing the expensive targeted monoclonal humanized antibodies for VEGF at it. They're throwing *vaccines* and immunomodulation at it. There are about 1000 clinical trials that turn up in a search for 'pancreatic cancer'.
If I were a 2bit psychologist, I'd say Kern tries to control his trainees, and his colleagues, because he *can't* control the reality that a lot of what he does is futile. Not because he doesn't do the best science, either. But because a LOT of energy is being thrown at this problem, and it isn't budging much.
Even viewing cancer through in this context, I don't think it's as futile as Mukherjee makes it out. Mukherjee is likely writing for a general audience, and the average person has no idea why we haven't cured cancer yet. I know *nurses* who think big pharma has the cures and isn't giving them out because treatments are so profitable. There's a good chance Mukherjee thought that if people understood the scientific challenge, they at least wouldn't get so frustrated at the scientists. But, see how well that works with Kern? He of all people should understand the science very well, and he *still* takes it out on the scientists.
Coming from a less well funded field (theoretical physics - sheesh, what good did that ever do anyone?) I have to say that (certain) cancer research is one of my pet gripes. One day a few years ago, when I was in a particularly bad mood, a boy on the street made the error of asking me for a donation for Rich People's Medicine X. He probably wasn't expecting an angry tirade about disparities in science funding, but he got one.
Cancer curing research isn't only done by scientists in a lab. A lot of the technology being developed to destroy cancer is being developed by engineers who are well compensated by medical companies. If you want to do science and get paid well (well...better than a lab scientist) I recommend getting into an engineering position. The hours are just as long, but the pay is a little better.
The company I work for does the R&D and the production of a device that ablates cancer tissue with HIFU. We are a U.S. based company and our device is approved in every country in the world...except the U.S. As a company; we are devoting thousands of hours getting the device FDA approved via boat loads of paperwork, several audits, and dozens of clinical trials.
The high cost of treatment in the US is directly related to the high cost of FDA approval. It is a ridiculous waste of time and money and is hindering the industry's ability to get effective treatments to the patients. While large medical companies (that have the FDA in their pocket) and pharmaceutical companies are getting rich; small companies are struggling for years to get products on the market.
The problems that medical device development struggles with is the same as every other sector; the interaction between big corporations and the government is corrupt.
Thegoodman- easy for you to say, you are a dude. I considered engineering. I don't want to deal with more crap for my gender, I get enough of it in regular life.
I am not doing too bad collecting and processing study specimens. I think I will keep hanging out with the other thankless lab professionals.