ONE IN THREE by ADAM WISHART

The Book's Introduction

I cling to my dad’s enormous hand. With long strides, we are rushing through London. I am six. I am sometimes catching my step, sometimes just being lifted by his forward thrust. I am wearing a bright yellow cape, with a sailor’s hat to keep the rain off, and at every puddle I splash the rushing Christmas shoppers. Dad scolds me, but I know he doesn’t mean it: we are a tight pair. We are coming from an exhibition about some ancient civilisation at the Royal Academy, where he had lifted me high above the crowds so that I could see the twinkling gold swords. Now we have to get somewhere, probably the coffee-bean shop in Soho, for he has very particular tastes. Although we are in a hurry, as we round a corner he stops sharply and I charge straight into his camel-hair coat. It is warm and wet. We have paused because he wants to tell me a story of a man called John Snow whose name and picture is on a pub sign across the road.

From The Herald

""Cancer is about mutated genes,, as is life's diversity. You couldn't have evolution without the ability of genes to be robust and mutable. It's entwined with how human life works. Dad might have died from it, but there was little that could have prevented that and his life probably couldn't have been extended. Death and life are part of the same thing."

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Sunday Times Review

An imaginative fusion of anecdotal detail, medical science and poignant, elegiac narrative marks every chapter of this unusual book..... What emerges is a unique profile of a father-son relationship, poignantly affectionate yet utterly devoid of sentimentality.

Every year a great many books are published about cancer. Scientific studies in oncology proliferate as medical science expands. There is a virtual publishing industry, moreover, in objective, information, advice, and self-help for a general readership. There are also books that tell the stories of individual sufferers; they do not make comfortable reading. Yet some accounts succeed in giving both sufferers and those close to them hope and strength. It is this cathartic effect that raises CS Lewis’s A Grief Observed (later made into the film Shadowlands), into a work of literature. And now there is Wishart’s book, which inhabits a remarkable genre of its own.

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New Scientist Review

From the New Scientist

"THIS book does two things well. First, it details the history of medical science's crusade against cancer, from the brutal surgery of the early 19th century to the latest work on its genetic origins, while explaining the biology of the disease and how it spreads so successfully. Secondly, alongside this the author interweaves a frank story of his father's fight against cancer. He spares few details, from the effects on his father's state of mind to the defective p53 gene in his prostate. The result is perhaps the most readable and comprehensive account out there of our battle with the big C."

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Assuming Responsibility

Judging from the conflicting advice I received about my treatment alternatives, the answer seems to be that we must assume responsibility for our own care. That means the less informed among us will probably suffer. Who will be the advocate for the poor, the elderly and the uneducated?

Here is a very modern memoir from the Chicago Tribune. It nicely portrays how patients are being asked more and more to discover their own treatments.

It's too late for my father but perhaps not for me

From The Times:

On a visit home for lunch one Sunday four years ago, I found Dad chopping and cooking vegetables — but instead of charging around the kitchen as usual, he was sitting on a stool. He was hunched-up and his head had retreated into his shoulders. He said that he had a little back pain.

His GP made an appointment for an X-ray, which revealed that one of the neck vertebrae had crumbled and a second was cracking. The hospital couldn’t be sure of the cause but my mother, a doctor, was certain. “The odds are it’s cancer,” she told me in her plain and doctorly way.

My first reaction was to search for a book that we could read and discuss. I found memoirs of celebrities who had battled the disease, self-help guides containing basic information and others that described the science in detail. None seemed to connect.

I started talking to doctors with the idea of writing the book that I could not find. Like many people, I believed that cancer was becoming more prevalent and that medicine had failed to cure it. But as Dad underwent surgery to remove his tumour, I learnt that the past decade has been historic for cancer research and that in a few more decades it will be a disease that we live with rather than die from.

Continued

Let's Change What We Think About Cancer

The Dana Centre are putting on an event:

The 'C' Word: Demystifying cancer

Break through the malignant myths surrounding cancer with scientists and those affected by the disease. Death rates are falling and our understanding of cancer is increasing, yet damaging misconceptions prevail. Join the discussion challenging the way we think about cancer.

Professor Karol Sikora will be speaking. As will Sandy Craine, a one time leukemia patient, and so will I.

Come along its free!

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A vaccine, at last

Late in September 1970, many in the US cancer establishment were promising that a vaccine for cancer was imminent. They thought they had found virus particles in a whole variety of cancers. They thought that cancer would succumb to human endeavour just as Polio had a decade or so before.

In the end, cancer turned out to be a more intractable problem. Yet there was one cancer were a virus was pretty clearly the cause. That was cervival cancer.

In the 36 years since the virus cancer fad of the early 1970s, much has been done. And finally last week, the US FDA announced that it had licensed a vaccine for cervical cancer. What a result?

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The Boom in Drugs

About 400 cancer drugs from 178 companies are in clinical trials, according to the Pharmaceutical Research and Manufacturers Association. That is twice the number of drugs in trials for illnesses like Alzheimer's disease and depression and nearly three times as many as for heart attack and stroke.

For patients, the flood of drugs is generally good news because it means a better chance of finding one, or a combination, that will work for them. "From the standpoint of the patients there is never too many," said Dr. Robert J. Motzer, a kidney cancer specialist at Memorial Sloan-Kettering Cancer Center in New York City.

Increased competition could also mean that drug companies will put more effort into reducing side effects. In the past, it was considered acceptable for drugs to have noxious side effects because cancer was a fatal disease.

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Our strange ideas about drugs

So at last the National Centre for Clinical Excellence has recommended that a new class of breast cancer drugs be allowed on the NHS. This news has taken a long time in coming. There has been some clinical trials that have shown the benefits of these newer and more expensive drugs for years.

What I find interesting is how aromatase inhibitors have been treated differently to Herceptin. The latter was hailed as a wonder drug. Tens of patients have been campaigning for their 'life-saving' drug. There has been a massive media campaign.

Yet arguably, aromotase inhibitors will save many more lives. The Daily Mail said they'd save 1000 lives a year in the UK. Of course, unlike Herceptin they are not based on the wonders of genetic manipulation. And they are only an improvement of an existing sort of drug - Tamoxifen has been working in a roughly similar way for twenty years. And as a consequence, they have sort of given a lower priority.

Its little wonder that patients find it so difficult to navigate the treatment choices - when the coverage in the newspapers is so lopsided.