[NStewart]

The Death of Cancer - Vincent DeVita, Jr, MD

by NStewart on Sun Nov 22, 2015 8:43 pm

I just finished reading this book and recommend it to anyone who is interested in the development of the use of chemotherapy for the treatment of cancer. He was on the frontlines of the "war on cancer" as a physician at the NCI for 28 years. Although his pats on his own back were a little annoying to me, he definitely was part of cancer treatment over the last 50+ years.

He states that we are winning the war on cancer and details why he feels that we are. There also is a good synopsis of how treatment for myeloma has changed over the last 20+ years, especially in the last decade.

This was a relatively easy read and I found it very interesting. Part of the reason for my interest was the fact that I was a normal volunteer patient at NIH during one semester in 1967 and my blood was used in cancer research.

Nancy in Phila

[Mark11]

Re: The Death of Cancer - Vincent DeVita, Jr, MD

by Mark11 on Sat Jan 02, 2016 9:55 am

I read an interesting review of "The Death of Cancer" by Vincent DeVita in the New Yorker (link).

As Nancy indicates, Dr.DeVita started his career at the NIH (National Institute of Health) during the era that Dr. Emil Frei and Dr. Emil Freireich were beginning to cure blood cancers, most notably childhood leukemia, with aggressive upfront combination chemotherapy. It follows his career to other institution that were not as innovative and aggressive about trying to cure cancer as the NIH was during the era he worked there.

Some excerpts from the review:

Half a century ago, the N.C.I. was a very different place. It was dingy and underfunded—a fraction of its current size—and home to a raw and unruly medical staff. The orthodoxy of the time was that cancer was a death sentence: the tumor could be treated with surgery or radiation, in order to buy some time, and the patient’s inevitable decline could be eased through medicine, and that was it. At the N.C.I., however, an insurgent group led by Frei and Freireich believed that if cancer drugs were used in extremely large doses, and in multiple combinations and repeated cycles, the cancer could be beaten. “I wasn’t sure if these scientists were maniacs or geniuses,” DeVita writes. But, as he worked with Freireich on the N.C.I.’s childhood-leukemia ward – and saw the fruits of the first experiments using combination chemotherapy – he became a convert.

Here we have a paradox. The breakthroughs made at the N.C.I. in the nineteen-sixties and seventies were the product of a freewheeling intellectual climate. But that same freewheeling climate is what made it possible for the stubborn doctors at Memorial Sloan Kettering to concoct their non-cure. The social conditions that birthed a new idea in one place impeded the spread of that same idea in another. People who push for greater innovation in the marketplace often naïvely assume that what is good for the innovator is also, down the line, good for the diffusion of their ideas. And people worried about diffusion often position themselves as the friends of innovation, as if a system that does well at spreading good ideas necessarily makes it easier to come up with good ideas. The implication of “The Death of Cancer” is, on the contrary, that innovation and diffusion can sometimes conflict.

When DeVita faced the naysayers at Memorial Sloan Kettering, who worried about their Hodgkin’s patients on the subway ride home, he informed them curtly, “If you told those patients that the choice was between being cured and vomiting, or not vomiting and dying, don’t you think they might have opted to take a cab?” This is how diffusion happens in a world without a diffusion gatekeeper. But how many doctors are capable of that kind of hand-to-hand combat? Life on the innovation end of the continuum is volatile, fractious, and personal – less a genteel cocktail party, governed benignly by bureaucratic fiat, than the raucous bender where your boss passes out in a bathtub. When DeVita returned to Memorial Sloan Kettering years later, as the physician-in-chief, the hospital got better. But DeVita didn’t last, which will scarcely come as a surprise to anyone who has read his book. “The problem with Vince,” the hospital’s president reportedly said, in announcing his departure, “is that he wants to cure cancer.”

[NStewart]

Re: The Death of Cancer - Vincent DeVita, Jr, MD

by NStewart on Mon Jan 04, 2016 3:46 pm

Very interesting review. Of course, much better stated than I ever could. Thank you for posting these excerpts.

Nancy in Phila