Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How can hope help make cancer a chronic disease?

J. Leonard Lichtenfeld, MD
Conditions
October 21, 2016
Share
Tweet
Share

Perhaps, doctors struggle more than most with memories that mark sad moments in their careers. For me, one of the most indelible was of a wonderful young man with chronic myeloid leukemia (CML).

When I started my oncology career in the early 1970s, CML was almost always fatal. It would start with a chronic phase, which was treated with pretty simple medications. But those medications didn’t cure the disease.

The “almost always” scenario with CML was that several years on, it would morph into an acute phase, or “blast crisis,” that almost always ended in an untimely and frequently very premature death.

I came in contact with this young man just as he was diagnosed with CML. A couple of years later, he entered that acute phase. Rather than face the rigors of intensive chemotherapy, a regimen that was almost always futile, he took his own life. Moments like that live with us forever.

Decades later — 2003 to be exact — a prominent oncologist, who at the time was the director of the National Cancer Institute, made an audacious promise. Andrew von Eschenbach said that by 2015 we would end the suffering and death from cancer and convert it to a chronic disease, much like hypertension and diabetes.

That prediction generated a lot of comments — some positive, many not so positive. But as it turns out, progress against CML, the disease whose prognosis was so bad as to make a young man choose a premature death those few decades ago, is the case study that shows Dr. von Eschenbach’s vision was not as far-fetched as some have come to believe.

A report in the current issue of the Journal of Clinical Oncology from Swedish researchers reviewed the records of all patients 50 and over diagnosed in Sweden with CML between January 1973 and December 2013. They then compared their survival at different periods of time with that of the general population in Sweden.

The researchers report that beginning in 1990, life expectancy began to creep up among CML patients in every age group, even in those diagnosed at age 85. The key result of their report: life expectancy “in 2013 approached that of the general population.”

In practical terms, the authors explain that a 55-year-old male diagnosed with CML in 1980 would have three and a half years of life remaining, while if that same 55-year-old gentleman was diagnosed in 2010 he would have 27.3 years of life remaining. Even 85-year-old people saw their lives extended: an 85-year-old male diagnosed in 1980 would live about 9 to 10 months after diagnosis. While if diagnosed in 2010, he would live more than four years.

One would assume that almost all of this improvement was due to a targeted therapy called imatinib, introduced at the beginning of this century. Imatinib did lead to improved survival, but some of that improvement was actually seen beginning in 1990 — well before that drug became available. And now, with yet more targeted therapies available to treat CML, we are able to provide effective treatments to many of those who either don’t respond to imatinib or become resistant to it.

This is, in human terms, a very dramatic story.

Yes, there are side effects to these drugs and treatments, including an increase in cardiovascular disease and, perhaps, an increase in the number of other cancers.

But for me, the enduring message is that maybe the audacious, oft-ridiculed prediction that we could cure cancer by 2015 had more validity that we recognize. With CML and for other cancers, we are turning cancer into a chronic disease for some patients. CML has led the way in this development. And even if it is a relatively uncommon cancer, seeing the enormous progress we’ve made in just the past 15 years should give us the will to continue to strive for similar progress for many more.

ADVERTISEMENT

This progress came too late for that patient I now remember from some forty years ago and for countless others. It is in honor of their memory that we should never give up on our goal; we should never abandon hope. Because for the thousands of people diagnosed with CML who’ve benefitted from the advances of the past decade, that doctor was right on target. They are the living proof.

J. Leonard Lichtenfeld is deputy chief medical officer, American Cancer Society. He blogs at Dr. Len’s Cancer Blog.

Image credit: Shutterstock.com 

Prev

Stop the competition in medical school

October 21, 2016 Kevin 3
…
Next

Why this doctor shares his patients' stories

October 21, 2016 Kevin 0
…

Tagged as: Hematology, Oncology/Hematology

Post navigation

< Previous Post
Stop the competition in medical school
Next Post >
Why this doctor shares his patients' stories

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by J. Leonard Lichtenfeld, MD

  • Why won’t unproven COVID treatments go away?

    J. Leonard Lichtenfeld, MD
  • How can we improve the quality of medications?

    J. Leonard Lichtenfeld, MD
  • Sunscreens: The balancing act between safety and cancer prevention

    J. Leonard Lichtenfeld, MD

Related Posts

  • Chronic disease is making medical education worse

    Jason J. Han, MD
  • Cancer patients who want to take unproven supplements

    Marc Braunstein, MD, PhD
  • Are hospital ads just unregulated false hope?

    Elina Serrano
  • My first patient to be diagnosed with cancer

    Ton La, Jr., MD, JD
  • Hormone replacement therapy is still linked to cancer

    Martha Rosenberg
  • We have a shot at preventing cervical cancer

    Lisa N. Abaid, MD, MPH

More in Conditions

  • Financing cancer or fighting it: the real cost of tobacco

    Dr. Bhavin P. Vadodariya
  • 5 cancer myths that could delay your diagnosis or treatment

    Joseph Alvarnas, MD
  • When bleeding disorders meet IVF: Navigating von Willebrand disease in fertility treatment

    Oluyemisi Famuyiwa, MD
  • What one diagnosis can change: the movement to make dining safer

    Lianne Mandelbaum, PT
  • How kindness in disguise is holding women back in academic medicine

    Sylk Sotto, EdD, MPS, MBA
  • Measles is back: Why vaccination is more vital than ever

    American College of Physicians
  • Most Popular

  • Past Week

    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why physician voices matter in the fight against anti-LGBTQ+ laws

      BJ Ferguson | Policy
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • When a doctor becomes the narrator of a patient’s final chapter

      Ryan McCarthy, MD | Physician
    • Why innovation in health care starts with bold thinking

      Miguel Villagra, MD | Tech
    • Navigating fair market value as an independent or locum tenens physician [PODCAST]

      The Podcast by KevinMD | Podcast
    • Gaslighting and professional licensing: a call for reform

      Donald J. Murphy, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Why fixing health care’s data quality is crucial for AI success [PODCAST]

      Jay Anders, MD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why physician voices matter in the fight against anti-LGBTQ+ laws

      BJ Ferguson | Policy
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How functional precision oncology is revolutionizing cancer treatment [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • When a doctor becomes the narrator of a patient’s final chapter

      Ryan McCarthy, MD | Physician
    • Why innovation in health care starts with bold thinking

      Miguel Villagra, MD | Tech
    • Navigating fair market value as an independent or locum tenens physician [PODCAST]

      The Podcast by KevinMD | Podcast
    • Gaslighting and professional licensing: a call for reform

      Donald J. Murphy, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How can hope help make cancer a chronic disease?
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...