Do not have nostalgia for the “old days”. Not that I am ready to try a flying car like the Jetson’s but I am all in for new and improved. Take cancer treatment (as many of you have.) Examining epi-genetics (genes on the genes) are giving us personalized information that even we cannot fathom about ourselves. In the “old days” we blasted tumors with radiation (initially they just shined cobalt on a tumor til the skin turned red… not very sophisticated, but effective.) Now we have nuanced treatments with precision delivery of beams, stereo tactic radiation, less invasive laparoscopic surgeries with rapid healing and … wait for it… even new and improved chemotherapy and immune treatment that target your specific tumor.
It’s a great time to be alive, even with cancer. The disease is being attacked by our own bodies with the help of these new tools. Take Mass General’s protocol for treating multiple myeloma. They take the T cells (white cells that fight disease) from the blood, activate them and put a chimeric antigen receptor (car) which can recognize protein on the tumor and infuse the cells back into the body where they multiple and kill more tumor cells. Its CAR-T therapy you will hear about everywhere, while not yet a cure, response rates are 80-100%.
There are new trials for glioblastoma multiforme ( GBM ) the most deadly brain cancer that are also gearing your own cells to fight. Who knew how powerful our bodies were? These same bodies that we think have let us down when the cancer diagnosis is made.
Two new pills (not IV and dreaded time in a chemo chair) for non small cell lung (Tagrisso) are targeted genomic therapy and Kisqali for breast cancer (many of you are taking).
Remember when the world wide web (WWW) started and you couldn’t imagine that something harnessing a universe of information, could actually be trusted with answers? We didn’t limit it then and we won’t for AI now. I prefer to think of new adventures especially in medicine as EI: Enhanced Intelligence. It won’t be perfect, and it will require human over site, but reading a breast mammogram more completely, planning radiation more swiftly and accurately, aiding a surgeon with an new tool or scalpel, developing treatments that boost our own immune system almost magically to battle disease, will continue to change, enhance and improve our lives.
Leeza stopped by to see me this week. We treated Spine, Brain, ribs and lung chasing her metastatic melanoma five years ago! Her scan looked like splattered paint- the disease everywhere, while no sign of where it started on her skin. With a chemo that specifically targeted her disease, her pet scans have been clear for years. She and her husband are in their late forties and a darling couple. He came everyday with her. He has always carried her handbag and is heartbreakingly sweet with his large eyes and hopeful tremulous smile. “Doctor we heard you were here today so I wanted to show you my wife!” Leeza grabs me in a fierce hug. “I am getting fat!” She gain about 15 lbs- so happy that is the greatest of her worries. What joy. I have met their darling children and they are now both headed to high school and college. Their lives are rich in love and gratitude- to which we could all aspire.
New and improved isn’t always easy to adapt to as we age, but I will never pine for the past. We are embracing fast moving, brilliant improvements in medicine and cancer care. I doubt I will fly a car since I have fear of heights, but I have hope that we can live our best and healthiest lives when we step boldly into new frontiers. There is nothing artificial about empowerment.