Thursday, December 18, 2008

A Matter of Perspective

EPA to test air, water in town fearing cancer
By Associated Press: 12:02 p.m. EST, Dec 17, 2008

CLYDE, OHIO: State officials say they will begin monitoring air and water in a northern Ohio town where there are a surprisingly high number of children with cancer.

At least 18 children in the Sandusky County town of Clyde have been diagnosed with cancer in recent years.

Ohio Environmental Protection Agency director Chris Korleski says he's making this his top priority.

He says air and water monitoring will start by January.

State health department officials also are analyzing where the children live and where they have spent their time since birth. That report is expected to be ready in April.

Still, officials are cautioning residents that the odds are against finding out what is causing childhood cancer rates to be higher in the Clyde area because it's not known what causes most child cancer cases.

Shannon Nabors, chief of the Northwest District of the Ohio EPA, said, "We don't know what causes the vast majority of childhood cancers."


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They are not optimistic that they will be able to find the cause, because "We don't know what causes the vast majority of childhood cancers." Could this have anything to do with the fact that less than 3% of all research funds go to childhood cancer?

In raising my sons, I have consistently taught them that in life they will accomplish what they focus on. Nothing worth having is ever achieved without dedication and focus. Can anyone give me a single example of a great accomplishment achieved with only 3% of our focus?
As usual, the findings will cause a lot of meetings and reports. However my experience has been that, after all is said and done, everything will be said but nothing will be done. And our sons and daughters will continue to suffer.

I believe it's a matter of perspective. Our children are being ignored in cancer research because there are "only" about 12,500 cases per year, compared to about 1.4 million adult cancer cases. No one wants to admit it, but that is the fact.

The focus in cancer research has been to go for the home run...to find the "ultimate cure" that will save 100's of thousands. That is why the children are ignored -- there is not enough of them. but with all the focus, the results have not been there. Dr. Harold Varmus, former Director of the National Institutes of Health and recipient of a Nobel Prize said that researchers most often focus on elegant science that make headlines but "have little or no impact on clinicians to diagnose and treat cancer". He said those who research and those who treat "seem to inhabit separate worlds".

Even with their limited funding, great strides have been made in certain childhood cancers. Childhood oncologist have shared information and created assembly line protocols that have been very effective in many cancers. But there has been a big cost. This does not work with rare cancers, nor with kids who deviate from the "statistical norm". It also has shown very poor results with teenagers, who have the lowest survival rates of any age group under 70.

The bottom line is we need more money and focus specifically on these childhood cancers. But this will never happen because the perspective is on big numbers. The focus of most cancer research is the theoretical data that grabs the headlines, the "grand slam" theories that make careers. But little of this gets results. If fact, less than 8% of cancer research ever results in a new treatment.

I would like to suggest new perspective. I suggest we focus on results, not numbers.

Since 1971 when president Nixon declared war on cancer, $200 billion has been spent on adult cancers. But the results have been very poor. The big problem is that adult cancers are more complex, and are often caused by a multitude of issues, including lifestyle, general health, environment, and heredity.

In contract, childhood cancers are comparatively much simpler, typically the result of a single mutation. With focus, these cancers are much easier to cure. But these are not big headline grabbing cures. The work is slow and plodding (there are a lot of childhood cancers). However the results are very real and very achievable. And results are within sight.

Finding the cure to a cancer that effects 100 kids a year will not make headlines or win a Nobel prize. Curing childhood cancer takes a series of singles, rather then the "grand slam" of adult cancer...but that is how ball games are won. With greater focus (meaning more than 3%), we can win this war very quickly. We can get the results. We can then use those results as a foundation to curing the more complex adult cancers.

So do we continue to spend our money hoping for the "miracle cure", or do we focus on saving 50, then 100, then 200, and more. Small steps, with consistent results. It's all a matter of perspective.

Now, if you are still big on numbers, let me offer another perspective. This one comes from A.J.'s dad. A.J. and my son, both 15, were both diagnosis with the same cancer last year. A.J.'s dad gives perspective on numbers. However his numbers are not on people saves, but years of life saved. The average age of a patient with adult cancer is 65, while the average for childhood cancer is 7. He has multiplied the number of patients by the number of years of life lost. You can see his chart here. His research shows that childhood cancer, although always called "rare", is one of the most devastating deceases in our nation in terms of years lost.

Despite these facts, the need for childhood cancer research continues to be ignored. I guess it's all a matter of perspective.

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