It is indeed rare that I find a book or article so powerful that I believe that it should be widely read and discussed. Some works make valid points but are not of a nature that it impels us to rethink our previously held convictions or make us reexamine our basic understanding of a disease process. However, after reading and rereading parts of the Death of Cancer by Devita it is my conclusion that this work falls into that rare category of medical literature. I would therefore recommend that you read this book. Although this treatise is at times technical it should be well within the grasp of the lay reader.
If you are going to follow my recommendation to read this work than I also make the unusual suggestion that you read the last two chapters of the book first. This is not a mystery novel and you do not have to worry that you will ruin your enjoyment of the book because you already know “who did it”. I make this suggestion especially for the non-expert lay reader who will likely be bored by some of the details in the beginning of the book. The meat of this authoritative work is in the last two chapters, the penultimate chapter is entitled the “Death of Cancer” and the final chapter is “Outrageous Fortune Part 2”. Let me explain.
The first part of this book is about the history of the treatment of cancer since the 1960’s. To a great extent it is a polemic by the author castigating those involved in the treatment of cancer for their lack of progress, short sightedness, inability to think creatively, insular approach and unwillingness to innovate or accept the results of innovation. For the most part it is not a pretty picture and is in many ways disheartening. The author has an obvious bias and I am not completely certain that some of his observations and accusations should be taken at face value for it is possible that his observation reflect his own inability to understand the position of others. That is something that I am ill equipped to judge and I am sure that others with greater expertise will comment. Certainly feel free to read the book in its entirety but I want to be clear that my reason for recommending it lies in the last two chapters.
The last chapters describe in a logical and clear manner the underlying pinning’s of the nature of cancer and the methods by which we can either “cure” this dreaded disease or treat it as a chronic disease disorder such as diabetes. What Devita describes is not some pie in the sky vision of a possibility of future developments. It is technologically achievable today. Perhaps most important of all is that he has a realistic plan for rapidly implementing new discoveries in the treatment of cancer for the use of the public at large.
Some of the language in the final chapters is technically difficult but do not worry about that. If you do not understand a word or phrase it is likely that he will make it clear as you read further. The important point to understand is that we have now arrived at the point where we have the tools in our hands to radically change what we have been doing. This is indeed a paradigm shift. It requires a new way of thinking about a common problem and promises results that are far better than we could have expected as little as five years ago. It is a demonstration of the integration of scientific and clinical knowledge across widely divergent areas of specialization and proposes a far more advanced model of care.
Some will reject the conclusions of this book because they may be either antithetical to their belief system or they view it as philosophically disingenuous. To those I would comment that if your opinion is based on hard evidence then I respect it and would appreciate further debate. However, I personally have little tolerance for those who reject these propositions based on an irrational conservatism that in essence says we do it this way because that is what we have always done it. That method of thought should be an anathema to the scientific integrity of our profession and is harmful to the public at large. For those who argue “first do no harm” it is clear that for those who desire reasonable treatment then patient autonomy trumps our individual pessimism. I am not arguing for futile care for that does violate other important medical principles. I firmly believe as a family physician that all physicians interacting with those who have serious illness have a responsibility to fully educate their patients and themselves about what is available and the consequences of making an either positive or negative decision about treatment. This book supplies some of the basic knowledge necessary to participate in that essential medical decision making process.
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About the author
The Non-Death of Cancer.
First, and foremost, this book truly is a must read, but not so much for the title, which is misleading. The DeVitas detail all the roadblocks, potholes, obstructions and other BS that has impeded the true demise of cancer. Only a small portion (< 10%, perhaps 5%) of this book discusses new inroads to the control of cancer. So why is reading this so crucial? The public needs to know that although cancer touches everyone on this planet, the arena of medicine is not some exalted profession but succumbs to the same greed and ego issues that permeate so-called homo sapiens i.e. sentient man. This is what the authors, mostly Vince, documents.And the BS continues, and perhaps is even worse than before. The "moonshot" approach to cancer as discussed by Obama and Biden, and the recent speech at the ASCO (American Society of Clinical Oncology) meetings in Chicago by Biden on the need for collaboration and collegiality, are but pablum for the people. We just don't seem to realize the need for a public outcry, a true people's revolution to redirect the way we approach all the problems we face relating to biology--from our internal environment such as cancer and other epidemics (obesity, cognitive dysfunction, traumatic brain injury) to our external environment (climate change, shortage of water).So this is a chronicle of the "crap" that cancer patients, Devita's patients and DeVita himself, routinely face. As a physician that has been in cancer medicine since 1963, and who came along just after DeVita, I have seen these roadblocks halt the progress that could lead to the real death of cancer. Medical oncologists as a group do not think outside the box. They do not take from other areas of medicine basic principles and apply them to the patients whose lives they are entrusted with. The "Death of Cancer" is a must read for all people, in every country, but there is no evidence that the concept or reality of human unity exists relating to the very things that will shorten the duration and quality of our lives.I gave this book a 4-star review because I believe Vince DeVita lacked the testicular fortitude to tell this story while he was in the heat of what should have been a battle. DeVita's disclosure of what he experienced is presented at the end of his career--after retirement. He did not rock the proverbial boat when he was actively involved at the NCI or at MSK (Memorial Sloan Kettering); he remained politically "correct". For that I criticize him. In "Death" he mentions the Abigail Alliance, a group of individuals who were fighting for early access to new anti-cancer therapies. Vince opted out in joining Emil J. Freireich of M.D. Anderson and myself, the only 2 medical oncologists, to file an Amicus Brief--a law suit against the FDA to allow access to investigational drugs after Phase I trials. See [...] for further details about Frank Burrows and the travails of his daughter Abigail. Note that DeVita did not join the Alliance nor did the major society of medical oncologists (ASCO), of which I have been a member for 41 years. The law suit was thrown out of court by a Federal judge, and no jury was involved.In summary, The Death of Cancer is a must read− if the reader understands that most of the book is about why we currently do NOT have the death of cancer. As Pogo said, "we have met the enemy, and it is us." The real issue is whether humankind can ever truly collaborate on issues that affect our lives--and not just talk about it but see it through in deeds."Our lives begin to end the day that we become silent about things that matter." -Martin Luther King
Top reviews from other countries
- Peter R.Reviewed in Canada on August 4, 2017
The good thing is that the field seems to be moving ...
- Jean Charles soriaReviewed in France on August 21, 2016
Great personal perspective on cancer care
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Fernando Gomollon GarciaReviewed in Spain on February 10, 2016
Un visión personal de un verdadero pionero en el diagnóstico y tratamiento del cáncer
- StefanoReviewed in the United Kingdom on February 8, 2016
This book should be on every oncologist's and member of parliament's desk!!
- S. SankarReviewed in India on January 13, 2016
I would recommend this book to be read by anyone interested in ...
