May 2014
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Lives depend on cancer research

By Katharhynn Heidelberg

This May 22 marks the fourth anniversary of my father’s death.

Four years.

THOMAS HEIDELBERGIt’s hard to fathom. I still hear his voice, and not a day goes by without a thought of him. Mostly, I think of him with fondness, not sadness – and if that’s not the way it’s supposed to be, then I guess I am glad to be an exception among the ranks of the grieving.

Of course, my father was not the exception — the reaper comes for us all — and I am not the exception. I am not the only person in history to have lost a parent to cancer, even pancreatic cancer, with its roughly 2-percent survival rate. A good friend last year lost his mother, young at 52, to lung cancer (she didn’t smoke), another “recalcitrant” cancer that appears to be on the rise. I know many people who have lost a loved one to cancer far sooner than the loved one should have departed.

All the ribbons and walks in the world won’t fix that; they aren’t intended to. What they are intended to do is raise money to better fund cancer research, and that is paramount. My family’s tragedy has taught me that much.

An April 25 article in Forbes reinforces this need. While Europe’s cancer death rates are going down on the whole, the exception is pancreatic cancer, which is increasing, as well as lung cancer among women, Dr. Robert Glatter writes, citing a new study published in the Annals of Oncology. The study’s grim prediction: In Europe, more than 82,000 deaths this year from pancreatic cancer, with the fatalities split almost evenly between the sexes.

American pancreatic-cancer death rates are about 38,000 per year (and there are about 44,000 diagnoses per year), making the disease the fourth-leading cause of cancer deaths in the U.S.

“As so few patients survive, the increase in deaths is very closely related to the increase in incidence of this disease,” Glatter quotes study author Dr. Carlo La Vecchia.

“This makes pancreatic cancer a priority for finding better ways to prevent and control it and better treatments.”

There is “no promising treatment” for the disease, La Vecchia notes. In the four years since Tom Heidelberg died of pancreatic cancer, little has changed on that front. La Vecchia dubs prevention “the only possibility” for the time being. He trots out the usual suspects, saying that smoking cessation should come first, then weight and diabetes control.

Glatter writes that a family history, smoking, obesity, diabetes and heavy drinking are established risk factors for the disease.

I accept their expertise, though I think there is a risk that laypersons will conflate risk factor with cause. Yet, per Glatter, La Vecchia finds that tobacco use “accounts for less than a third of all cases of pancreatic cancer and the other causes together account for another 10 percent. More work needs to be done to discover other possible causes.”

In other words, and as always, weight in and of itself doesn’t cause cancer. In terms of pancreatic cancer, it would be a factor less than 10 percent of the time, since “overweight” is included in the “other causes together” that total 10 percent. And again, tobacco use applies in “less than a third” of cases.

We need to seek the actual cause of this disease, as La Vecchia noted. We also need to come to terms with the fact that disease is not punishment. It is luck of the draw.

While emphasizing “lifestyle” does no harm, we can’t surrender to the temptation of doing so in place ofˆ meaningful advances in eradicating pancreatic cancer. That won’t save anyone. It can also serve to make people think that if they don’t drink or smoke and are not overweight, they are immune from pancreatic cancer, and they will miss the warning signs.

This is what follows when that happens: Pancreatic cancer cuts down a 6-foot- 3-inch tree of a man, whittling him to a sack of bones within eight months, one his 5-foot-3-inch daughter can lift onto and off of a seat. It paralyzes the nerves in his stomach, making digestion impossible; it makes him turn to his daughter and say “It’s time,” and then sign the paperwork for hospice care, so when the “time” comes, he is at home. It makes it impossible for him to eat Jell-O. Then impossible to swallow water and the roof of his mouth turns black from thirst as he desperately sucks a sponge “lolly” dipped in water. It robs him of his speech; it leaves you unaware of whether he can hear you. And at 1:39 a.m., May 22, 2010, his eyes roll back, his breath leaves him and that hand you’ve been holding goes instantly to ice.

My dad was not fat. It had been 40 years since his last cigarette; he said he’d quit because God told him, “I don’t want you to smoke anymore.” He’d long left behind the party days of his youth; by the time I came along, he just had an occasional glass of wine. That ended the day he saw me drinking grape juice out of a wine glass; the next time I saw him drink, it was my college graduation day, and he’d scored all of the champagne flutes that I and my other guests turned down. I am told he spent the ride home flat in the back of the minivan, giggling.

Could his past smoking and drinking have set the stage for the cancer that killed him? Perhaps. But he did everything people recommend to “prevent” the type of cancer that killed him in the end; there is no failsafe way to avoid cancer, let alone death itself.

So while I am all for undertaking “preventive measures,” I think it is fair to demand something clearer than: “Well, since we don’t know how to prevent this, we’re going to recommend basic healthy living.” This won’t hurt, of course. But neither should it be offered as, or interpreted as, a panacea.

No, when it comes to pancreatic cancer, “don’t drink, don’t smoke and lose weight,” just isn’t good enough advice, nor should it be our only strategy.

We have to push for better treatments. Pancreatic cancer is notoriously difficult to treat, in part because it is so difficult to diagnose early enough for conventional treatments to do any good. It stands to reason, then, that the focus needs to be on research: research for better treatment methods, but especially for methods of reliable, early diagnosis.

A good start was made last year, when President Obama signed the Recalcitrant Cancer Research Act (previously the Pancreatic Cancer Research Education Act). The law directs the National Cancer Institute to look at its research efforts on deadly cancers — especially pancreatic and lung cancers — and work to develop early diagnosis methods, as well as treatment.

For now, there is no routine screening test, per the NCI, which estimates that $2.3 billion is spent on treating the disease each year. The NCI has significantly increased its spending on pancreatic-cancer research — to more than $105 million in 2012, from $82 million in 2008 — but that’s nowhere near what is spent treating this monster in order to give its victims a few more months. It is obvious where we lag.

The NCI has made some interesting finds in recent years: a possible signaling pathway that contributes to metastasis; an indication that a polyphenol from green tea inhibits tumor growth (in mice), and that reduced levels of a protein receptor lead to increased growth of the cancer cells in a lab setting. The NCI also reports that a clinical trial that added ascorbate to gemictabine (the drug that prolonged my father’s life for longer than we were told to expect) proved to be “well tolerated” and warrants further study.

We put men in space. We have pocket-sized computers. We have information literally at the tip of our fingers, thanks to the profound technological advancement that is the Internet. You can’t tell me that we can’t find a way to diagnose pancreatic cancer before it’s too late to save its victims.

Fund cancer research.

Katharhynn Heidelberg, a journalist in Montrose, Colo., just was awarded first place in news columns in the 2014 Society of Professional Journalists Top of the Rockies competition.


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