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tv   Book Discussion on The Death of Cancer  CSPAN  February 6, 2016 6:00pm-7:01pm EST

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>> just a few housekeeping items before we get started. take a moment to silence your cell phone. pleased to have c-span here. tonight all states conversation. an opportunity for audience
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questions at the end. please wait for microphone and speaking do it clearly. after the discussion the authors will be pleased to sign copies of their books that are available here. if you could please form a line. that would be great. for those with a book in hand already jump right in the line. thank you so much for supporting the library and this programs. these things will help library to run for programs. tonight we have pioneering oncologist is going to share personal history of one of the great stories of our time, the fight against cancer. after 50 years.
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while wind cancer, how we can get there, covert by journalists. we are privileged to have the opportunity. received wide praise for craftsmanship, hope, humanities. tonight they were interviewed her father about the work and personal story. arrived in 1963 eventually becoming a director and yale university areas professor of medicine and professor . elizabeth received a masters degree and health rights, science whole society. self-help psychology.
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please welcome the doctors. [applause] >> thank you all for coming. can you hear me? i'm a bit of a low talker. something i have done a lot of. most of our conversations took place over text. put together some of the conversations. and before you begin i would like to introduce lived through many of these conversations. [applause] and now it will begin. this book is about the cancer in your journey
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through it, most people don't really know that much about how it came to be. >> well, 23rd of december. christmas gift to the nation. it was the brainchild very wealthy philanthropist and it was a very confident program. 's national cancer institute and different separate agencies. the fda controlling drugs. and controversial.
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problems that have been passed the cancer act. >> no scientists. >> members of congress. the best way to for about 30 days. so it was very controversial program. book is really about my truck. >> something like this in mind for a while but was biding her time.
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>> well, her husband died of cancer. the chapter for marrying her machine. she had ann landers as part of her operation. american people, congressman she had this big machine she said in motion. it was a very successful endeavor. >> a lot of people would be surprised to discover one
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patient had a lot to do with feeling that it was time to push forward. >> we tell story in the book i write coincidence. 1969 sitting in my office and the phone rang and it was a chemotherapy us from boston to kelly. so that patient who had just been operating on a great commonwealth. and he lived in washington and worked with congress wanted to be treated here. i was working on the fullness. i really don't work with the whole lot of cancer there was nothing we could do at that time. 's. >> one drug. >> one drug. so i said thank you i can take. the phone the university
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farmer and he said he told me that the patient is likely taken. i said comeau i don't work with this kind of thing. he said you will take this -- you will take this patient. i said okay. when i examined in working full of notes and so on: cancer does many things but it doesn't go phones. it turned out he had lymphoma. we now have a 2nd treatment we developed that was working very well and we treated them. use that as her cute. that we have provided the missing link. most people don't die from the cancer were starts.
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get breast cancer .-ellipsis cancer in the breast. so we were looking for ways to the drugs outside. >> connected to marry. >> well, he was working for the american cancer society. she played his -- pay his salary. it was her eyes and ears. the armed forces liaison to congress. basically was a part of her machine, her eyes and ears on the hill and was identified as supportive. those that are neutral. deal with each one a different way. and once it was intermission
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he began to put witnesses together to testify before congress and the national cancer act itself. so i followed a visible through the congress. arrest me your most of the people i suggested. setting it is somebody who was more of a believer. it was very interesting. >> i think pain discussion can describe what a contradiction she was. >> there was no way like for and has been no one sense. she was in the national cancer advisory council.
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sitting in the board meeting should take other compaq and put makeup on. if the impression that maybe she was just a frivolous observer. very, very sharp woman the knew what was going on. met her when i became director of the treatment division. and i remember posting don't worry, they can take care. in my office, very smart woman. you cannot really argue with logic. she is the take me around congress with her. a lot of my experiences come us.
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>> unorthodox methods to advance her goals. she had the machine in place. second down instead with a good friend in a lovely home visit various congressman we go see the congress have denizen lunches. dennis always sitting next to somebody. very carefully planned. one day i call. when you come to lunch today? of the clinic this afternoon. mary once you become. please come. all right.
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i rearrange my schedule kemal to my car. featherstone reid. we had lunch. the usual routine. all the good things we could do with more money. say something about what we were doing. in the not in our later said he had to return to congress and left. i went in there with her. who is featherstone reid? is maggie's driver. the chairman of the senate appropriations committee. and so seeing my shocked look she put her hands up, drives me to work everyday. how shopping all day. the last person.
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a friend of hers and surrounding him. i chuckled all the way back to my office. >> the war on cancer was a very popular idea, and politicians. the many who were appalled by this. >> is a very unpopular idea. indication. of course that is untrue. give money to scientists and they go to work. pour money and make it work. universities money to go in the grants.
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then some very happy with the money. smiling. you can agree is not terribly popular. unless maybe ten years. >> so i'll try and bring us all. i couldn't get a backpack. the relatively slim volume by comparison. what compelled to met. >> it was very clever.
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submitted a chronicle the dead. the hundred billion dollars is a lot of money. they should know something about the way it happened. the 2nd is, i was very fortunate work we did lead to it. the biggest cancer center in the country. into an accident got myself
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playing position to describe the whole thing. >> there are some things in any got a lot of e-mails that anyone caution you write things you didn't tell you not to? >> no. adequate, my good friend was
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there. have lunch. mr. scott really fun very serious. go ahead and do it. so people don't really need to know the story. i was a little shocked. >> a wonderful man but it was so out of character. >> are you concerned about the responses? >> yeah. well, people seem surprised.
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i think everything in as good as i can numbers. people complain: dry film book. >> what criticism has been the hardest? >> well, if you twice in the new york times. was not bad. >> it would like to see more the party but the field.
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i describe undermine to now i'm from institution to institution. next line could have median survival of what 3.9 months. one of my favorite depictions of this is median disease. i was trying to get him to a study with the survival curves like this. if you look at the survival curve 25 percent of the people were surviving.
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statistician working for many years. there is a statistic. laboratory. wonderful scientist. said it's good. we don't know enough to do these things. i responses you don't know enough of we. laboratory scientists, has been overtime didn't want everything for you do anything. in the cancer fields you don't have to do that. have to fix critical parts of the cancer so that is exposed to treatment. come back to where they were before you don't have to. otherwise. otherwise not have been able
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to do what we did so many other treatments. so those are the two that bothered me the most. they are understandable. >> early in the book start a chapter with a scene from party. and our new at the nih and it is a party thrown by your bosses. overflowing martinez. glasses fly infested the bathtub. i would you show them that way so early? are you trying to say? >> we went to this party.
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most junior people. by the way mark them as marquez has been most people could walk on their feet. two reasons. they are very important people. and throughout the book and make it clear that the contribution. i thought it was important to describe the way that they work. they worked hard and played hard. we have a photo. you can look and see. the other thing was, i had to make a decision. these people are so far out of the norm and to stay away from. there because it was a
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privilege to get there. we wanted to be there. it's a video for that reason but don't get too close to them. now i'm at a party and they sound like they are just as crazy. and so i had to make a decision about staying with these people to work on this power of us are going on some important that i realized it was the right thing to do. if you remember. and i got a lovely letter. so proud of the work together. very important.
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it is indestructible. >> a little mellower. >> a lot more. >> we interviewed for four hours. the interview itself is interesting. in fact, gladwell wrote the book. one chapter in the book is all about it. and i told him all the stories. >> you 1st about in 1963. first out there. >> 1963 few lucky you are operating on. early enough in my survive. a lot of people didn't. and then radiotherapy was
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round of really good ones. so overall survival was about 37 percent. chemotherapy was considered kind of a lunatic fringe. most people didn't believe it. very peculiar. advanced cancer and all of them died. not much excitement. testing drugs without much hope. >> one of the time. >> one of the time. then children with leukemia. >> upstairs, doing this thing. happy.
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he may not have liked it. but there was no escaping. so provocative. he saw things happening that you never saw before. in spite of the fact that i've been told to avoid these people were telling me something different. as a very well known cancer institute, internationally known. any. crazy. stanley talking about the shooting.
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maryland's back. still in the veins. and i would say myself, is telling me that it is working. it was very interesting to me within the campaign. rounds of 12 for. on the 12th floor. we crossed paths in the people departments would come up. never heard this before. it was really seem to make some people's blood flow. we tried. should the atmosphere.
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>> we should.out what they were doing it was so different. >> well, at that time using drugs in combination was considered bad medicine. started out at the same time. considered to be worthless. getting to toxic trace the same time. giving four was considered insane. develop the program. different drug combination. it turned out to be a very useful combination. drugs one of the time. they were happy. the program upstairs.
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it was very interesting time , the turmoil was unusual. >> so, the regiment that you came up with for hodgkin's disease, but that was a your 1st half. >> so much feeling. they call it mom. it was a shorter study. hello more toxic than the program. we put patients and. careful. we did not have drugs to control nausea, vomiting. it was a very trying time but it worked.
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the 1st 14 patients when intermission. we begin to face a very unusual problem. do something for a longer duration. treating the bone marrow. this continually treated. treating something, the amount was normal. have to get it long enough so that the tumor doesn't grow. and then we made translations we came up with a fairly complicated schedule. i did this with my 1st partner. and jack to the program.
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an interesting story. shake hands, how are you. to be a day. two years later. medical school. asked what happened. we still stay in touch. so we can. with a fairly complex schedule. >> was the biggest obstacle? >> the 1st four years pretty sure.
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the patient was going to occur they were the 1st four years. when your asking people who had never done things like this, and if you did not believe in you are making patient sick for nothing. work on the schedule. i was invited out. i went up for grand rounds. they could not make it work. my father worked in new york. and all this exciting data. the implication was that i
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was taking the easy cases and the retaking our cases. what do you do? they said well, they don't like it. use drugs. easy-to-use. we cut that doesn't have. carefully worked out a schedule. veteran of the window. so i finally caught why you do this? we don't want them to vomit
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on the way home. tell the patient's. is it that my take the taxi. but that was very emblematic of the problems getting people sick. they tackled. 6-foot seven. they check the dose was there they said this is crazy. plan to go and check this with the dose. the body surface area. i had to go in the clinic.
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when intermission. we still have it. you need measurements. come regiment. >> are running out of time. you're pretty critical. what are they getting wrong? >> somebody. >> they do a lot of good
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things. approved drugs rapidly. that they tender life when comparing a new drug to an old. very difficult circumstances. what they should do is approve the drug and if the tips the biological target nowadays pick up a mutation. if it hits the target safe. most of the advances we are talking about, they were
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done in the postmodern. give these tools to the oncologists. let them come up with a way to do it. the way to do that is on the basis of safety. what we call phase one. in the conditions. but the way it is now, some of the protocol in some cases takes 800 days to get a protocol. three, four, five committees. the fda changes the protocols. they have not mentioning it. one of the meetings i
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attended was nicknamed by my colleague from a society of jabbering idiots. people would take a piece of chalk. it was actually the most exciting in all my years. the name is misleading. brought everyone together and decide how to adjust the protocol. now the next day monday 800 days. if you do what i said delegate ocean eyes and.
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next line all kinds of people and committees go. government institutions. take some interest from the caucus. >> merry lasker, never want to me this congress. they really really loved her. we'll have an organization. >> what changes are emotion?
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>> a lot of people came up and asked questions. in the papers was which is very exciting. given that going at it for years. not making much progress. one of the most successful. we were stymied rally to get the immune system to react. 1996 the doctors the checkpoints. turn down. when the body protects ourselves.
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so now the cancer cells the cancer cells and they have been approved. how they are treated. patients with melanoma. working in lung cancer. the fact that it is working pretty much everyone is being tried for breast cancer, the response rate is lower. working out the details. now we have chemotherapy. we can mix and match.
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we cannot engineer. you can find responsive. they get responses. very personalized medicine issue. very sophisticated laboratory. much more widely available. >> so has the cataract performance mandate?
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>> about 70 percent she would ask, going to ask $200 the thing i can say can justify. sure enough 5 million of the going to the area i talked about. which is find a way it should be. instances coming down. cancer incidences down. reduce incidence of the number of cancer. the mobility is so much less. you see.
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the difference in outcomes of mobility. overall 25 percent. texas five years to collect the data. so supported research, reduce the incidence of morbidity and reduced mortality. it was not possible in the taken a while. measuring the impact. >> thank you. some time for questions.
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>> i don't here as well as i would like. >> i would like to ask you, what do you think is the role of hope in the treatment of cancer? >> you know, it is very important. if it sells, we need there is no difference. if responding to treatment. so the ability to say i'm going to do this is very important. an important component of treatment. here's to come back and
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submit when i leave here i get the treatment. pupils by the side. our walk through the pool. take all the help i can get. >> thank you for your talk. i has been had esophageal cancer offered by doctor swanson it teaches now harvard medical school. what progress has been made? a very difficult cancer.
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has anything, any progress made? >> we usually don't do surgery alone anymore. patient is usually treated with chemotherapy, radiation therapy. so there are a lot of people about a quarter we treated without surgery. the dance. >> it doesn't make any difference anymore. easier to give surgery and chemotherapy. still a way to go.
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>> a lot has been said lately about the cost of cancer check. if the fda approval process was shortened the new drugs are being given the patient's a lot of these don't have the means to pay for it. almost 200,000 a year, something like that. so just wondering how to deal with the crazy prices. >> took care of language. the cost is very complicated.
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the insurance company paid for. not approved in the becomes a cost of the patient. the cancer institute said it was good. it gives credit. been on the board of the companies that manufacture drugs, only put out the cost $800 million $800 million. have a duty to the shareholders to make sure the company doesn't go bankrupt. it's a tough issue.
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a lot of clarification. it's not all one way or the other. >> in addition to the advances in treatment could you comment on any advances that might be made in the early identification? they tend to have very low success rates. >> the two big ones. pancreas cancer for more difficult to treat. ovarian cancer the same way. talking about liquid biopsies. then you will tell whether.
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to tell you whether or not they were cancer cells present, they took the test and it was negative. advanced cancer like hopkins. you have to give six cycles. it will happen to take a lot of doing. i am hopeful. right now we have one. >> it to me that begins, is a material.
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>> this is recommended. one of the reasons is one of the last of our success something knew. and so when people are developing and measure how they are doing. i would give it a try.
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>> when anyone else comes through clearly in the book. the two-minute. talking about gladwell has a tipping., but it is hard to get. so these obstacles when the leg is up tomorrow. what about those people that are coming up in this day and age with significant advances that don't yet have the momentum? how do you get those people? >> open a few dollars for people.
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some of the barriers can come down. we did about three years. it would take 15 years. with all the rules and regulations that are in place. how do you maintain momentum and enthusiasm? they don't have enough energy left after the protocols and committees. it is very difficult time. it is a shame. loosened up the system. things will happen a lot faster. >> hello. i think it is motivating a lot of providers. besides cancer early
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identification the best preventative method whether it be prevention, what do you think is the future? >> stop smoking. 40 percent of all cancers related to cigarette smoke. cut the smoking right now. the biggest development just tell you the story. listed in the stories of vacant. if you a bacon every day the risk of getting all cancers i, but if you smoke any bacon the risks are so much different. we know people migrate certain areas with a have a
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good diet, lower incidence of cancer. we know that's important but have not learned well. we don't know. thirty-five different diets. i think the one thing we do know. >> with the microphone. >> unit spoken briefly about hopefully there are people in the private sector there were stepping up and helping to avert some of the frustration. in putting this out there because my father has been very involved in the subject of alzheimer's, but he was a
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venture capitalist. he is actually started companies, nonprofits to attract investors, and what they are doing is certain doctors and programs that have a potentially excellent success rate. >> tended to cancer program. they put $50 million in the hands of doctors like this is thought to go through these hoops. >> thank you for coming. how close are we talking in the laboratory conjuring
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blank coming up with a diagnosis make. >> well, there are companies now that exist solely for that purpose. ..
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i heard it's unique to mammals and therefore we have some kind of receptors. how are we doing in that department or is that just kind of propaganda? >> no. we have receptors in our brain for morphine. morphine attached and the reason you get high on morphine -- there's no surprise for ones that come from plants are the same kind of receptors. marijuana works. it was a fine time to walk down the hall. [laughter] >> making people eat and having

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