One Moment in Research

Recently, I was approached by one of my Texas colleagues and asked if I could help out with some legislation before the Texas state Senate. The bill (HJR90), which would authorize $3 billion for cancer prevention and research over the next 10 years, had passed the Texas House of Representatives, and was currently "in process" in the state Senate. It had run into some roadblocks, and there was a hearing pending for Friday afternoon. If it were to pass the legislature,* it would go to the Texas voters in November as a constitutional amendment authorizing funding for the single largest state investment dedicated solely to cancer research and prevention programs.

I indicated I would be glad to help out, and received a phone call indicating that I would be participating in a news conference. The lead attraction was Lance Armstrong, a Texan, and someone committed to supporting this legislation and getting it passed. I heard Lance speak last year at the annual meeting of the American Society of Clinical Oncology. I never had the opportunity to meet him in person, until now. His story is well known, but nothing prepares you to see him up close and personal, take a measure of his commitment and his intensity, and understand that this is obviously a very personal and very important mission for him. You think about him as a person, and about the battle that he fought to overcome a disease that could have led to a different outcome.

But that moment also brought back another memory for me. It is a memory of the way things were, and a memory of what can be. It is a memory of a miracle. When I started my cancer training in 1972, I was at a National Cancer Institute facility in Baltimore. We did cutting edge research in cancer, both in the lab and in the clinic. We treated patients with lymphoma, leukemia, sarcoma, and solid tumors such as lung cancer and colorectal cancer. We also treated (usually) young men with testicular cancer. We had little to offer these young men. If they had seminoma, we at least had a shot of helping them live. But for the other types of testicular cancer, there wasn't much to offer.

The memory that came to my mind was of a young man who had one of the nonseminomatous types of testicular cancer. This young man had widespread disease, and it wasn't responsive to chemotherapy. The disease was spreading rapidly.

I remember being the physician on call in the intensive care unit one Sunday, spending hours by this young man's bedside, trying to do something to save his life. But there was nothing we could do. The disease would progress, and all the supportive care and chemotherapy would make no difference. The young man died.

And then there was cisplatinum, a new drug discovered because someone in a laboratory noted that bacteria died when exposed to an electric current from a platinum electrode. The researchers took that observation and worked with it. They found that the platinum compound was responsible for what happened, and then they learned that it worked as a cancer treatment drug in animal systems. And then, they learned that the drug they produced was exquisitely effective in the treatment of testicular cancer. Suddenly, young men who would have died a quick, difficult death were living and thriving. Suddenly, we had survivors.

Lance Armstrong is a survivor because someone in a laboratory made an observation and developed it into a more robust treatment. He is a survivor because of one moment in research. I discussed this with Lance that morning in Texas, and told him about that young man in a small ICU in Baltimore, where all of our efforts couldn't make a difference. There are millions of other survivors in this country, some of whom are here today because some researcher somewhere had the ability to make an observation that made a difference.

The Texas legislation is a bold step in support of advancing the dream that we will be able to further diminish the suffering and burden of cancer in this country. The American Cancer Society vigorously supports the efforts of the many special people and legislators in this great state who are making an effort to make a difference.

As a physician you can never forget that moment of a miracle. My young patient didn't have a chance for a miracle; Lance Armstrong is a miracle. Hopefully, by emphasizing our investment in prevention and research, there will be many more.

—J. Leonard Lichtenfeld, MD