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The Funeral I Missed But Did Not Skip

This is a story about a cancer patient’s funeral that I did not attend, because it never happened.

A woman I know, whom I will not identify out of respect for her privacy, was diagnosed nearly four years ago with inoperable and terminal stage 4 cancer. It had started in her lungs, and subsequently spread to her brain and other locations around her body.

She enrolled in a series of clinical trials involving some of the latest technologies, including gene therapy. I do not know all the specifics of these trials, because I did not press for details.

One therapy which may or may not have been included was immunotherapy. A recent article in The Wall Street Journal described the search among drug companies and research centers for better and more effective ways to use the body’s own immune system to attack cancer cells. While immunotherapy is a relatively new treatment option, it shows promise so far.

The article does point out that results are mixed and more research on these sorts of therapies is needed. Some patients experienced relatively mild side effects; others developed severe complications. Now researchers are trying to find a way to harness what is effective in immunotherapy agents while minimizing risks to patients. Many experts believe it will take a combination of treatments to create regimens that are effective against a broad array of cancers. It is going to take a lot of time and even more effort.

Though the treatments on the cutting edge of cancer research haven’t yet offered any blanket solutions, they are already making a difference. The Journal interviewed cancer patients whose survival times have been extended and, in many cases, whose quality of life has been substantially improved, by treatments that are still in trial stages. These so-called “super-survivors” are reviving scientists’ hopes in the long-term promise of immunotherapy. While the treatments are far from a panacea - published studies say they have only shown evidence of working on kidney cancer, melanoma and lung cancer - researchers continue to explore how to improve immunotherapy’s effectiveness.

As for my friend, the particulars of her treatment were her own business, but the results of them are evident. Rather than attending her funeral, I have seen her on many occasions in the last few years, often at dinner or when she and her husband take vacations near my home in Florida. Whatever the larger outcome of the treatments she received, in her case, they gave us time together we would not have otherwise expected.

There is a lot wrong with our health care delivery system and its costs. A lot of criticism is directed at drug companies that price their new technologies at seemingly exorbitant levels or game the patent system in pursuit of big financial advantages while offering little medical benefit to society at large. Some of these criticisms are justified.

But we should not lose sight of the larger truth that thousands of researchers, doctors and other health professionals place their formidable intellects in the service of mankind every day, searching for that scientific needle in a haystack of data to extend and improve the lives of people they will never meet.

While there is clearly room to improve the way we manage health care costs, it is also true that developing a drug is not cheap. Many people argue about the actual dollar amount - a recent think tank analysis pegged the figure at $2.6 billion - but as drug makers tackle increasingly complex diseases, research costs and the costs for failed attempts are unlikely to subside. And the costs in the number of hours, mental energy and frustrating dead ends are unlikely to diminish, either.

The development of new treatments for cancer and other deadly diseases is no light task. But researchers’ efforts with avenues such as immunotherapy and other treatments under development offer the promise of giving parents more time with to watch their children grow, spouses more days at one another’s side and friends more conversations over leisurely dinners.

With each meal or walk on a sunshiny beach with a person we value that would never have happened but for these efforts, we should remember, in some corner of our mind, to say thank you. It is also worth remembering that for as much as science has already taught us, there is still a vast amount about our world that we don’t know. Things that seem improbable, like teaching the body’s immune system to fight off otherwise incurable cancers, may simply be out of reach until we make enough foundational discoveries to push us forward.

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