‘Tis the season once again to celebrate and be grateful for our many blessings, from family and friends to the historic freedoms we enjoy as heirs of The Great American Experiment launched almost 250 years ago.
Sadly, it is hard to focus on positive thoughts in the midst of incessant news coverage of division in our body politic and dysfunction in our government. Notwithstanding all of it, I firmly believe that our republic will survive.
I intend to focus my gratitude this year on something very simple, and so very fundamental: life.
This is not an article about life’s origins or timing (I leave discussions of Darwinian evolution and the “birds and bees” explanation to others), but rather about the miraculous reality of just being alive. And an invitation to seize the opportunity (“carpe diem”) to live in the moment and be grateful for the chance to have a positive impact on ourselves, our neighbors and our world.
This summer, our family faced a very difficult challenge. A close family member in her twenties was unexpectedly diagnosed with metastatic melanoma, the deadliest form of skin cancer. Years ago, the prognosis would have been immutable, and the timing would have been a few weeks or months. Fortunately, much has changed in just a few short years.
With the help of friends, we were directed to two amazing health professionals specializing in the use of a relatively new treatment protocol for melanoma called immunotherapy: Dr. Jedd Wolchok of Memorial Sloan Kettering Cancer Center in New York City and Dr. James (Jim) Allison of MD Anderson Cancer Center in Houston. Dr. Allison won the 2018 Nobel Prize in Physiology or Medicine for launching immunotherapy as an alternative cancer treatment, the story of which has recently been made into a movie called “Breakthrough” (see www.breakthroughdoc.com). Dr. Wolchok collaborated in that effort.
This new approach eschews traditional treatments like surgery, radiation and chemotherapy in favor of infusions of specifically tailored monoclonal antibodies (that is the full extent of my technical expertise in this area) to strengthen the patient’s immune system and direct it more effectively in attacking tumors.
Here is my best (though overly simplistic) explanation of how immunotherapy works:
The human immune system contains “T-cells” which seek out and destroy foreign objects that pose a threat to the body’s health, such as cancerous tumors. One of the reasons melanoma is such a deadly cancer is that it has a surface feature that “turns off” the T-cell’s ability to attack it by essentially telling it “there’s nothing to see here.” I liken it to Harry Potter’s “invisibility cloak.” Certain immunotherapy infusions strengthen the T-cells (much like multiplying the number of Marine battalions available for battle) while others strip the melanoma tumor of its ability to hide. As a result, the patient’s own immune system does all the work, and it’s “D-Day” for the cancer.
I am so very pleased and grateful to acknowledge that this treatment has been successful for our family member. Though she is not entirely out of the woods yet, her prognosis is good and she is back at work, enjoying her friends and participating again in her favorite outdoor activities. This new lease on life has had a profound effect for the good on our entire family.
A note of caution: this is just one patient’s story; this treatment is not for everyone or every cancer. But it is an amazing example of the promise of cancer research and the ability of our pharmaceutical companies to bring this technology to the market. It is worth remembering these positive contributions in the current environment where it is fashionable to demonize the pharmaceutical industry and propose changes to our approach to medical insurance and drug pricing that could have a chilling effect on the innovation that has so greatly benefited our patient populations.
So this will be an especially joyous Thanksgiving holiday for our family. I hope that it similarly is one filled with all positive attributes possible for you and yours as well. Let’s remember what a gift it is simply to be alive and to participate as best we can in this wild and crazy world. For all its challenges, it is worth it.
On Thanksgiving Day, please join me in a toast borrowed from our friends of the Jewish faith: “L’Chaim!
To life!
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