Progress

We just got a new puppy. I tell people he's a mutt but that's a half-truth because he's half-lab and half-poodle and I just can't bring myself to use the term that has been coined for the combination of those two breeds.

One night last week I took him to the vet and she was running a few patients behind so Dog (that's not his actual name) and I waited in an exam room for forty minutes. I fed him half of their treat jar trying to teach him to sit down (he's got it, now). When the vet made it into the room, flustered and tired, she apologized kindly and I asked her not to worry about it and told her what I do for a living.

"Are we making any progress with that disease?" she asked.

"We actually are, I know it sometimes doesn't seem like it," I said. Not the first time I've gotten this question.

*That disease*. 

Cancer is a word that almost invariably elicits recoil and is one that nobody ever wants to hear in a doctor's office or on a phone call with a family member.

However:

Even in the time I since I started residency, there have been entire new classes of cancer drugs developed.

(**Sidebar, please:** before I say this next thing, let me proffer a blanket apology for how expensive cancer treatment is, especially the new drugs. I'm sorry. I hope we figure it out someday soon).

Thankfully, a lot of the new meds are being approved not only because they offer new treatment options, but there's also a focus on approving drugs that have better toxicity profiles than the older ones.

Everyone's heard the objection that the treatment for cancer is sometimes worse than the disease itself (in my opinion, not an entirely fair statement). The drugs that are coming are hopefully better tolerated because they either make use of normal processes like the immune response to get rid of cancer, or they target the cancer cells more specifically so the drugs leave the healthy cells alone.

So even though it seems like we're approaching cure at a snail's pace, and despite claims that pharmaceutical companies want to create chronic customers rather than find cures (based on the current structure of the trial landscape, I really don't think this is true), we actually are currently moving toward a cure faster than we ever have.

When I was applying to medical school and telling people that I was interesting in learning how to treat cancer, more than one person asked me if I was nervous that cancer would be cured and I would be out of a job.

Truth? I would love that.

There are plenty of other things to do.