Louisville Medicine Volume 63, Issue 10 | Page 21

BOOK REVIEW THE DEATH OF CANCER Vincent T. DeVita Jr, MD Reviewed by Goetz Kloecker, MD D r. DeVita has been at the forefront of cancer research and treatment for the last 50 years. In the 1960s, he was the driving force for the first curative therapy of lymphoma when many in even his own field doubted that this would be possible. As director for the National Cancer Institute (NCI), medical director of the Memorial Sloan Cancer Center in NYC and medical director of the Yale Cancer Center, he has been a major general in the war on cancer. His book predicting the death of cancer is a testimony to his courage and fighting spirit. His lively anecdotes describe the hurdles and barriers in this war in vivid detail. Many of the barriers in his mind had less to do with the viciousness of cancer, but dealt in no uncertain terms with the limitations imposed by prejudice and institutional or personal self-interest. I was surprised how deep grudges can run, even after half a century of fame and confirmation. Many of the initial standard bearers of oncology- Karnofsky, Zubrod, Paul Carbone, James Watson - look less like heroes after reading DeVita’s account. DeVita obviously is not mincing words and not shy in expressing uncomfortable opinions. The first part of the book describes DeVita’s s hesitant but then whole-hearted conversion to the budding field of oncology, after signing up at the NCI to evade the Vietnam draft. When he calls the ground-breaking scientific brain storm sessions with mythical founders of the field such as Freireich and Frei “the society of jabbering idiots,” it reminds me of the absurdities (and the truths) in the book “The House of God.” Sometimes extreme medical intellect can appear grotesque, until its value is proven by surprising clinical breakthroughs. After an impressively successful career which DeVita describes with the help of his daughter, a scientific journalist, he attacks simmering disputes and issues in cancer research, funding and treatment. In his opinion no one is brave enough to express the flaws in our system openly for fear of upsetting the establishment - except for himself, at this stage in his life. Therefore he takes up this mantle and, with uncompromising honesty, does not hold back about the problem of politicians meddling with medicine, the woes of the National Institute of Health, the FDA, the conflicts within many world renowned nationally designated cancer centers and, of course, specific persons with whom he worked. Many of the practices that we take for granted nowadays, e.g., combination chemotherapy or combining antibiotics, giving platelet transfusions and targeting molecular pathways, have been part of a slow process, moved forward by determined personalities often against much resistance. We [