SIDNEY FARBER VS. LEUKEMIA pt. III
In
the last installment we saw what a breakthrough the use of aminopterin was in
battling what was, at the time, a childhood illness with a one-hundred-percent
mortality rate – ALL, or acute lymphoblastic leukemia.
This time we look at some of the statistics about the disease and the
effect Farber’s treatment had on his patient’s odds of survival.
ALL accounts for twenty five percent of all
cancer in people under the age of 15, and affects 1 in 50,000 people in the
US. As mentioned, when Farber first
began administering aminopterin, the mortality rate was one hundred
percent. According to the Journal of
Clinical Oncology, the survival rate had increased to about ten percent by the
1960s (read the article here: http://bit.ly/1ckrT0p). This is important to note for two
reasons. First, while ten percent may
not seem like much, it is a dramatic improvement over zero. Imagine the difference between being told
that your child had a zero percent chance of survival compared to being told
her odds are one in ten. It may only be
a slim hope, but it is hope nonetheless, and the difference between no hope and
slim hope cannot be overstated. Second,
it is important to note that aminopterin was not the end of the story – new and
improved drugs would soon step in to replace it. The breakthrough was in Farber showing the
medical community that these types of treatments were indeed effective. Up to this point, it was considered cruel,
perhaps even inhumane, to inject these children with substances known to be
poisonous. “Let them die in peace” was
the motto of the day. But these children
were not dying in peace – they suffered terribly before their inevitable
end. The extreme suffering of these
children is what drove Farber to such a radical treatment, as he felt each loss
deeply and personally.
As I said, Aminopterin was not the end of the
story. The same Journal of Clinical
Oncology cited above states that, by 1985, the survival rate had increased to
seventy seven percent. By 2005 the
survival rate had increased to over ninety percent, and that number has
increased steadily up to the present. It
is important to note that these are five to ten year survival rates. ALL is still a deadly disease that affects
many children, and also affects adults, albeit at a much lower rate. But Sydney Farber paved the way for the
increased survival rates that we enjoy today by proving that chemotherapy was
effective. His legacy as the Father of
Modern Chemotherapy is well deserved – may his memory be for a blessing.
"The extreme suffering of these children is what drove Farber to such a radical treatment, as he felt each loss deeply and personally." This reminds me of conversations we had in class about how engaged we thought a physician should be, emotionally, with his patients. There's just no question, is there, that physicians and researchers who are in touch with their humane sensibilities are rightly driven to address the humanity of their patients with greater urgency? Those concerned with "just the facts" are lacking an important dimension. Might as well call it the psycho-social dimension, no?
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