The passing of Randy Pausch, Carnegie Mellon University professor and author of “The Last Lecture,” on Friday and my own recent health ailments have me thinking a lot about life and death. While I have a lot to say on that particular subject, I would like to focus instead on the disease that took Dr. Pausch’s life – pancreatic cancer.
The National Cancer Institute (NCI) puts the 2008 incidence of 37,680 with deaths at 34,290. The 5-year survival rate for pancreatic cancer is almost zero (in real terms). New pharmacotherapies like Tarceva (from OSI Pharmaceuticals and Genentech) and Erbitux (ImClone Systems) have both had some clinical success with pancreatic cancer, but more options are needed. Cancer vaccine trails into pancreatic cancer have all but come to standstill after the debacle and controversy surrounding the FDA’s bungling of Dendreon’s Provenge.
In contrast, the NCI puts new 2008 breast cancer incidence at 182,460 (female) and 1,990 (male). Breast cancer deaths are estimated at 40,480 (female) and 450 (male). The 5-year survival of breast cancer (even with metastatic disease) is very good. There are dozens of options and combinations for treating breast cancer and all have very good outcomes.
Why such inequalities? Pancreatic cancer is very different type of cancer. It is more difficult to detect and much more difficult to treat. The other answer lies in sociology – the squeaky wheel gets the grease.
Despite being more of killer (as a percentage of incidence), pancreatic cancer is vastly under researched compared to breast cancer. The number of treatments is much more limited and clinical pipeline is radically smaller. Few people with pancreatic survive long enough to go on and form and establish advocacy organizations and conduct educational outreach. Without those compelling patient stories, pancreatic has become the invisible cancer. Randy Pausch’s very visible, moving and vocal advocacy has been the exception in pancreatic cancer, not the rule.
Breast cancer is the cancer of choice for celebrity endorsements and mega-charities like the Susan G. Komen Breast Cancer Foundation. Susan G. Komen took in over $207 million for fiscal year 2006 (the most recent year for which its financials are available). In stark comparison, the Pancreatic Cancer Action Network took in just $7.3 million (2007 financial data). Susan G. Komen wastes more money in a year than goes to pancreatic cancer research and education (Susan G. Komen spent over $15.2 million on fundraising alone; almost $18 million on administrative functions and the organization had a budgetary excess of $17.7 million).
I don’t fault Susan G. Komen for what they have achieved. There was a time when breast cancer needed the kind of visibility that Komen brought. That time has passed and Susan G. Komen has become a perpetual charity – growing to grow and existing to exist. The organization is more about the status of hot pink than it is about breast cancer.
But the silent killer of pancreatic cancer needs attention too. If your company is being extorted to participate in yet another Susan G. Komen event, consider opting out. Susan G. Komen is well funded and doesn’t need your money, but other diseases and other charities could really use your support.
It’s sad that cancer research and support has to be a zero-sum game, but it is. Every dollar into the pockets of Susan G. Komen means that research isn’t being done into other cancers – other cancers that have far higher mortality rates. Don’t believe the media hype of the Susan G. Komen PR army, it’s time to let the hot pink go and focus on cancers that actually killing mothers and fathers in America. Mothers like my aunt Marilyn, who lost her battle to pancreatic cancer years ago. And fathers like Randy Pausch, who leaves behind three young children.
