While in his late 50s, my dad was diagnosed with myelodysplastic syndrome (MDS). His course of illness was rocky. He spent a few tough years in and out of hospitals. He died suddenly, at 62, because of an intracranial bleed when MDS transformed itself into acute leukemia – a common pathway (I wrote about it here). During his illness he was under the care of multiple specialists (not his choice) but never really found someone who could guide him through the brutal landscape of the disease with confidence and compassion.
When I heard Dr. Raza speak (Peter Attia’s podcast) I had this sudden realization that she is exactly the person we were looking for during his illness and never found.
My dad met many clinicians, who wanted to help, but none with the exact combination of scientific expertise, deep understanding of the disease through years of taking care of patients with MDS, and a compassionate human approach that Dr. Azra Raza represents.
“I have been seeing 30-40 cancer patients each week for the past 30 years, I have an active lab and I am a cancer widow.” (Her husband Harvey Preisler, a prominent oncologist himself, died of lymphoma in 2002).
One of the obvious problems is that MDS is a relatively rare disease (10-20K cases per year in the US) and few hematologists specialize in it. Partially because the treatment options have been very limited and ineffective. Only a bone marrow transplant (a very expensive and available only to some patients option) offers a chance of cure.
Dr Raza has recently written a remarkable and beautiful book: “The First Cell.” The book is a memoir, but it is also a scientific exploration, and a commentary on cancer research.
She strongly believes (and I encourage you to read the book to hear her entire argument) that the way we have been thinking about and conducting the cancer research has been largely misguided. She has a compelling argument that calls for a substantial re-allocation of the research dollars into early detection and prevention. A vast majority of new therapies fail. They fail because they are being used against cancer that has already spread, rendering them ineffective (or marginally effective). Instead, she advocates for research focused on prevention and early detection when a chance for cure is the highest.
What if we directed billions of dollars at using new technologies to detect cancer at a very early stage? Before it manifests itself?
Dr. Azra is a beautiful writer. She can combine a deep understanding of science, research, and our health care system and tell the story with empathy and deep care for others. Her writing reminds me of the works of Sid Mukherjee, her colleague at the Herbert Irving Comprehensive Cancer Center at Columbia University.
Listen to the podcast to hear her speak with passion, honesty and erudition.