Book review by Candice Louisa Daquin
Title: The First Cell and the Human Costs of Pursuing Cancer to the last
Author: Azra Raza
Unless you are an oncologist, what would possess you to read a book on cancer?
Azra Raza’s unexpectedly well written book gives you the only reason you’ll need. Because it’s necessary.
Why? We go through life without thinking of death very much. Maybe this is a good thing. However, all of us shall die. And many of us shall develop or die of cancer. Whilst we may not wish to think about this during life, that she tells us is precisely why the progression of cancer treatment has been stymied. It’s not the only reason of course. There is more money in treatment than cures. But as long as we are all too busy to read on these subjects, we can be assured nothing will change and it really does need to change.
If you read the news, you’d be forgiven for believing cancer treatments have progressed and improved. After all we want to believe that don’t, we? But like any statistic, it can be inaccurate and miss the larger picture. Unfortunately, much as we want to be positive, we need to be realistic. The truth is cancer deaths have only lessened because of social change (less smoking, healthier lifestyles) and early detection (screening programs) and not because of the actual treatment.
The actual treatment (cut, poison, burn — surgery, chemotherapy, radiation) remains the most popular of choice for battling majority forms of cancer. We can all point to the notable exceptions but they make up a relatively small percentage. The vast percentage of cancer patients are given these options in varying forms.
Those cancers that do not necessarily kill, may not terminate lives. But it isn’t because of the treatment so much as the cutting out of, or sheer luck, that the cancer was caught in time. The treatment itself, if you are unlucky enough to have an advanced cancer, hasn’t changed much (with the exception of gene therapies that have been advancing but are not applicable for all cancers) since the 1950’s. Yes, that’s right, the 1950’s.
So, while doctors want to offer hope, they do so more out of a stubborn desire to ‘try anything’ rather than because the six months they may give a dying person, is really beneficial when you consider the sheer backbreaking cost (bankruptcy from medical costs being the number one reason) and very small gains (six months more of life and you have spent all your money on a treatment which only benefits Big Pharma). The unwillingness of doctors to give up, is admirable and very human (who wants to tell someone there is no hope?) but it brings with it, a false promise.
What’s the solution? Azra Raza’s solution is very simple but mostly overlooked. She believes from her own experience of watching her husband die of cancer despite her being an oncologist and researcher that we have to stop looking for the ‘magic pill’ and go back to basics. Let’s find out what causes cancer. Let’s intervene before cancer gets a foothold. Why are we only looking at how to treat the incurable? Why aren’t we looking at how to prevent it in the first place?
Raza points to a Westernized, masculinized perspectives in the medical world that makes true research very prohibitive, that research being done is drowned out by the lack of people who will be willing to take it to the next step, and a lack of funding. Without this, we cannot hope to change a decades old ‘tradition’ and yet, this tradition is causes enormous suffering. Every time Raza sees a new advertisement on TV for a ‘platinum-based treatment’ or something that offers ‘real hope’ to cancer survivors, she is acutely aware of the enormous price tag and literal months or weeks these treatments really offer patients. She asks; ‘Is throwing up every day in agony really worth spending your life savings on for a scant six weeks more of life?’
Of course, there are miracles. But Raza says, rather than looking at the outliers, we need to be honest about how many people with cancer have horrible odds and suffer hideously at the hands of an unchanging system that doesn’t really address the problem at its root.
“We have seen that the current cancer landscape is worse than it was in the 1970s. Even today 95 percent of experimental trials continue to fail…. By law the FDA can only take safety and efficacy data into account when reviewing a drug for approval, not its price-tag.”
So, if we were to do that, what would it look like? When someone is treated for cancer, doctors reverse engineer the tumour to see if the cancer is returning in the body, that way they can ‘detect’ returning cancer and treat it. What if we could do this before cancer exists in the body, by looking at biomarkers and other evidence that pre-dates the actual development of cancer, so that along with improved screening measures, we can stop cancer before it starts?
Once a cancer has metastasized, we are chasing our tails in many ways and while this can give a patient many years of life, just as often it does not. And rather than slashing and burning and causing more cancers, if traced prior to the onset, the ‘first cell’ can be a less invasive and less catastrophic method of treating or avoiding cancer where no ‘work-up’ costs a million dollars. The concept of ‘prolonging survival’ needs to be re-examined against the invariable suffering of those who are terminal.
As Raza says: “The very terms meant to empower end up detracting from the profound human experience of an individual facing mortality head-on in all its chaotic savagery, the physical suffering, anxiety, the grief…. The terminology of positive thinking also stigmatizes by indirectly blaming the victim.”
Additionally, we test on the wrong thing, by testing on animals we cannot hope to reproduce the effect a medication has on a human body. “I’m not saying all scientific research on animal models should be abandoned. What I am saying is that animal models are misleading and harmful for cancer drug development, because the disease cannot be reproduced in such simplistic, artificial systems.”
Using poetry from India and the Middle East, interspersed with recounting of real lives affected by cancer, Raza makes the unpalatable subject, readable. I cannot say this is easy reading, or that it will be a book many lay people read, but I’d hope more than cancer sufferers pick this up, because there is a real answer here, and it’s written with such compassion and intelligence, it’s as evocative and vital as the very treatments it considers.
I was so impressed with the bright star that is Azra Raza and her courage, compassion and bright mind. If more were like Raza, maybe we’d already be further along the road in offering long lives to those with cancer. We may instinctively wish to turn away from this subject and thus, this book. But if we do one thing for ourselves, we should read The First Cell and consider, if not for ourselves, for someone we love, if we are mindlessly ignoring the problem and thus, letting it perpetuate. We need to have this conversation and we have needed to have had it since the 1950s. Let’s be brave enough now. As Raza says:
“There is no activism without despair, no despair without hope. Despair can be as powerful an engine for change as hope.”
Candice Louisa Daquin is a Sephardi immigrant from France who lives in the American Southwest. Formerly in publishing, Daquin is now a Psychotherapist and Editor, having worked in Europe, Canada and the USA. Daquins own work is also published widely, she has written five books of poetry, the last published by Finishing Line Press called Pinch the Lock. Her website is www thefeatheredsleep.com
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