Modern cancer treatment became available just as Vincent T. DeVita Jr. began his career as an oncologist. That's no coincidence, since DeVita, along with a few colleagues, invented it.
In the 1960s, when he was only a few years out of medical school, DeVita led a team that discovered cures for childhood leukemia and Hodgkin's lymphoma. Giving desperately ill patients several potentially toxic drugs at once with the goal of curing cancer seemed, to many doctors at the time, both cruel and futile. Today, combination chemotherapy, adjuvant therapy (using chemo with surgery and radiation), specialized cancer centers, and many other advances that DeVita helped pioneer have contributed to sharp declines in mortality from malignancies once assumed fatal.
Now 80 years old and a professor of medicine at Yale, DeVita is pleased with the progress he's seen in the field he's shaped over the past five decades as director of the National Cancer Institute, physician-in-chief at Memorial Sloan Kettering, and in other powerful roles. Pleased, but not satisfied.
In "The Death of Cancer,'' a fascinating new memoir written with his daughter, Elizabeth DeVita-Raeburn, DeVita argues that while we're finally winning the "war on cancer,'' which began in the 1970s and of which he was a chief architect, physicians too timid to prescribe aggressive treatments often deny patients with cancer potential cures. He also faults the "overly cautious'' FDA for delaying the release of promising new therapies and the Affordable Care Act for not covering them.
Early in the book DeVita tells how he called colleagues around the country to enroll a friend with prostate cancer in one experimental protocol after another. The man lived for 12 more years, much longer than predicted. "I will do whatever it takes to cure patients and, if that isn't achievable, keep them going as long as possible," DeVita writes.
Sadly, DeVita had a chance to apply this credo when his son developed aplastic anemia, a rare disorder that destroys the immune system. The boy lived for eight years in a germ-proof room and received experimental therapy at the hospital where his father worked before dying at age 17.
DeVita's moving account of his son's illness, as well as that of his own recent bout with prostate cancer, help soften what feels, at times, like a litany of criticism. DeVita judges harshly individuals and institutions whose efforts in the fight against cancer he deems inadequate. He names names, including that of the late Edward M. Kennedy, who sat on a Senate panel that questioned DeVita about the ethics of the cancer-drug development program at the National Cancer Institute. DeVita excoriates Kennedy for his willingness "to play political games with cancer," noting sharply: "You might think that given his son Ted junior had had cancer and survived, years earlier, and that I was one of doctors involved in his case, we'd be on the same side."
More appealing are DeVita's portrayals of the many colorful characters he's encountered in his long career, including an assortment of vain, jealous, and drunk colleagues; a patient who sent a vintage Rolls Royce to pick DeVita up for house calls; and Ann Landers, who used her popular advice column to solicit support for the 1971 bill that launched the national campaign to defeat cancer.
Particularly delightful are DeVita's memories of his collaboration with philanthropist Mary Lasker. Though the elegantly coiffed Lasker "had the appearance of a lightweight socialite with too much time on her hands," she proved shrewd, smart, and as determined to cure cancer as DeVita was. Lasker, who along with her husband established the Lasker Award, the "American Nobel" for medical research, also helped create the American Cancer Society, and pressed for massive increases in federal spending on cancer research. DeVita's revelations about Lasker's methods — she once paid a spy to infiltrate Congress — are especially entertaining.
The most interesting character in DeVita's book, though, is cancer itself. His detailed explanations of how "clever" cancer cells evade normal genetic checks on growth and how new drugs like Gleevec, which can cure the previously lethal chronic myelogenous leukemia, outwit them are both riveting and encouraging.
Siddhartha Mukherjee called his Pulitzer Prize winning "The Emperor of All Maladies'' a "biography" of the disease. "The Death of Cancer'' is its obituary. We're at "the beginning of the end," DeVita declares of the war on cancer. He accepts that people will still die of something. But, DeVita notes wryly, "We can worry about immortality after we cure cancer."
THE DEATH OF CANCER:
After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer is Winnable — And How We Can Get There
By Vincent T. DeVita Jr. and Elizabeth DeVita-Raeburn
Sarah Crichton, 324 pp.,
Suzanne Koven is a primary care physician and writer in residence in the Division of General Internal Medicine at MGH.