Cancer Looms Large on US Television and Radio

Zosia Chustecka

February 12, 2015

In the United States, cancer is having an extended moment in the limelight, with a three-part television documentary to be aired next month and a 10-story radio series that is already underway.

Both projects are tied in to the Pulitzer Prize–winning book The Emperor of All Maladies: A Biography of Cancer, by Siddhartha Mukherjee, MD. The book tells the story of cancer from its first identification thousands of years ago through modern times, especially the discoveries that have been made since the 1950s that have led to paradigm shifts in how cancer is now treated.

The new documentary — Ken Burns Presents Cancer: The Emperor of All Maladies, a Film by Barak Goodman — is a three-part, six-hour television series that will air on PBS stations on the evenings of March 30, 31, and April 1. The film has been supported by a number of organizations, including the American Cancer Society, the American Association for Cancer Research, as well as pharmaceutical companies (Genentech and Bristol Myers Squibb) and other institutions; a full list of partners and also short previews are available on the series website.

"There is an interesting moment in time just at this moment where there is a confluence of medicine and technology to make a really significant advance against cancer in a way that we haven't before," said Louis J. DeGennaro, PhD, president and CEO of the Leukemia & Lymphoma Society (LLS), one of the supporters of the film.

"What the book and the film do is chronicle, in a very approachable way, the efforts of many scientists and physicians over the years to bring us to this moment in time," he told Medscape Medical News in an interview.

"The film actually goes beyond the book to some new developments that...chronicle the future of cancer treatment," he said.

The book leaves off with the promise of targeted therapy and personalized or precision medicine and the idea of drugs that home in very precisely on cancer mutations. The poster child for this approach was imatinib (Gleevec) for chronic myeloid leukemia (launched in 2001), which represented a real paradigm shift and proved the concept of targeted therapy, he said.

The film goes further and details the most recent advances that have been made in immunotherapy. This includes drugs that act as immune checkpoint inhibitors, which have made such a splash in melanoma and now are being explored in many other cancer types, and also the chimeric antigen receptor (CAR) T-cell approach, where immune cells are doctored to home in on cancer cells.

The CAR T-cell approach has recently shown "spectacular results" in leukemia and in some lymphomas, Dr DeGennaro commented, adding that the LLS is particularly proud of these successes, as it funded much of the early research on this approach ($20 million between 1998 and 2014 to the University of Pennsylvania).

Many of the breakthroughs in cancer treatment have been made in the hematological malignancies, beginning with chemotherapy for childhood acute lymphoblastic leukemia in the 1950s. "What grew out of that, and it is addressed very nicely in both the book and the film, is the idea of combination therapy," Dr DeGennaro said. "If one drug works to some extent, perhaps two or three or even four would be better.... This systematic testing of various chemotherapy combinations brought us from what was essentially a death sentence in a child — at the time the survival rate was 3% — to the success we see today, with survival rates of 90%."

The book captures very dramatically the trepidation of the early days of these studies, when there was some criticism of this approach of pumping ever increasing amounts of what were essentially chemical poisons into children who were already very ill and frail. The doctors pioneering this approach were very brave, said Dr DeGennaro. Some of them are interviewed in the film, and what comes across, "at least in the portions that I have seen, is their concern for the patients, but you also sense their heartfelt belief that they were right to press on, and their conviction that they would find successful treatment combinations."

"Historically, cancer has been something that we don't talk about," he said. "I think that's changed recently, but in the past, it would not be a subject of wide discussion." The book chronicles the history of cancer, and has "allowed us to have that discussion in a much more meaningful way, and the film will reach a larger audience."

"The film will help to educate more people in both the challenges and the advances, both the history and the promise of cancer research," he said.

Radio Series: Living Cancer

Produced in conjunction with the documentary, and in partnership with Dr Mukherjee, is a 10-story public radio series entitled Living Cancer that is already underway. The first stories are being aired this week (starting February 9), and the next set of stories will be aired during the week of March 23. The stories are being featured on the National Public Radio (NPR) programs Morning Edition and All Things Considered, which are broadcast across the country.

In addition, WNYC's nationally distributed program On the Media will devote an entire episode to the history of cancer and the way that media has portrayed the disease on March 27.

"Almost every American family is touched by the disease in some way," NPR notes in a press release. "In the past, a cancer diagnosis was often kept a family secret with a grim prognosis. Now, thanks to advances in treatment, many people are "living cancer," whether we're being treated ourselves or helping a family member or friend."

"Cancer remains widespread, but in a growing number of cases, it has become a manageable disease," said Laura Walker, president and CEO of New York Public Radio, which owns and operates WNYC. "Through a remarkable blend of science and narrative, Living Cancer tells the story of the emotional and medical consequences of living with cancer."

Radio stories aired this week have covered subjects such as harnessing the immune system to fight cancer (aired on February 9), the tricky issue of prognosis and the question of "Doctor, how long have I got to live?" (aired on February 10), and environmental exposures and cancer (aired on February 11).

The next series of radio stories, to be aired in the week of March 23, will cover issues such as where we are now in the "war against cancer," the tantalizing subject of why some patients are exceptional responders to drug therapy, and will also delve into the thorny issue of paying for cancer treatment in the United States.

All stories from the series will be available on the WNYC website following their broadcast.

Dr Mukherjee talked about his book with Medscape in a one-on-one interview with Editor-in-Chief Eric Topol, MD, last year, and will be interviewed about the new film for Medscape by former ASCO president Clifford Hudis, MD (and posted soon).

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