Almost 10 years ago, at the tender age of 90, former U.S. President Jimmy Carter was diagnosed with advanced metastatic melanoma, with lesions studding his liver and his brain. Historically, that diagnosis was a death sentence, with scant months between diagnosis and demise.
But Carter’s diagnosis came shortly after the dawn of a new approach to melanoma treatment, called immunotherapy. In the face of infusions of pembrolizumab, a “checkpoint inhibitor” designed to harness the power of his own immune system, the cancerous lesions melted away, and the president made a complete recovery. He’s since died—but not from melanoma, and not until the slightly less tender age of 100.
I feel a small sense of kinship with the late Mr. Carter. Not because I have melanoma, but because pembrolizumab is currently keeping me alive.
Since 2007 I’ve been battling a rare cancer called chordoma, a collection of rogue cells nestled in the middle of my head. A series of surgeries in 2007 removed most of the tumour and a concerted blast of radiation knocked the remainder into submission.
But after nine years, the cancer grew back, and repeat surgeries provided only temporary relief. Thankfully, after sequencing some of the surgically removed tissue, we discovered that the malignant cells carried a mutated epidermal growth factor receptor (EGFR), a possible driver of the tumour’s growth. And it turned out that there was a class of drugs—EGFR inhibitors—available to block that receptor, one of which (afatinib) I subsequently began taking. And it worked: the tumour stopped growing.
But after almost seven years of assault by afatinib, the tumour mutated further and resumed its expansion. A repeat craniotomy a year ago obtained a piece of the cancer (it’s impossible to remove it all because of its delicate location), and repeat sequencing showed the EGFR “driver” was no longer in charge. But that analysis revealed a series of other mutations possibly responsive to a checkpoint inhibitor, which is how I ended up on pembrolizumab, and I’m happy to report that tumour growth has once again been arrested.
How long the arrest will last before the tumour again escapes its handcuffs, I have no idea. Unlike in Carter’s case, the nubbin of tumour in my head isn’t “melting away.”
But while the odds of me of living to 100 are just about zero, these drugs—first afatinib and now “pembro”—have gifted me precious years with my family. I’ve been able to watch my four kids grow into teenagers and young adults. My oldest daughter, just 14 when I started taking afatinib, is in her third year of studies at McGill; my son, the youngest, is now 14 himself and shooting skyward at an astonishing rate.
So, hooray for “Big Pharma,” I say, because without the now-much-maligned pharmaceutical industry, none of these drugs would exist, and nor would I.
There’s no question that an enormous swathe of society grapples with chronic illness. Much of the blame can be attached to unhealthy eating and lack of exercise. But much of it, too, is the fact that people like me have “chronic disease” because our disease hasn’t killed us; and the reason it hasn’t killed us is because of the innovative wizardry of pharmaceutical companies developing new drugs (at great cost) that have kept us alive.
I’d be dead if not for Big Pharma. And that applies to many of you reading this piece, and no doubt to many among your families, friends, and acquaintances.
None of which is to say that the pharmaceutical industry doesn’t have its problems, that it isn’t contaminated by greed and corruption. It does, and it is. But to paint the entire industry as the devil incarnate, to smear all drugs and vaccines as simply vehicles for grifters to get rich, is to throw the baby out with the proverbial bathwater.
Drug companies make money, and a good thing, too. If they were unable to turn a profit in that hugely capital-intensive business, we’d have few of the medicines that keep many of us alive (and not just alive but productive): chemotherapy drugs, antibiotics, clot-busting drugs, painkillers, vaccines, novel forms of insulin, high blood-pressure medication, anti-transplant-rejection drugs, and so on.
I thank God every day that I’m alive.
And I thank Big Pharma, too.
