Vincent T. DeVita Jr, MD
For the past 50 years, Vincent T. DeVita Jr, MD, has been one of the world’s leading oncologists and one of the field’s most innovative thinkers. He developed the first successful strategy to cure adult cancer with a combination chemotherapy regimen and led the National Cancer Institute (NCI) at a time when many vital treatment concepts were just being translated into clinical practice.
Now, DeVita has offered an insider’s view of those years in a recently published book, The Death of Cancer
. The book, coauthored by his daughter, the science journalist Elizabeth DeVita-Raeburn, takes the reader on a compelling journey through DeVita’s struggles to advance cancer care, often in the face of colleagues hostile to new ideas and a political establishment that stymied progress.
Although the book is written for a lay audience, DeVita’s insights into the operations of the FDA and the National Cancer Institute will hold a special appeal for oncology specialists and healthcare providers. He forcefully argues for dramatic changes in the oncology drug evaluation and approval system that would give the nation’s cancer centers a more vital role and streamline the development of new therapies.
At age 81, DeVita remains on the faculty of Yale School of Medicine, where he is a professor of medicine, epidemiology, and public health. He is working with his co-editors on the 11th edition of Cancer: Principles & Practice of Oncology, the seminal and widely used textbook of cancer medicine. He still sees patients in consultation and he still teaches. “It’s part of the benefit of growing older,” DeVita said in an interview. “You have more time to sit back and look at the field and make judgments about it.”
DeVita did just that when he sat down with Maurie Markman, MD, editor-in-chief of OncologyLive
, for an extensive interview in March.
OncLive: What prompted you to write The Death of Cancer?
: The American people paid over $100 billion in taxes for the war on cancer. I was in an unusual position in the sense that I was in the right place at the right time. I was there at the National Cancer Institute before the Cancer Act was passed. The work I did was partly responsible for the philanthropist Mary Lasker getting interested in cancer. And then I wound up running the whole program, and I wound up at two major cancer centers. Then, I had the opportunity to be president of the American Cancer Society.
As if I didn’t have enough experience, I got cancer myself. So I said to myself, a person in that position should really recount their experiences so that people know what they got for their money from somebody who saw it happening.
What is the major message you wanted to convey in the book?
That the war on cancer not only is winnable, but it’s actually being won. People don’t appreciate the significant change in the whole cancer field since the Cancer Act was passed back in 1971. The mandate of the war on cancer was to support research, and for the application of the results of research to reduce the incidence, morbidity, and mortality from cancer. In the Cancer Act itself there was never any mention of timespan. So since 1971 we have put 65% of the $100 billion into research. The incidence and mortality rates have been coming down since 1990-1991. It’s never easy to be treated with cancer but the morbidity is way less than it was.
The message is that we’re not only winning it, but it’s winnable. And I mean the latter because the new targeted therapies and the immunologic therapies are not even in these data. They’re just hitting the clinic, so the best is yet to come, and we know they’re going to be good.
I think we need an optimistic message to people. One of the reasons people are confused is that when we treat people with cancer, we want them to go home and live a perfectly normal life, and they do. The great majority of them don’t walk around and say, “I had cancer.” Some do, some become activists. But the great majority don’t. The ones you see generally are people who are suffering from it, and they’re much more visible. So people don’t appreciate how many people are being cured already of their cancer.
Is there also a message for medical professionals—either oncologists or generalists?
As I point out in the book, there are some doctors who are not enthusiastic about treating patients with cancer. There’s always been this tug of war. You have cancer, it’s a self-fulfilling prophecy. It’s a lethal disease so you don’t treat it. If you don’t treat it, it’s a lethal disease. And some cancer patients get themselves in the hands of doctors who don’t believe [they can help].