It turned out to be a gastric cardia cancer; it’s a cancer at the junction between the stomach and esophagus.
There was really no opportunity for any sort of treatment because it was too advanced. One of the hardest things for us — since we devoted our lives to try to understand cancer — was that nothing was learned from his cancer. Not a thing. There was no genome or transcriptome analysis, no clinical trial, nothing. And that’s very frustrating if you’re a scientist. Even if it’s not something that would have benefitted him directly, you’d like it to be something that contributes to the knowledge of how we would go forward with that type of cancer treatment.
He never felt sorry for himself, he never said why me. He always said, “Who should it be? Who does deserve to get cancer?”
For me, it definitely changed how I approach life. The small things don’t annoy me as much as they did before. You realize there are a lot of big issues in the world. Some things are more important than whether you get your grant funded or get your paper accepted in some journal. Losing someone you love is a much more profound loss.
‘Not having the impact it could’
I’ve always been intrigued by the fact that you can take a virus and put it into a normal cell and make that cell become something like a cancer cell. And that’s basically what I’ve studied for most of my career. When there were the first indications that HPV might be associated with human cancers, I thought I would work on that.
It’s been an incredible ride to go from not really knowing that HPVs cause cancer to having a vaccine that can prevent cancer. That’s more than most people could hope for in their career.
By the mid-1990s, we thought we could make virus-like particles that could induce an immune response that would likely be protective. It took a long time after that to actually develop the vaccine. It took Merck something like a billion dollars to develop a vaccine to do the clinical trials that showed it could protect against HPV.
I think about the generation of young people going forward.
My younger daughter was vaccinated. I think we’re in a family where the use of vaccines is not something to be debated. It’s the most rational way to prevent disease. So I don’t think my kids have ever had any hesitation about vaccines. And I just assumed that they’re going to be sexually active. I mean, that’s life.
Now we have a great vaccine and it’s not being used enough by people in this country. It is incredibly frustrating that in the U.S. only about a third of women under the age of 18 have received all three doses of the vaccine. If you look at places like Australia or parts of the U.K. where the uptake of the vaccine is 80 percent, and you look at the earliest manifestation of HPV-associated disease, which is genital warts, there’s virtually none in Australia. I think people in the United States are leery of vaccines or they don’t trust pharma or they don’t want to talk about sex. So something that could prevent cancer is not having the impact that it should.
There are still a lot of questions left. Although we have this vaccine to prevent cancer, there are of course a lot of people who already have HPV infection and will develop these cancers. We haven’t made progress in treating HPV-associated cancers in 50 years, so there’s a lot to be done there. And there could be better ways to utilize the HPV vaccine, so I’m trying to figure that out.
I’m not done yet. There’s still a lot to learn.