Last night we finally watched Living Proof, the Story of Herceptin which came out in 2008. The central character is based on researcher Dr. Dennis Slamon, and was played by Harry Connick Jr. in the film. The story was first captured in the 1998 book HER2, the making of Herceptin by Robert Bazell.

Usually I am distracted while watching a film adaptation of a book with the irritating differences in the stories, this time I feel that there was a good amount of integrity in the project which made a compelling true story come to life. (Though keep in mind, it was a made for TV movie about a topic of obvious interest to me.) I told myself going in that I wouldn’t cry, which I wasn’t able to pull off.  The film covers the fierceness of Dr. Slamon in his efforts to get Herceptin through the clinical trial process.  Also depicting the very real losses that result when a potentially lifesaving drug is unavailable while percolating through the slow channels on its way to FDA approval.

The movie could have been an infomercial- but it isn’t. In fact it shows how money concerns, or a vote by the Board of Directors can seal the fate of research projects. Money concerns, which BTW where very real concerns for the small company Genentech, which produced Herceptin, was at the time – I like that the film acknowledges some of the conflicts that exist between commerce and the mission to create drugs to help people.

One criticism I have is that the film makes a point of being dismissive of food and herbal approaches to cancer. I believe that the best strategies for addressing cancer need to be multifaceted, and that food and herbal modalities have much to add to the picture. It is however the party line of western conventional medicine to ignore information about other approaches. It seems clear that in the future we may see it differently. The many modern studies about turmeric, a plant revered in the ancient Ayurvedic system, provide an excellent example of how such things can change. (Ironically, as is the journey of Herceptin, which had to overcome barriers of perception, because it was such a radical new pathway to address cancer.)  The thing about herbal medicine is that it has a completely different philosophy- it is not seeking the silver bullet- but rather creating supportive synergy that is conducive to healing. To accurately  measure its success does not fit easily within the toolkit of western medical model.

In addition to seeking out the movie, I definitely would recommend reading HER2, because my favorite aspect of the book didn’t make it to the screen. Namely the tightly documented series of improbable meetings and happenstances that allowed the whole thing to happen. Two scientists meeting while they waited for a delayed plane at an airport, for instance.  The way that social capital led to real capital.  Social Capital definitely played a role in Dr. Slamon getting funding through the fundraising efforts of philanthropist Lilly Tartikoff. An excellent read, which I was glad to have read later into my treatments. The straight up acknowledgment of just how HER2+ cancers are more aggressive would have been worrisome to know about prior to my pCR in May 2014.

1998 was the year Herceptin was first approved for use in metastatic breast cancer, it was also the year my first son was born. Ten years later in 2008, the year the film came out, was the same year that Herceptin was approved for use in the chemo combo of TCH Taxotere, Carboplatin & Herceptin for early and advanced breast cancer. This was 3/4 of my cocktail, the last quarter, Perjeta was approved September 30, 2013 just weeks prior to my diagnosis. Though I did many things in addition to Herceptin and Perjeta, I am fully aware after having read the book and watched the film of what an incredible gift it was to receive both drugs. It is humbling. To think about how much has changed during my son’s lifetime in regards to breast cancer treatments is hopeful, and saddening at the same time. Because I know that there are people who will die of their disease in the coming years, who might have been cured if various modalities were available that even now are going through the approval process, or worse are being back burnered.

The film also showed how the input of the National Breast Cancer Coalition, led by advocate-founder Fran Visco, negotiated to get the drug to some metastatic women through a lottery system prior to its approval. Which highlights the need for patients to advocate for what is needed, making a priority of saving lives in the present moment, not only for the future.  The Breast Cancer Coalition continues their work today, and has set a deadline of January 1, 2020 to have some very real answers to the causes of breast cancer, and why it metastasizes in roughly 30% of breast cancering women.

I have spent a lot of time reading through various studies, and the onset of targeted therapies changed everything.  Many “studies” that set standard of care today are really just a collation of data from prior studies.  Some of which are decades old, prior to the understanding of the very different molecular signatures of various breast cancering presentations. This means that those older studies have limited application in this new age post targeted therapies. We have come so far, but many aspects of the process of bringing therapies to the frontline of care are ponderous.

Perhaps someday soon we will reach the point of being able to offer the hope of targeted therapies to all of the subtypes. When we do it will be thanks to the efforts of men and women like Dr. Slamon, and those who fight not just for awareness but for answers.