Dr. Peter O’Dwyer is a dapper Dubliner who talks a straight game. He didn’t skip a beat when I asked him to share what he wishes people knew more about:
“Patients should be aware of their family histories, number one.” I wanted him to stop for a singsongy, “and that’s the he and she of it,” but the comparisons to Joyce stop at his nationality and his scrubby mustache.
Why is this so important?
Clinical research in Dr. O’Dwyer’s field of GI malignancies used to be limited to trials conducted on patients and also patients’ family members. With the advent of individual gene sequencing, it is a little less that way, but family history is still relevant. Extraordinarily relevant. Dr. O’Dwyer describes it as “surprising how many people with pancreatic cancer have a family history of someone else in their family having pancreatic cancer.”
If you have no idea about your family history with pancreatic cancer, do not be afraid to be the first one to record your status within the family tree. This is another recommendation Dr. O’Dwyer had: take the recommendations for screening very seriously. Know the state of your GI tract, because some of the worst cancers (like pancreatic, which has a very high rate of relapse) do not typically present until a late stage. This can be devastating.
That said, he was kind enough to tell me about one of the most exciting new ideas in his field. It is possible, he suggested, to develop blood tests for pancreatic cancers that scan the blood for the presence of pre-cancerous pancreatic cells. Such tests could allow doctors to find lesions in the pancreas that are “destined to become pancreatic cancer.” Whoa.
But doctors and researchers cannot be the entire solution. In order for research to move forward, for such testing to be possible, patients need to prioritize their own health to a greater degree. This means–as I mentioned–following all medical recommendations, but it also means pushing the boundaries of what we are traditionally willing to afford ourselves in terms of quality of care. There is a lot of effort in the medical community to reach out to the disaffected. It’s happening on a global scale. But there are also economic gaps that we ourselves have to fill. If you’re a middle class, middle-aged, middle American citizen, and you have a looming GI cancer, you might need to take into account a few things:
- Where do you feel comfortable being treated? Anybody will tell you that this is a factor.
- Where will you get the best care that you can access? Anybody will also tell you that this is a factor.
- Which institutions are likely to benefit from you as a research subject?
We don’t tend to think about that third one. This is what Dr. O’Dwyer means when he says, “Their support of research is important…at the individual level…if they come to a cancer center like ours, they should know that this is the way forward.”
That’s a very controversial statement. Not everybody can get to a cancer center like this one. What you get from most people is, “if you can, get to a good cancer center.” What you get from Dr. O’Dwyer is a little more drastic: It’s important that you get to a good cancer center. If you don’t, not only do you run the risk of receiving care that is sub-par, but you also, in some ways, waste your insurance payments on hospitals that aren’t investing time and effort into eradicating your disease.
Of course, Dr. O’Dwyer did not say that. That’s also not the view that OncoLink officially endorses. But it’s something to keep in mind when you’re looking for where to get treated. You know what? Maybe you have to think a little further down the line and bite the bullet. Go to a great cancer research hospital–not just if you can definitely afford it, but even if you think you can maybe swing it. Your life is worth it. Scientific progress is worth it.