On January 23, C-SPAN founder Brian Lamb recorded his twentieth interview with Christopher Hitchens. It’s nearly an hour long, but if you have the time it’s worth watching a brave, thoughtful, and articulate man facing death. The interview is largely about Hitchens’s cancer, his treatment, and his attitude toward mortality. There is very little about politics. I’ll let some of our cancer experts comment on the treatment that Hitchens describes.
Hitch’s hair has partially grown back, but he’s a bit hoarse here.
If you don’t have time to watch, you can read the written transcript of the interview here. I’ll highlight just one quote:
And there’s a certain ghoulish element, even about the nice people who’ve been praying for me. Because they are not just praying for my recovery, they’re praying for my reconciliation with religion. And I—I proposed a tradeoff the other day, I said, I tell you what, what if we secularists stop going to hospitals and walking around the wards and asking if people are religious when they are in extremis and in their last days and saying look, you’ve still got a little time, why don’t you live the last few days of it as a free person. You’ll feel much better. All that nonsense they taught you. You know you could still have every chance to give it up. Experience the life of a free thinking autonomous person. Don’t live in fear, don’t believe in mythology.
They – I don’t think they’d welcome it. And of course, we don’t do that. But it seems to be considered the right of almost everybody to do it the other way around. I don’t resent it at all, because I like every opportunity for the argument, but it—a lot of it has been to do with that.
h/t: Joe and Sigmund
I work in cancer genomics and can, perhaps, add some information to the interview, in particular regarding the possible new treatments that Hitchens mentioned.
Those currently being tried involve using the traditional platinum based DNA damaging
chemotherapeutics – such as the one Hitchens mentioned he has been taking, cisplatin, along with something like a tyrosine kinase inhibitor such as gleevec or perhaps a drug like velcade/bortezomib
that inhibits the unfolded protein response. These drugs were
originally developed for specific malignancies (CML and multiple
myeloma respectively) but have been found to be effective in a wide
variety of other tumors.
Hitchens also mentioned something in his interview that makes me suspect
another line of action; he said he had to go to St Louis to be tested for his new experimental treatment.
This doesn’t sound like a standard genomic screening since a simple
blood sample taken at his regular clinic would suffice for that. It
sounds more like he has gone for a tumor biopsy that will be used in
some sort of screening procedure. This use of live tumor cells is very unusual at the moment at the patient level but it has enormous potential for quickly improving treatment outcomes. What it involves is growing the patients cancer cells in the presence of multiple anti-cancer agents and then choosing the most effective one for use in that patient. This is quite different to the standard clinical oncology approach which instead looks at all the markers present on a particular tumor (for instance what antigens it expresses) and then grouping the tumor into a specific subclass. This grouping is then used to decide which drug to use. This approach works OK on some levels but is particularly ineffective in late stage patients (such as Hitch). There is therefore a move towards looking at tumors on an individual basis, both in terms of genetics but also in terms of their susceptibility to particular chemotherapeutics. To do this, however, you need to be able to grow the tumor in culture (not such an easy task).
About two years ago I was at a talk where one team, working on leukemia, showed the result of such a screening procedure. Basically it involved the application of the sort of systems biology approach that has been developed in genomics.
They took leukemic cells from a patient and seeded them into medium in a series of 96 well plates and grew them in the presence of
the full range of chemotherapeutic drugs – in other words they tested
every possible currently available and licensed anti-cancer drug. The team tested multiple samples and were able to find effective drugs in every single case, even those that were highly resistant to the most widely used therapy for that condition. At the time the procedure was only available for leukemic cells rather than solid tumors like Hitchens has but it showed that useful treatments (although not cures) might be available quickly
– an important consideration since a completely new drug will take five or more years to clear the testing hurdles before its available for use in the clinic. Other promising treatments, targeting things like angiogenesis, glucose metabolism and autophagy, are currently underegoing development but I suspect will not be available for current patients but should be available within the next five to ten years.
Thank you for this very useful and fascinating description – I wondered exactly what Hitchens was describing.
Indeed thanks too!
Sigmund
Which group is doing this patient tumor screening? Can you point us to some papers?
I was ralking about the Szekely group at the Karolinska Institute in Sweden http://www.ncbi.nlm.nih.gov/pubmed/20837094
But I suspect the same approach is being used by others.
‘talking’
Fascinating. Thanks for that.
+ 4 Most fascinating!
It does bother me (and I’m sure Hitchens is aware of this) that he, by virtue of who he is and who he knows, is getting access to treatments or at least testing that the average patient would never get access to. He of course made reference to the need for research funding, but I sort of wish he’d say something about American so-called healthcare in general…
Hitchens is such a unique combination of intelligence, fortitude and wit. When I saw this, I was especially glad to hear about the effort by Collins to include Hitchens in a genomic approach to combatting tumors. Almost makes one forgive some of Collins’s silly pronouncements.
Man, I’m gonna miss Hitch when he goes..
I’m looking forward to Hitchens’s thoughts about the events sweeping the ME as we type. This is one chance to redeem himself after declaring Walid Jumblatt to be a true ME revolutionary while speaking at AUB a year or so ago.
“…we secularists start going to hospitals…”
Possibly what Hitch actually intended?
Thanks for posting the interview. I enjoyed it.
There is a better quality video on the CSPAN site:
http://www.c-spanvideo.org/program/Hitchen
His death will be a great loss to honest discourse.I am going to miss this Man very much when he is gone.I dont agree with him on everything.But to so claim about anybody would be well..dishonest.Well done Christopher,well done indeed.
Religions prey on the young, the poor, the sick, the emotional distraught, and the dying in order to win easy converts.
Ask them to only sell their wares to the adult, stable, healthy individuals in society and you’d be taking away a substantial portion of their market.
I clicked on the vid before noticing you’d posted the transcript link, which normally I would have jumped to in a flash; and I’m so glad I did! I intended to only watch the first 15 minutes or so but ended up watching it all. How beautifully human; and wickedly funny in parts. Truly inspiring.
(Except–whenever he starts talking about Kissinger lying about Viet Nam, etc., I want to jump through my monitor & grab his lapels and say so WHY did Irag look so different to you?!)
I was also most impressed with Brian Lamb for being so good at letting Hitchens tell the stories rather than employing the lengthy, self-serving lead-ins of so many interviewers nowadays.
Please, Diane G.
Hitchens can also be seen as an experimental case. He may be well known and have Francis Collins on his side but basically Hitchens is being experimented on. And that will benefit your ‘average patient’.
My mother died in 1968 from secondary cancer growths across her abdomen. Actually, of course, she died because pneumonia laid her too low to recover. And some bug or another will probably take Hitchens off as well.
My mother was the wife of an academic biochemist who was part of the university medical school. My mother subjected herself to experimental treatments precisely because her cancer was inoperable. That made her an ideal candidate to undergo treatments that needed to be tested. My father and she agreed it was a good thing to do.
Hitchens quotes ‘until you have done something for humanity, you should be ashamed to die’. My mother would have understood.
Hitchens – 40 years on from the treatments available to my mother – can be an experimental case for cancer research and I take my hat off to him.
I have enormous regard for him, his articulateness and his lack of sentimentality but his ability to express his feelings. That takes some doing.
Hmm. It appears you’re reacting to my sentiments in a comment at the end of comment-thread #1? I did not mean to imply that I begrudged him his access to cutting-edge medicine, only to point out it was yet again an illustration of the US’s unequal approach to healthcare, something I believe Hitchens himself has decried from time to time. (Tho of course, to be fair, countries with universal healthcare also have an upper tier of services available to the wealthy. And of course, clinical trials, etc., logistically have to be limited in availability.)
I’m over 60–I can match you anecdote for anecdote in personal experience with cancers and other illnesses amongst family and friends. Oh, and my husband’s a biochemist.
Very sorry about your Mom.
Heh heh heh.
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