“The problem, at least in dollar terms, is that most children are healthy. In the health consumer market, big patients simply overpower little ones. In any given year, more than one million adults will learn they have cancer, but less than 13,000 children under age 19 will get the same diagnosis. To makes things worse, at least for the bottom line, the common cancers—breast, prostate, colon, and lung—occur rarely, if at all, in minors,.. children’s cancers are often too infrequent to be profitable.”

...After years of high expectations, reflection, and plenty of sticker shock, targeted therapy met reality. In many ways, the love affair with targeted therapy has been like any other romance. At first sight, it was new and exciting. Lots of people became starry-eyed over the possibilities. But as time passed, researchers began to see that targeted therapy was more complex and flawed than everyone first thought.

“Because it has the power to switch our genes off and on, epigenetics is the reason that a skin cell doesn’t look or act like a liver cell, even though they both carry the same DNA. Epigenetics is the reason that identical twins, even though they are pretty much genetic clones of one another, don’t get the same diseases. And it is often the reason that a perfectly normal cell goes bad.”

“There are five things that can happen with cancer screening, and four of them are bad,” Calonge says. Most people know only the one, hoped-for benefit: detecting cancer at an earlier, presumably more treatable stage. “We never think about the ramifications,” he says.

“Health care reform stands to affect almost all people with cancer, both those who lack insurance and those who already have it. Some will be affected profoundly, as they will be spared from financial ruin because of their treatment. The bill also addresses cancer screenings, out-of-pocket expenses, clinical trials, the Medicare “doughnut hole,” and even creates new taxes on cancer-unfriendly industries—such as tanning salons—to help pay for it.”

“...Most patients want to take their medicine, fully intend to, and do. For others, though, life interferes. The side effects become more burdensome than the threat of cancer. The drug is too expensive. Other reasons for halting treatment include wanting release from routine of a pill—which sometimes has to be synchronized with other pills—misinterpretation of instructions, forgetfulness, or just plain denial. And sometimes, when viewed through the prism of surgery, radiation, and hours in a recliner watching medicine drip into your veins, a little tablet can seem inconsequential...”