The Truth in Small Doses: Why Were Losing the War on Cancer-and How to Win It

The Truth in Small Doses: Why We're Losing the War on Cancer and How to Win It

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The Dark Side of Statins: The Wonder of Cholesterol. The Metabolic Approach to Cancer: The statistics are depressing: And more than 1. Of course, many survive. Leaf blames the failure to cure cancer on mismanagement. He would also like the government to fund people rather than projects, to focus less on publishing studies and more on solving problems, and to avoid awarding money to the same institutions.

Leaf's command of the science is masterful, his passion is palpable, and his critique of a broken research system is utterly convincing. But, like the best advocacy journalism, The Truth in Small Doses is ultimately inspiring, pointing the way toward a more hopeful future. It is a landmark achievement. But Clifton Leaf offers more than a history of our national cancer effort: He provides a vision and a roadmap for a creative and bold national cancer strategy.

In this refreshingly impassioned volume, Leaf explains why while offering a path forward…Perfect for: Anyone curious about the history of medicine, as well as the fraught intersection of pharmacology, public policy and the corporate world. Leaf's extensively investigated treatise will resonate with researchers and patients frustrated by the bureaucratic woes he delineates. Public policy makers, grant reviewers, and pharmaceutical researchers alike must consider Leaf's indictment and proposed solutions.

His groundbreaking story went on to describe the failures of researchers and drugmakers alike, and a system so focused on incremental improvements in the treatment of the disease that it could not arrange itself to tackle the roots of a persistent and still growing problem. As Leaf writes, "Science determines the limits of the possible. Engineering lets us reach them. In this history of the fight against cancer, he describes how scientists often cannot secure funding for risky research in a culture that rewards competition over collaboration. The Truth in Small Doses, a book told with the rigor of a brilliant journalist but with the heart of a cancer survivor, is certain to disrupt the conversation on the state of cancer research and inspire new approaches to win this war.

See all Editorial Reviews. Product details File Size: July 16, Sold by: Share your thoughts with other customers. Write a customer review. Read reviews that mention war on cancer cancer research must read clifton leaf truth in small losing the war read this book small doses win this war cancer survivor beautifully written anyone interested emperor of all maladies men and women early detection touched by cancer thoroughly researched important book pharmaceutical companies nine years. Showing of 71 reviews. Top Reviews Most recent Top Reviews. There was a problem filtering reviews right now.

Please try again later. Kindle Edition Verified Purchase. I wish I had money to buy this for ever cancer researcher I know. Anyone in cancer research can see that the way research is paid for and managed isn't working.

The Truth in Small Doses

But what can one person do with their lone perspective? Now that we have another "moon shot" for cancer treatment, is the NCI establishment doing anything different? Doesn't look like it. More money given to the same people and same giant cancer centers isn't helping, and hasn't helped in 30 years. The only research in cancer research that seems to be making a difference is the community-based, home made medicines from cannabis. I am a Keynesian fiscal liberal. I believe strongly in the importance of basic research in the sciences. And I work in a lab funded largely by the National Cancer Institute, and thus benefit as much as anyone from the U.

In spite of all this, there have been times when I've prayed that the sequestration battle ax fall hard on our heads. This book does a good job of explaining why. I've been plagued for the past few years that we - as a field - are doing little to advance the overall understanding of cellular processes that will contribute to better diagnosis and treatment of cancer and a host of other diseases, while still managing to publish papers, get funding, and convince everyone that we are just on the edge of a big breakthrough.

Research in the biomedical sciences has become about having the best toys and the resources to employ cutting-edge techniques, and not about answering questions. If we were Wall Street bankers or dot-com entrepreneurs we would have all had to find other jobs by now, because the patience of investors would be gone. Unfortunately, public funding doesn't work that way. It was a surprise to me that the structural problems in the field were actually identified a priori before the National Cancer Act was signed into law by Richard Nixon in As described in the book, the bills' sponsors including Ted Kennedy originally envisaged a NASA-like foundation that would coordinate the overall effort and direct the research.

Scientists objected, insisting instead that research be investigator-driven. This was essentially the model that already existed, but with more money.

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As explained in the book, this has led to a culture where people do not share data or materials, projects are conservative and make minuscule contributions to questions that are already long picked-over. If I have one criticism, it's that the author does very little to "prescribe a treatment" for this problem. This is perhaps understandable, because most people seem unaware of the problem in the first place. This can be a starting point for a conversation; hopefully, not the end. I accidentally heard about this book on NPR where the author was interviewed, together with the Chief of Cancer research at Dana Farber.

I was astonished at what the author had to say, and was struck by the inability of the person from Dana Farber to meaningfully respond. This book is a diagnosis of what went wrong and what can be done about it. The dysfunction appears to be in the poor management of the "war" and the growth o The "War on Cancer" fizzled from it's beginning in The dysfunction appears to be in the poor management of the "war" and the growth of a cancer research system that actually resembles the growth of cancer in the body The mushrooming system of grant, grant applications, grant evaluations, the narrow target-drug strategy, etc, literally sucks the resources from the actual scientific effort!

The 'publish or perish' mentality, the endless clinical trail process, the lack of standardization of nomenclature and tissue collection So, the system needs a pretty radical change. Leaf lists "7" changes that need to happen now. They all address the issues listed above, but his most salient point is that this war needs some professional management, some command and control, some engineering mentality.

I enjoyed this read almost as much as I was troubled by it. After all, now that I am 65, the diagnosis of Cancer is probably just around the corner. I would like to think someone is taking the cancer war seriously. Jul 02, A Malcoski rated it it was amazing. A must-read and hopefully, a game changer in how cancer is fought in this country. An entertaining book filled with wonderful stories of how we came to fight the war on cancer and lost the battle in the process. Filled with easy to digest science and facts, Truth is also a scary eye-opener to the flawed culture surrounding the cancer fight.

The same universities are awarded grants. Outside-the-box thinking is frowned upon. Hungry med students eager to make a change are met with the uninspired tr A must-read and hopefully, a game changer in how cancer is fought in this country.

“A VERY TOUGH SET OF PROBLEMS”

Hungry med students eager to make a change are met with the uninspired truth that makes up the system. This book is a call to arms and one, that I hope, opens up the discussion that will lead to change. Jun 13, Sheila Read marked it as to-read. If I win this book I plan on donating it to the local cancer center.

Jan 01, Angie Hahn rated it really liked it. Learned a lot about the pharmaceutical industry and medical research. Was published in and there have been many changes in the last couple years, so some things are already out-dated. Aug 03, John Kerastas rated it it was amazing. This is an important book about an important topic: They are, indeed, the core of this book. The book has four sections: Part I describes the enormity of the cancer burden — a burden that is rarely understood and horrifying when it is. He takes complex science and process issues and writes these issues about them in the simplest way possible.

To counteract the density of the science, Leaf often illustrates his point with a very human tale about how some doctor or scientist made a significant impact in the war against cancer. I hope that everybody involved in cancer research reads this book. I wish that folks who control cancer research grants are required to read this book.

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I want my doctors to read this. I do hope that Mr.

If folks want me to review their books in the future, though, please keep in mind that I really like hazelnut gelato. Aug 16, Jonah rated it liked it Shelves: This book contains great points about reforms necessary in healthcare but contains numerous glaring flaws. First of all, the objection to how cancer death rates are reported can only be evaluated if we did an age by age comparison- which he doesn't provide.

His numbers in no way reject the hypothesis that we are reducing the cancer death rate for all age groups. Secondly, he falls far short of showing that we need to be less cautious about treating pre-cancer; his claims that pharmaceuticals are r This book contains great points about reforms necessary in healthcare but contains numerous glaring flaws.

Secondly, he falls far short of showing that we need to be less cautious about treating pre-cancer; his claims that pharmaceuticals are responsible for drops in heart disease and liver disease are not borne out unless the pharmaceuticals in question are vaccinations for hep B. Although he claims that cancer research money misallocation is responsible for lost research, the evidence of previous researchers who wouldn't be funded today is mostly researchers who weren't funded when they did their research either Further, many of the history he reports on didn't happen that way.

Insulin wasn't "discovered" as a new thing by Banting- using pancreatic extract was an old tack that was tried by Banting largely as a way of trying an old and unexciting thing again for grant money and alcohol in a prohibition era town.

And the "clinical trial" that showed lemons and oranges treated scurvy effectively made no scientific splash and was even, to a large extent, RECANTED. Also, a lot of rise in cancer in the first half of the 20th century is anything but mysterious- it's the cigarrettes, stupid. At some points, half of cancer deaths have been attributable to smoking- an issue barely touched on.

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I appreciate the perspective, and the look at how our money is mis spent, but I really thought the book could've been done better. Sep 07, Traa rated it really liked it Shelves: I am always dubious of books that have the word "TRUTH" in large letters on the cover a tactic employed by people with strong opinions that may or may not be based in reality , but by the end of this book the author had convinced me that the "War on Cancer" needs some serious reform.

Be warned, this is not a light read. In order to support his thesis, Leaf first endeavors to convince the reader that progress on this front is minimal at best and regressive at worst. There were times that I felt I am always dubious of books that have the word "TRUTH" in large letters on the cover a tactic employed by people with strong opinions that may or may not be based in reality , but by the end of this book the author had convinced me that the "War on Cancer" needs some serious reform.

There were times that I felt that his bleak opinion of the current state of cancer research may have been a little overblown, but at the same time he provides a powerful argument that we cannot begin to reduce the cancer burden until we improve upon the current system. The "and How to Win It" portion of the title also comes "in small doses", so don't go in hoping this book has all the answers.

It has many more questions than answers, but most importantly, it has a call to arms. I received my copy of this book for free through the Goodreads First Reads program. Sep 04, Matt Heimer rated it it was amazing. You wouldn't think that a book of this nature would make ideal vacation reading, but I picked up my copy while on a cruise ship, and found myself almost unable to put it down for three days. Cliff Leaf who's a friend and former colleague of mine finds a remarkable narrative balance: He includes just enough hard science and there's plenty to give a not-especially-knowledgeable reader an introduction to the workings of cancer research and the grim bio-mechanics of cancer itself.

But at the sam You wouldn't think that a book of this nature would make ideal vacation reading, but I picked up my copy while on a cruise ship, and found myself almost unable to put it down for three days. But at the same time, he includes enough anecdotal and historical color to keep the book from bogging down in dry details. And it's all knit together by a passionate urgency of tone that reflects Leaf's own experience as a cancer survivor. I think there's a lot of room for debate about the details Leaf's short prescription for "How to Win" the war on cancer, but by the time he offers that prescription at the end of the book, even the most skeptical reader will have to concede that it's founded in responsible, dedicated and immersive research.

Jun 03, Anup Sinha rated it it was amazing. Outstanding book by Clifton Leaf on what is a most profound issue. Leaf is not a doctor or a researcher, nor does he have any scientific background that I can determine but that just makes it more impressive. In fact, he takes the angle of a very intelligent person financial writer by trade who has been touched by cancer himself and is looking at a dysfunctional system from outside.

He is willing to make observations that people in the field would be scared to, or perhaps, too blinded. There's Outstanding book by Clifton Leaf on what is a most profound issue. There's no question that the tremendous financial investment into a cure for cancer is yielding very little result. Leaf doesn't have all the answers, but he sure has some good ideas on what went wrong and what we can do to fix it. This is much too important an issue to ignore and I hope it gets traction. He has an excellent writing style and the narrative should be at least readable for non-science people.

Aug 29, Billy rated it liked it. A powerful indictment of our cancer industry that has made marginal progress at great expense in fighting this disease s. From a broken grant-funding process, to an over-abundance of caution on the part of drug companies, to a failure to focus on prevention and "preemption" of disease. A severely flawed clinical trial process that selects for drugs that are often no better than existing treatments, lack of standards that make comparing data almost impossible, inability of researchers to acquire A powerful indictment of our cancer industry that has made marginal progress at great expense in fighting this disease s.

A severely flawed clinical trial process that selects for drugs that are often no better than existing treatments, lack of standards that make comparing data almost impossible, inability of researchers to acquire tissue samples, funding going to a select group of researchers and institutions who play it safe and don't look for innovative solutions which wouldn't be funded , and researchers spending half their time applying for grants are some of the issues covered. Solutions proposed include better management of the overall enterprise, funding people, not projects, focusing on prevention, which has worked in heart disease, stroke and infectious disease.

Dec 10, Dorothy Steffens added it. Thank you Good Reads for sending this book to me for free. A very detailed account of the journey that scientists, pharmaceutical companies, universities and researchers searching for a cure for cancer. One of the deadliest diseases there is and with all the years of work, a cure is still a long way off. The research is well documented with recognizable and well known professionals in the medical field. I recommend this read Thank you Good Reads for sending this book to me for free. I recommend this read for anyone interested in an detailed explanation of the directions these health and research professionals have taken over the past 30 years to bring us to todays accomplishments in the fight on cancer.

Thank you Sincerely, Dorothy Steffens I'm giving the book a 5-star rating because the author did an excellent job of writing this book. In reading it however, I found myself fairly disturbed and angered by current state of the current "war on cancer. In the end though, the book shook off whatever I'm giving the book a 5-star rating because the author did an excellent job of writing this book. In the end though, the book shook off whatever semblance of naively feeling I'd be in good hands if I ever get the disease Nov 07, Zebulon rated it really liked it.

The author uses the mavericks in the cancer biological science as examples of how we are currently stifling progress through bureaucracy and micromanagement. Leaf contends that we have lost sight of the goal of the "war on cancer" and have instead fixated on increasing budgets and funding. Certainly more resources cannot hurt but surprisingly little has come from the billions spent since the Cancer Act of the early s.

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