The three-part PBS documentary, "Ken Burns Presents Cancer: The Emperor of All Maladies, a Film by Barak Goodman," based on medical oncologist MD, PhD's 2010 Pulitzer Prize-winning book, "The Emperor of All Maladies: A Biography of Cancer," was promoted as a vehicle to both educate and mobilize the public about cancer, but what did it mean to oncologists?
This is the second installment of 番茄社区's interviews with leading oncologists and cancer researchers to get their reactions as well as their predictions about the potential for lasting impact. Each was asked a number of questions including overall impressions of the documentary's accuracy and balance, and reactions -- if any -- from patients.
None of the oncologists were directly involved in the production of the documentary, but some had tangential roles, which they disclosed.
The 12 interviews are presented in two parts. Here are the results from the remaining interviews:
, Distinguished Professor Health Policy and Management and Medicine at UCLA's Geffen School of Medicine, and Director of Cancer Prevention and Control Research at Jonsson Comprehensive Cancer Center.
Ganz replied by email that she had watched the second episode because she wanted to see Bernie Fisher.
"For those of us in the field who have lived this, there was not much new. I am sure for the lay public it might have been of interest," she wrote, adding that several members of her staff found the history interesting.
However, she noted that 2 hours without interruption was a bit tough, and that many people seemed to have recorded the documentary to watch later.
"What I saw seemed accurate, but I am not sure if someone who was not cancer knowledgeable would have caught many of the subtleties and nuances of the information," she concluded, noting the need to tap into a lay audience to find out.
Deputy Director at Large, Mayo Clinic Cancer Center.
Perez responded by email that she thought it might change the public's awareness and perception of cancer "a bit," but noted that thus far none of her patients had mentioned the film.
She said the documentary was accurate and balanced, but added, [There were] "almost no women physicians highlighted for their contributions," and "it could have included more pharma or biotech perspective related to Herceptin and Gleevec's development."
Perez commented she would have liked to see more information about the role of clinical trials; access and outcome of underserved populations; the significant decrease in NCI funding for trials; the role of community physicians and nurses in trials; and the need to save and utilize biospecimens to understand the biology of the disease.
She also thought that too much time was spent on "things that happened a long time ago," and would have preferred more of a focus on current research.
, Executive Director of the Biodesign Institute at Arizona Sate University; Dalton Professor of Chemistry and Biochemistry at ASU; Professor of Medicine at the Mayo Clinic (Arizona)
DuBois, who served as AACR president, disclosed that several years ago when he was provost at MD Anderson Cancer Center, he was interviewed off camera by some of the team involved in the film, but there was never any follow-up, and he didn't know if any of the information was used.
"Overall, I think the documentary did a tremendous service to those of us working in cancer research and treatment, because it created a compelling narrative about cancer. It gives an historical perspective about our understanding of cancer and cancer therapy; describes the enormous hurdles, both physical and emotional, that our cancer patients and their families go through during treatment; and highlights the progress made -- initially in tiny increments before gaining real momentum -- in cancer research over the past 100 years," he replied via email.
He noted that many of the advances discussed occurred in and around Boston, but acknowledged that Mukherjee had often said that he chose the area because he had trained there and anchored much of the history in his own back yard."
Stating that it was not possible to cover everything in a 6-hour documentary without "boring a lay audience to tears," he said it was understandable that numerous advances that had played important roles in the progress of cancer research -- in molecular biology, genetics, genomics, and informatics -- really weren't touched on very much, but added that "If Ken Burns were to produce a 6-hour documentary on the Iraq War, he'd be forced to leave out a lot of important battles. It's simply the nature of the form of communication."
DuBois said that he hoped the film would dramatically impact the public's awareness and perception of cancer, and that "Most importantly, I hope legislative decision-makers will come to understand the seriousness of this disease and will support more research to continue our momentum and build on the progress we've made so far."
He concluded that as someone who has been in this field for his entire career, it was gratifying that a filmmaker with the world renown and respect of Ken Burns has taken on the topic of the history of cancer.
"I'm extremely grateful to him," he wrote, "but also to Sid for writing such a vibrant account of cancer history and research, and to Stand Up to Cancer and AACR for putting their collective brain power and initiative toward this project. Sometimes those of sitting back in the trenches of academic medicine don't realize the many forces out there wanting and willing to help us do our jobs. "The Emperor of All Maladies," both in book form and documentary form, has given a real boost to us all."
CEO and Executive Director of Inova Comprehensive Cancer and Research Center in Falls Church, Va., and Professor of Oncology at Roswell Park Cancer Institute, where he formerly served as its president and CEO
Considering the documentary dealt with an "enormous subject," Trump said he thought that it covered the subject matter well. He said that members of his family and other laypeople had commented on how much of what they watched was new to them.
"I fell in love with Ken Burns' work during the Civil War series and must have watched it half a dozen times," he said, adding the cancer film had some of the same characteristics of Burns film-making, and that he realized how impossible it can be to fully account for all the variations and themes and personal stories and different perspectives that happen in human life.
Trump said that about half the people he had come in contact with while engaged in fundraising during the week of the broadcast told him they found the documentary very interesting and didn't realize how complicated cancer research and the development of cancer care was.
He was a little concerned that areas such as targeted therapy and sequencing the genome might seem to be relatively new to some viewers who were not aware of the continued maturation of cancer research over many decades.
"I wouldn't be surprised if this film becomes a substantially important event around the discourse of cancer and cancer research," he said.
Director, Division of Cancer Prevention, NCI; Editor-in-Chief of the Physician Data Query (PDQ) Editorial Board on Screening and Prevention; and former longtime editor-in-chief of the Journal of the National Cancer Institute.
"Overall, I was impressed as I always am with Ken Burns, and this time in concert with Sid Mukherjee, with his creating an engaging, intriguing, interesting, and informative documentary," he said during a telephone interview, adding that the film faced the challenge, just like cancer, of covering all complexities of an extraordinary spectrum of diseases in 6 hours.
He thought the film captured extremely well the history, especially in the first segment, as well as how many times we were on the verge of thinking we had the cure or solving the problem of cancer and how many times it turned out we were wrong.
"I think it set the stage very well for how complex the issue is and also for priming the public to put into context the recurring claims that there are breakthroughs and we're just about there. It was a nice contextual background for the entire series that went into the areas of promise, progress, and future progress, and I also think it set the tone nicely with president after president saying that we're just about there," he said.
Kramer said that it was important that viewers watch the series in sequence or they might miss something since it was put together so nicely.
He said the film did a good job of presenting extremely complicated biological issues in lay terms and an understandable format, and liked the switching between progress in science and personal stories, some of which turned out well and some which did not, reflecting the reality of cancer. He also thought the burden of suffering was presented accurately.
As for the prevention message, Kramer said that "it is more difficult to be engaging about prevention as compared with treatment, because patients know when they're being treated, know when they are benefiting, and when they've outlived the statistics, and that's not true in prevention because if you've had a disease prevented you don't necessarily know that it has been prevented, making it less compelling and engaging."
He said that since stories about prevention are much less poignant, he understood why the series might have under-emphasized some of the important research accomplishments in prevention including vaccines for HPV, and hepatitis B leading to liver cancer, H. pylori causing gastric cancer, and chemoprevention.
"It's hard to link these to personal stories, but it is equally important, if not quantitatively more important for global health to tell the prevention story," he said.
breast cancer specialist at Dana-Farber Cancer Institute, and an ASCO spokesperson..
"Cancer is a scientific challenge, a personal challenge, and a societal challenge, and the show captured each of those elements of this disease quite powerfully," he wrote, adding that the series captured the excitement about newer discoveries and how people hope this disease and patient outcomes will be transformed by them.
"In a show intended for a broad audience, it is tough to convey both a sobering reality and a true sense of optimism, and I thought the show gave a sense of both."
He said that many oncologists and patients that he spoke with thought that some topics could have been covered in greater detail or length, and that combination chemotherapy came off sounding "old fashioned" when it made tremendous strides in treating breast cancer, testicular cancer, lymphoma, and many other tumors.
"Patient survivorship issues could have been more prominent. Surgeons felt that the advances in surgical techniques were underplayed. But these are the kinds of choices that a producer has to make when given only 6 hours to cover a disease that has existed since time immemorial, and affects millions of people a year," he wrote.
Burstein said he hoped that the series conveys the idea that cancer treatment is being revolutionized and encourages people to do the "common sense" things for prevention and early detection.
"I hope that it affects public awareness. The patients I have spoken with found the show very inspiring. They were thrilled to know that there is so much new information and so many new treatments emerging that might be relevant for their care. They like knowing that they are not 'alone' in their fight against cancer," he concluded.