New book a poignant tale of cancer treatment
Marian Timmerman, MS
While Madison author, Marnie Schulenburg, was researching treatment options for a friend diagnosed with cancer, she came upon a simple test, called an assay, which could predict which chemotherapy treatment would be most effective for an individual patient.
Although this real test has been around for 20 years, many medical providers are not telling their patients about it, or are citing arguments against it. But why? This is the question Schulenburg explores in her powerful novel, "A Test of Survival." Her story of commitment to family, and commitment to an idea whose time has come, provides for a complex and immensely satisfying read.
The protagonist, Dr. Gus Ephraim, works for decades at the fringes of cancer research, convinced he has discovered a better way to predict patient response to certain drugs, but unable to convince the medical establishment of the validity of his work. The story unfolds as Gus and his wife Dani move their lab from California to Wisconsin to be closer to Gus’s estranged teenage son who may lose his own mother to pancreatic cancer.
In making the move, Gus puts his second marriage at risk, and puts himself straight in the path of the powerful Dr. Lyman Deering, internationally respected leader of the local cancer establishment. Schulenburg’s characters are passionate and imperfect. But in the end, it is their commitment to each other and the science they believe in, which allows Gus to face the medical establishment with courage and reason and prove himself as a physician, father, and husband.
"A Test of Survival" has special poignancy for all whose lives, or the lives of loved ones, have been touched by cancer. One cannot help but experience some outrage at the real-life drama that inspired the book. The book is fiction, but the science and the politics behind it are real. Schulenburg’s compassion for her characters and for the real life cancer patients whose lives and hopes are being denied shines through every page.
Read more about the real life science on the Internet at www.marniesfiction.com and in the brief Nursingmatters interview with author, Marnie Schulenburg, below.
Nursing Matters Q&A
Q: Did you have cancer, is that why you wrote the book?
No. But it takes all my fingers and most of my toes to count the people I know who’ve died of cancer, or who are survivors. Who among us couldn’t compose such a list? I stumbled across the real-life chemosensitivity test, began to believe in it, and could not dig up a satisfactory answer for why people with cancer are not told about it.
Q: The cell-death form of the assay has been around for over 20 years, you said. Can you talk about some of the unsatisfactory reasons it isn’t in widespread use?
Medical politics and money and closed minds are part of it, and a fossilized, circle-the-wagons resistance to fresh ideas from outside the so-called centers of excellence. Even people inside the system are talking about how the incentives in cancer research and treatment don’t always line up with the needs of desperately ill patients.
Q: You’re not suggesting some kind of conspiracy against this ex-vivo test, are you? It’s important to demand proof that the test works.
Agreed. But how much proof is enough? A Medicare panelist, who was part of a thorough and open examination of the assays way back in 1999, offered a wise viewpoint. He likened people resisting the preponderance of evidence supporting the assay to economists who, when something is proven to work in practice, they want to find out if it works in theory.
Q: You’re satisfied it’s an accurate test, then.
Yes, and so are the oncologists who regularly use it. Over 40 published studies of the cell-death assay in peer-reviewed literature document that killing cells in the test tube correlates with dead cancer cells in the patient. If there’s an effective drug to be found against someone’s cancer, this test is the best bet at finding it.
Q: Why did you write it as a novel (Instead of non-fiction)?
Sometimes you can get closer to the truth in fiction. Plus, no way could I have endured this topic without my characters to keep me company. I didn’t want a book that people with cancer picked up to figure out what to do next; I wanted the fact of this technology to mingle in the more general marketplace of ideas, and to entertain people in the process. That’s my own preferred, if lazy, method of learning.
Q: It sounds like you care more about getting the word out about this assay than you do about book sales.
Yeah, and a lucky thing, too! Look, before the sun sets on this day, 1,500 more Americans will die of cancer. I see this, at heart, as a matter of informed consent. Desperate people with cancer should be given every reasonable option and this technology is eminently reasonable; a way out of one-size-fits-all chemotherapy. I really do believe it’s ‘a test of survival.’
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