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"We're just seeing the start of matching patients with the right drug and seeing rapid improvements," says Dr. Brian Druker. (Robbie McClaran)

A Triumph in the War Against Cancer

Oncologist Brian Druker developed a new treatment for a deadly cancer, leading to a breakthrough that has transformed medicine

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There’s a photograph of LaDonna Lopossa that helps tell the story. She’s all smiles, lying on the grass in a vaguely Betty Grable manner atop her own cemetery plot. The portrait was her husband’s idea—in their decades together it seems George, a.k.a. Mr. No Serious, never saw a gag he didn’t like—but it was LaDonna who came up with the cheesecake pose.

“OK,” George had said, “now take off your shirt.”

“George!”

Click.

On the one hand it’s a silly snapshot of a 60-year-old woman in a cardigan and sensible sandals in Winlock, Washington, one sunny day in May 2000. On the other hand it’s a glimpse of a possible future in which science has solved a fearsome problem. For this is how LaDonna and George faced her lethal cancer, not just whistling past the graveyard but clowning around in the middle of it.

Three months before, LaDonna was lying in a hospital bed in Olympia about to draw the curtain. There was a lot to let go of: four grown children, several grandkids, friends at church, a good marriage. (Never mind that as she lay there George was loudly telling the nurses he was going to hit the bars to find another wife, which she understood as his oddball effort to ease her mind.) She was ready to leave everyone and all those things and more because of the pain.

Her spleen, normally tucked beneath the lowest left rib and no bigger than a peach, was so engorged with white blood cells it was the size of a cantaloupe. She could hardly walk. Her skin was ghostly, her blood dangerously short of red cells. To breathe was a chore. Regular vomiting. Stabbing aches deep in her bones, where the marrow was frantically cranking out white cells, or leukocytes. Recurring fevers. And cold, strangely, unnervingly cold: she was freezing under the hospital blankets.

She was too old and too sick to undergo a bone marrow transplant, a grueling, highly risky treatment for her blood cancer, chronic myeloid leukemia (CML). She had already tried the other standard CML treatment, regular doses of the powerful compound interferon. But it so intensified her nausea, fevers and bone pain she abandoned the medication, come what may. With nothing left in their leukemia-fighting arsenal, the doctors were down to Dilaudid, a derivative of morphine, the narcotic painkiller. It was calming, it was comforting and for a patient in her condition it was, of course, the end.

George had given away most of her belongings and had reserved a U-Haul truck to cart his stuff to Southern California, where he would move in with one of their sons. The music for her funeral was chosen, including “Because I Have Been Given Much,” to be sung by the grandkids. When the hospital recommended moving LaDonna to a hospice, George took her home instead and followed her doctor’s advice to summon the children; Terry, Darren and Stephen flew up from the Los Angeles area, and Kelly drove over from her place in Winlock. One by one they went into the bedroom, sat at LaDonna’s bedside and said goodbye.

CML is one of the four main types of adult leukemia, but it is not common, striking 5,000 people in the United States each year. As a rule, it is fatal, with most patients dying within five years of being diagnosed. The first phase, a stealthy explosion of otherwise normal white blood cells, can last months or years; patients are often alerted to the condition by a routine blood test. If the disease goes unchecked, the white cells become increasingly abnormal, issuing helter-skelter from particular stem cells in bone marrow called myeloid cells; such leukocytes burst capillaries, overwhelm organs and suffocate tissues by crowding out oxygen-carrying red blood cells. The disease’s course is exceptionally predictable, physicians say, but its clockwork nature has also provided scientists with an opportunity: prying into the molecular gears and springs that propel CML, they understand it better than any other cancer.

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