ALTER: How are you feeling physically? EDWARDS: Fine. I had a broken rib, a fairly benign condition, but that’s the only uncomfortable part.
Let’s talk about what I think a lot of cancer survivors think of as being almost harder than the physical pain: the emotional cost. When I was first diagnosed, I was going to beat this. I was going to be the champion of cancer. And I don’t have that feeling now. The cancer will eventually kill me. It’s going to win this fight. I come from a family of women who live into their 90s, so it’s taken something real from me. There was a time during the day when we were getting test results when I felt more despair than I ever felt in any of the time I had the breast cancer. I have a lot that I intend to do in this life. We’re here at the house. I’m going to build paths through these woods so we can take long walks that I intended to take when I was 80. And I have a 6-year-old son. I was going to hold his children someday. Now I’m thinking I have only a slim chance of seeing him graduate high school. How do I accomplish, in what time I’ve got left, all that I’m meant to do? I’m writing a letter to my kids. It gives them something to hold on to and because you’ve got to butt yourself into their lives even after you’re gone.
You wrote in your book, “Saving Graces,” that nothing can be as bad as your son Wade’s death 11 years ago in a car accident. It’s odd to think of Wade’s death as having given us gifts, but it gave us quite a few. We just assume we’ll be able to do something next year or 10 years from now. How many of us have said, “I’m going to work in a soup kitchen next Christmas, I’m going to do that good thing”? And we all put it off. And one of the things that Wade’s death taught us is that we can control what we do during the day, during each day. Other than that, we really can’t control very much. Nothing we could do could change that one fact we wanted to change more than anything.
You’ve kept God out of the public discussion of your situation. Why? I had to think about a God who would not save my son. Wade was—and I have lots of evidence; it’s not just his mother saying it—a gentle and good boy. He reached out to people who were misfits and outcasts all the time. He could not stand for people to say nasty things about other people; he just didn’t want it. For a 16-year-old boy, he was really extraordinary in this regard. I wish I could take credit for it, but I can’t. You’d think that if God was going to protect somebody, he’d protect that boy. But not only did he not protect him, the wind blew him from the road. The hand of God blew him from the road. So I had to think, “What kind of God do I have that doesn’t intervene—in fact, may even participate—in the death of this good boy?” I talk about it in the book, that I had to accept that my God was a God who promised enlightenment and salvation. And that’s all. Didn’t promise us protection. I’ve had to come to grips with a God that fits my own experience, which is, my God could not be offering protection and not have protected my boy.
You didn’t lose your faith, you changed your faith? Or did you lose it for a time? I’m not praying for God to save me from cancer. I’m not. God will enlighten me when the time comes. And if I’ve done the right thing, I will be enlightened. And if I believe, I’ll be saved. And that’s all he promises me.
Are you clear to say pretty much what you want— Because of the cancer?
Yeah. In the first hours after the diagnosis, the campaign is probably glad there was no reporter around. Because I was feeling like, all right, I am completely free to say whatever I want.
What do you say to the Rush Limbaughs of the world who have the nerve to judge how you should cope with your disease? Words don’t bother me. If John had pulled out of the race, they would have said, “Oh, he was failing in this race and this was just an excuse to get out.” This is a no-win situation with those folks, and you just have to accept it. But what you hate is that other people might listen and say, “Oh, that’s right, it’s our job to tell them what is right.” There’s going to be a day before each of us die, and you have to think a little bit about how you want that day filled. Maybe when you’re doing that judging thing, think about how you want the day before you die to look. I want that to be a productive day about which I am enormously proud, as opposed to a day where I had the covers pulled up over my head. That’s unbelievably important to me. And if somebody is judging me, and doesn’t hear me say that, maybe it’s partly my fault for not saying it clearly and maybe it’s their fault for not thinking about it.
Is some of the criticism about what you and John said about giving the kids “wings” just old “Mommy Wars” stuff? Having lost a child, I promise you that making certain that I do not have regrets when we finally say goodbye is really important to me. I think the hardest question—and this, I think, we haven’t adequately explained to people—is the children. I think we’ve pretty much settled on what it is we’re going to do. I think the children will finish out the school year and then, in the fall, they’ll travel with us. We will home-school them. We’ll employ a tutor to travel with us to help teach them. I hope it will be an extraordinary experience for them.
If you go to doctors and they say, “Look, there’s this drug that’s in clinical trials right now. It’s no guarantees. We have no long-term data on it. It is going to make you sick, your hair is going to fall out,” are you going to do it? Yes. I’m going to do it. I have an obligation to try to live as long as I can for my family. So if I campaign less or if I campaign with a wig, then I’ll do those things.
title: “Transcript Lance Armstrong On Surviving Cancer” ShowToc: true date: “2022-12-04” author: “Pearline Mata”
Now Edwards and his top counselor are facing their toughest campaign challenge yet: how to manage her future on the trail. In the two weeks since the Edwardses learned that Elizabeth’s breast cancer has returned and is incurable, the couple has seen an outpouring of support. Lance Armstrong, a family friend, called. So did George H.W. Bush, who suggested a specialist at Houston’s M.D. Anderson Cancer Center. The campaign raised $540,000 online in the week after Elizabeth’s announcement. In the latest NEWSWEEK Poll, 56 percent of adults think Edwards made the right decision by staying in the race; only 12 percent think he is trying to use his wife’s illness to his own political advantage. “When I walk down the street I can’t move,” John tells NEWSWEEK. “People stop me: ‘How’s Elizabeth? We’re thinking about her’.”
But in the coming days, John and Elizabeth will face tough choices about how to balance private and public responsibilities. Most immediate: what to do about their two small children, Jack, 6, and Emma Clare, 8? In a much-dissected interview with Katie Couric on “60 Minutes,” the couple seemed oddly wooden when asked if a campaign was worth the time away from their kids. (“The most important thing you can give your children is wings,” Elizabeth told Couric. “Some time they’re going to have to be able to fly by themselves.”) “I know we’ve been asked about that in the press,” Edwards says, “for both of us that’s the hardest issue. We have to figure out what to do with them.” To that end, the couple has decided to take the children out of school for the campaign and home-school them on the campaign plane. The children won’t mind the road, says Edwards: “Jack said to me on the phone just a few days ago, ‘Dad, I want to go on the campaign trail, when are we going to go on the campaign trail?’”
Another challenge will be keeping Elizabeth healthy amid the demands of a presidential race. Edwards, who says his wife has a tendency “to downplay her own needs,” admits he may not always know if she is pushing herself too hard. “It’s a good question,” says Edwards. “I can usually tell by the way she talks how she’s feeling, but the doctors will have to keep watching her very closely.”
Watching her closely could mean less time on the trail. Edwards says that while he expects Hillary Clinton raised far more money than he did in the first quarter of 2006, he hopes to be “in touch of” Barack Obama in campaign donations. If so, it will be in part because, unlike Obama, Edwards was not tied to a job in Washington and spent most every day of the quarter on the road raising cash. “Before this recurred, the intensity of the need for me to be in her presence and vice versa was not as great,” he says. “Now it’s very intense.”
Elizabeth’s diagnosis has made presidential candidates’ health a top issue for the first time since Bob Dole ran against Bill Clinton in 1996. Republican front runners John McCain and Rudy Giuliani—survivors, respectively, of skin and prostate cancer—will soon face questions about their own long-term prognoses. Edwards has said he does not want anyone to vote for him because his wife has cancer but says it’s appropriate for voters to evaluate how he handles Elizabeth’s condition. “When people think about electing a president,” he says, “they think about the substance and they also think about what kind of human being you are.”
title: “Transcript Lance Armstrong On Surviving Cancer” ShowToc: true date: “2023-01-04” author: “John Martinez”
I was struck, in particular, by the headlines about Elizabeth Edwards and the repeated use of the word “incurable.” That word is so contrary to the American spirit and what we believe about our ability to innovate and excel. It doesn’t take into account Elizabeth’s considerable courage, and it says something alarming about the complacency that leads us to just expect another diagnosis with another new day.
It’s clear that the way we battle cancer is deeply at odds with our values as a country, and with our common sense. There is a serious gap between what we know and what we do; what we deserve and what we get; what should be and what is.
The shameful reality is that we do not ensure that everyone benefits from what we know today about cancer prevention and detection. The outcome of a cancer diagnosis often depends on factors that have nothing to do with the disease, including race, insurance, economics, age and proximity to treatment centers. We can prevent about one third of cancer deaths just by widely distributing information about prevention and early detection—but we aren’t doing it.
Meanwhile, we know scientific discovery is critical and our best hope for the future. Research labs hold the promise for improved screening and therapies and better understanding of metastases and prevention. Congress, however, repeatedly fails to fully fund the requested budget for the National Cancer Institute and recently cut cancer funding for the first time in more than 30 years.
These are only two examples of the disconnect between what we know and what we do. At some point we have to ask ourselves what is at stake. Who is left vulnerable by that gap? The answer is our spouses, parents, children and friends.
For that reason I am determined to lead a movement to fundamentally change the experiences and expectations of cancer patients. We need an unapologetic effort to demand what is right and champion what works. We have to be ruthless and relentless, as the author Jim Collins often says, in our quest for results. We must honestly and clearly affirm that this is an ethics issue. To confront it we must summon our resources and the moral courage and political will of the public, the health-care system and our government.
To that end, Americans deserve leaders who understand the magnitude of the problem and have carefully considered what to do about it. Trust me when I tell you that we are going to ask them. And we expect an answer.
title: “Transcript Lance Armstrong On Surviving Cancer” ShowToc: true date: “2023-01-02” author: “Billie Trout”
According to three new studies published Sunday in Nature Genetics, though, those days are over. Three separate groups of scientists have pinpointed seven variations in DNA that definitely increase a person’s risk of prostate cancer. All of the variants are found on the same chromosome. But don’t call them “prostate cancer genes”—the reason scientists couldn’t find those before, it seems, is that the culprits turned out not to be genes at all. Instead, they are found in so-called “junk DNA,” portions of the genome that don’t make proteins. “What these variants are doing inside the cell is still a big question,” says Brian Henderson, dean of the school of medicine at the University of Southern California. “But whatever we’ve found, it’s the same finding by three different groups who didn’t find anything else. After 15 years of looking, that’s very exciting, believe me.”
One of the studies, led by Henderson, David Reich of Harvard Medical School and others, lays out where the seven genetic variations are. All appear in seemingly barren stretches of chromosome 8 with virtually no genes. The other two studies confirm the location of the prostate-cancer risk factors and show independently that they do influence a person’s risk for prostate cancer. In the uncertain world of prostate cancer, that confirmation is crucial, says William Catalona, a urologist and surgeon at Northwestern University who coauthored the second paper with the Icelandic firm deCODE Genetics. “One of the problems that has plagued prostate cancer is that nobody can ever confirm anybody else’s work,” Catalona says. “You’ll have a really good research group saying, ‘We have a signal here,’ and then everyone else will try to reproduce that signal and they can’t. So people get skeptical and think that it’s a false positive signal, and in genetics, false positive signals occur all the time.”
The scientists’ frustration has been amplified by their certainty that genetics play a large role in who gets prostate cancer and who doesn’t. Unlike breast and lung cancer, which are clearly influenced by factors such as obesity and smoking, prostate cancer doesn’t have as strong as a link to lifestyle choices. A family history of the disease, which strikes one in every six men, is by no means a sure indicator that someone will get it, but it is a major warning sign. Race also seems to be involved—African-Americans’ risk of developing prostate cancer is about 1.6 times higher than any other group’s. The new studies begin to explain why. The seven genetic variants appear “across all ethnic groups,” says Reich, but “all are more common in African-American than in European-American families.”
The newly discovered variants on chromosome 8 are present in “a lot of prostate-cancer cases, the majority of them,” says Henderson. But other portions of the genome also certainly contribute to the disease. It’s hard to estimate how many more troublemaking variants there may be, he says, much less what chromosomes they’re hiding on. But for the moment, he adds, the seven known variants “will certainly keep us busy for a while.”
That’s because scientists don’t yet know what role the variants play in the body. It will be “a formidable challenge to unravel,” says Chanock, a coauthor of the third paper. Increasingly, though, research has been revealing that “junk DNA” is a misnomer—it seems instead to play a key role in regulating the amount of proteins made by certain genes. The variants linked to prostate cancer may be involved in this type of regulation. They could influence, for instance, the activity of a gene called MYC, which controls cell division and has been linked to many different kinds of cancer. It, like the variants, is found on chromosome 8. “Everyone has a high level of suspicion about MYC. Could what we’re finding be related to that gene?” wonders Henderson. “Maybe there’s some long, distant effect it’s having that we don’t understand and don’t have any prior knowledge of.”
Alternately, the seven variants might be linked to an unusual property of chromosome 8, one that becomes clear only when a cell is cancerous. Tumor cells have genomes that look different from healthy cells; they develop mutations that enable them to thrive at the expense of the rest of the body. In almost all types of tumor tissue, including prostate tumors, says Chanock, “All hell breaks loose in this region where the variants are found.” Healthy cells have two copies of chromosome 8; some tumor cells may have as many as 10 copies of this region. Perhaps, says Reich, “these genetic variants could be increasing the propensity of the DNA in this region to copy itself.”
For scientists, then, task No. 1 is to explore the new biology they’ve found. “These discoveries may provide us with new markers and blood tests for prostate cancer susceptibility and aggressiveness,” says Catalona, “as well as possible new targets for treatment and even prevention.” However, it is far too early, adds Chanock, for clinicians to get involved. “Right now, we’re a long way away from testing people for these variants and judging their risk by it. It would be challenging to determine exactly what you would say to counsel someone before and after the results of such a test,” he says. But further down the road, he says, doctors will indeed be able to test men for these seven genetic variants and others, determining who’s really at risk.
