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

(Paperback)

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A brilliant (Fortune), eye-opening history of the war on cancer, The Truth in Small Doses asks why we are losing this essential fight and charts a path forward.

Over the past half century, deaths from heart disease, stroke, and so many other killers have fallen dramatically. But cancer continues to kill with abandon. In 2013, despite a four-decade war against the disease that has cost hundreds of billions of dollars, more than 1.6 million Americans will be diagnosed with cancer and nearly six hundred thousand will die from it.

A decade ago, Clifton Leaf, a celebrated journalist and a cancer survivor himself, began to investigate why we had made such limited progress fighting this terrifying disease. The result is a gripping narrative that reveals why the publics immense investment in research has been badly misspent, why scientists seldom collaborate and share their data, why new drugs are so expensive yet routinely fail, and why our best hope for progressbrilliant young scientistsare now abandoning the search for a cure. Through flowing prose Leaf delivers, alongside facts and data, stories on personalities involved in research, the fascinating process of solving an unusual and highly deadly cancer in Africa, and the heartbreaking realities of cancer treatment in children today. Leafs 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 Leafs indictment and proposed solutions (Publishers Weekly). The Truth in Small Doses is that rare tale that will both outrage readers and inspire conversation and change.

Reviews

As a cancer patient and advocate, I applaud Clifton Leaf for so boldly pulling back the curtain on the cancer culture to reveal why we've made limited progress toward cures. 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. -- Kathy Giusti, founder and CEO, Multiple Myeloma Research Foundation and Multiple Myeloma Research Consortium
In this brave and important book, Clifton Leaf explains the state of cancer research today, traces the battles we have won and lost in the war on cancer, and most importantly shows the ways in which doctors, researchers, and even patients might improve what we are doing to combat this disease. Leafs own pathfrom cancer patient to journalist to authoris an inspiring story itself, and his book will benefit both patient and doctor alike. The Truth in Small Doses will be the most important discovery in cancer this year. -- David B. Agus, M.D., author of The End of Illness
"In this lucid, convincing, and gripping book, Clifton Leaf lays out, in heartbreaking detail, why our well-intentioned war on cancer has produced such dispiriting results. 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." -- Jason Tanz, executive editor of WIRED
"Beautifully written, with the twists, turns and suspense of a great novel, The Truth in Small Doses tells the tale of the great individual successes and collective failure of both government and the pharmaceutical industry to impact the increasing number of cancer diagnoses and deaths in the U.S. 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." -- Frank M. Torti, MD, MPH, Dean, University of Connecticut School of Medicine, former director Wake Forest Comprehensive Cancer Center and former acting commissioner of the FDA
"An important evaluative study meriting serious public discussion." * Kirkus *
"It matters because: Weve been at war with cancer since 1971, and despite endless promises, are not much closer to truly winning that battle. In this refreshingly impassioned volume, Leaf explains why while offering a path forwardPerfect for: Anyone curious about the history of medicine, as well as the fraught intersection of pharmacology, public policy and the corporate world." * TheAtlanticWire.com *
[An] eye-opening look at why the U.S. is losing the war on cancerThe Emperor of All Maladies got Americans talking about the stalled battle against cancer. Leafs book keeps the conversation on track. * Booklist *
"Through flowing prose Leaf delivers, alongside facts and data, stories on personalities involved in research, the fascinating process of solving an unusual and highly deadly cancer in Africa, and the heartbreaking realities of cancer treatment in children today. 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." * Publisher's Weekly *
""Why have we made so little progress in the war on cancer" Clifton Leaf asked Fortune in 2004. 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. For a decade Leaf has followed the story, and though we are no closer to curing cancer, we can now imaginethanks to his lucid and fascinating workwhat that solution might look like. In Leafs brilliant new book, he reframes the challenge as one of engineering, not science. As Leaf writes, "Science determines the limits of the possible. Engineering lets us reach them."" * Fortune *
"According to Leaf, a journalist and cancer survivor, the [1971 National Cancer Act] failed because of the flawed research culture it spawned. 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." * Recommended by Scientific American *
Leafs book serves as a powerful call-to-action that our current system is too structurally flawed to provide the transformation in cancer care we all seekthe longer format has given Leaf room to explore the wide range of issues in more detail, and several chapters merit reading as stand-alone piecesLeafs analysis is clear and accessible to scientists and non-scientists alike, and should probably be read and debated by senior executives at all oncology-focused drug companies. * Pharmagellan.com *
A fascinating resource for anyone interested in understanding more about the biological mechanisms of cancer and curious about the history, politics, and ethics of the current cancer culture. * HuffingtonPost.com *
Exhaustively researched. * Nature *
Provocativehis prescription is dead on. * New York Post *
A ferocious call to action, backed up by both data and experience. * Newsweek *

Author Bio

Clifton Leafwas, until recently,a guest editor for The New York Times op-ed page and Sunday Review. Previously, he was executive editor at both The Wall Street Journals SmartMoney magazine and Fortune. A winner of the Gerald Loeb Award for Distinguished Business and Financial Journalism and a two-time finalist for the National Magazine Award, Cliff has received several leadership honors for his efforts in the cancer fight. He lives in Brooklyn with his wife and daughter.