Who Fights Cancer In a Lockout? (I)

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[Originally published at Overtime by The Hockey Writers]

If you don't know someone, or of someone, who is struggling with a cancer diagnosis or who has died of cancer, you are either too young or in a state of denial. Cancer is indiscriminate, incessant, and ubiquitous.

In the United States, we've been hurling money at cancer for several decades. If President Nixon's declaration of war on cancer in 1971 has taught us anything, it's that money can't buy a cure.

Actual cancer cures are rare. The greatest anti-cancer pharmacological breakthrough in the last 50 years, a drug called Gleevec, saves the lives of people with chronic myeloid leukemia (CML) not by scrubbing the body clean of cancer cells but by managing the disease at the molecular level. As recently as the mid-1990s CML was a death sentence. Gleevec single-handedly transformed a killer disease into a chronic one no less manageable than type 1 diabetes. Nothing communicates the phenomenal power of Gleevec better than a scene in the Farrah Fawcett documentary Farrah's Story. Long-time partner Ryan O'Neal, who has CML, is laying next to Farrah begging her not to die, saying that if she dies then he too wants to die. A weak and barely audible Fawcett gives him a simple solution: "Then stop taking your Gleevec."

One of the discoverers of Gleevec is Dr. Brian Druker. As the story goes, Druker saw something promising in the molecule that would become Gleevec, but in order to carry out clinical trials he needed money from Novartis, which owned the molecule. He fought against recalcitrant executives who didn't see what he saw, but finally Druker won out. The result is a blockbuster drug that is both commercially and clinically successful, a true wonder drug.

Ingenuity brought Gleevec to life, but money was a key player. It didn't buy a cure; it bought the many expenses associated with getting there.

No. 66

Organization or industry-led fundraising initiatives against cancer or any disease generally come from personal exposure. The most obvious example for hockey fans is the Mario Lemieux Foundation. Mario created the Foundation in 1993, the same year he was diagnosed with early-stage Hodgkin's lymphoma, the same year he was cured of Hodgkin's by radiotherapy, and the same year he won the Art Ross Trophy by scoring 39-65-104 points in 40 games before his diagnosis and 30-26-56 points in the 20 games following treatment.

The contributions made to the fight against cancer by the Mario Lemieux Foundation over the past 20 years are by any measure extraordinary, but arguably the most extraordinary is yet to come. The Mario Lemieux Center for Blood Cancers at the Hillman Cancer Center is scheduled to open this winter. It will change the otherwise complicated and frustrating journey of blood cancer patients as profoundly as Mario changed hockey.

HOCKEY FIGHTS CANCER

The largest charity initiative of the NHL season is the annual Hockey Fights Cancer (HFC) campaign, which takes place in October. All 30 teams devote a home game to the cause. According to a joint press release from the NHL and the NHLPA in 2010, these home games include "on-ice presentations, 50/50 raffles, promotional giveaways, contests and discount ticket offers." Additionally, "arena suites and tickets will be donated to children’s hospitals and cancer-affiliated programs, and young patients will be involved with in-game opportunities - including rides on the ice resurfacer, puck-drops, radio booth visits and player meet-and-greets." Silent auctions of signed memorabilia help raise extra cash, and awareness continues through player visits to local hospitals and their participation in other fundraisers.

A component of the league's The Biggest Assist Happens Off the Ice program, HFC began in 1998 on the heels of Tampa Bay Lightning forward John Cullen's bout with B-cell non-Hodgkin's lymphoma. Following diagnosis in 1997, Cullen endured six rounds of combination chemotherapy (multiple drugs administered at a sitting) only to learn it didn't work. In cases like his, second-line treatment guidelines back in 1997 recommended high-dose chemotherapy and radiation followed by what's called 'stem cell rescue'. The procedure effectively wipes out the patient's immune system then 'rescues' it with a hematopoietic stem cell transplantation (also called a bone marrow transplant; in reality it transplants blood stem cells), either banked by and for the patient, or received from an anonymous donor. The outcome is a new and hopefully cancer-free immune system. The potential complications--including death--are too numerous to list here.

HFC brings in on average about $1 million annually. The biggest recipients last year were the four primary partners: the Leukemia & Lymphoma Society, Prostate Cancer Canada, ZERO- The Project to End Prostate Cancer, and the Pancreatic Cancer Action Network, each of which receives grant money. Each team then receives $10,000 for distribution to local cancer charities.

As a joint initiative of the NHL and the NHLPA, it will not occur in the event of a lockout. To be fair, $1 million per year doesn't go very far in cancer research, but it can go a long way when put towards outreach programs and patient-assist programs, in particular for some of the 50 million or so Americans without health insurance. Cancer is so expensive it is a risk factor for personal bankruptcy. Meanwhile, the value of the interaction between players and cancer patients, survivors and loved ones can't reasonably be quantified.

LEUKEMIA & LYMPHOMA

What kind of an impact might a lockout have on the finances of the premier blood cancer charity in North America? Realistically, very little. HFC's contributions to the LLS, which total around $200,000 or so each year,  are peanuts compared to their total annual revenue from contributions, which in 2010 alone totaled $274.8 million (Source: LLS 2010 Annual Report).

That said, the money does have an impact.

In September of 2011 at league headquarters in New York, players including Zach Parise, John Tavares, Brad Richards and Henrik Lundqvist presented a little plaque to Columbia University's Aldolfo Ferrando, MD, PhD., a plaque that symbolized the grant funding provided to the LLS thanks to the HFC campaign. The money raised that year helped to fund a portfolio of ten research grants into pediatric cancers, one of which is led by Dr. Ferrando.

Ferrando is associated with Columbia's Center for Cancer Genetics, and one of his projects involves a comprehensive, genome-wide mutation analysis of T-cell non-Hodgkin lymphomas. T-cell lymphomas are rare, accounting for about 15% of all non-Hodgkin's lymphomas. According to the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) statistics, this means there are about 11,000 new T-cell lymphoma diagnoses in the US each year. Compared to lymphomas of B-cell origin, the many subtypes of T-cell lymphomas tend to strike a much younger patient population, and in general they have a poorer prognosis. Fewer treatment options exist, and those that do aren't terribly effective.

A genome-wide mutation analysis of T-cell lymphoma tumors will likely uncover mutations shared among the various subtypes of T-cell lymphoma; discoveries that can lead to pathways researchers can exploit in the development of targeted therapeutic treatments.

PROSTATE CANCER

Prostate Cancer Canada uses its share of grant money for outreach programs that aim to get Canadian men tested and treated for prostate cancer who might not otherwise have access to testing or to treatment. The money that goes to ZERO funds prostate cancer education and research programs. It also helps to fund The Drive Against Prostate Cancer, a program that makes the highly controversial PSA testing free for hundreds of men across the US. Last season, ZERO partnered with Millennium Pharmaceuticals and the Boston Bruins for a campaign called Patients' Assists where a $100 donation was made to ZERO for every assist the Bruins picked up (they had 423 for a total donation of $42,300).

PANCREATIC CANCER

According to the Pancreatic Cancer Action Network's annual report, in 2010-2011 the National Hockey League contributed between $25,000-$49,999 to that charity. People with pancreatic cancer need all the help they can get. Even though the disease takes as long as 15 years to develop in the body, it is rarely caught early. Most diagnoses are made after the disease has metastasized, resulting in one of the worst prognoses of any cancer subtype, if not the worst in terms of five-year survival.

Of the four partners and the NHL, the Pancreatic Cancer Action Network was the only organization to officially decline my request to comment on the NHL or the lockout or how it might impact them.

Click here for part two.

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