探秘胰腺癌：名人抗癌经历与新型免疫疗法的争议

这段时间，我还是忍不住会去查找与癌症尤其是胰腺癌相关的资料。虽然绝大部分都是些悲观的消息，但有时我也感到无法理解，父亲本来有着很健康强健的身体，为什么会突然患上癌症之王呢？如果是其他的癌症，比如更为常见的肺癌，因为化疗和靶向药较多，产生耐药后不停地也能够撑个 5，6 年，甚至上十年。

同时，我也会去检索一些关于胰腺癌患者的资料。这一搜才发现，患有胰腺癌的中外名人还真不少，其中不乏专业领域的人士，像 80 后、90 后比较熟悉的香港明星沈殿霞，出演过《哈利・波特》中斯内普教授的演员，还有苹果公司的原首席执行官乔布斯。

不过乔布斯这件事还是个特例，他患的是腺癌中非常罕见、恶性程度比较低的类型 —— 神经内分泌肿瘤，按照他的财富是完全可以治愈这种病的，只是他拒绝化疗，错过了最佳的治愈窗口期，即便如此，他也与疾病抗争了 8 年。而绝大部分胰腺癌患者患的是导管腺癌，即使有机会手术，总体的 5 年生存率都不到 10%。

疫情期间，经常上电视的公共卫生专家吴尊友，他就是在疫情期间确诊胰腺癌的。按理说他是医疗专业人士，而且处在那么重要的位置上，所能获得的医疗资源也是常人不具备的，但是经过手术治疗之后，他的生存期也仅仅两年而已。

而在这些因为罹患胰腺癌的名人当中，最吸引我注意的是一位诺贝尔生理学或医学奖的获得者拉尔夫·斯坦曼。他的获奖成就，就是发现了免疫细胞树突细胞，发挥抗原递呈作用，所以说他是这一领域的顶尖专家了。尽管他最后也没有战胜癌症离世，但他的抗癌经历，却是非常值得、非常引人深思的。

因为他确诊时和绝大多数癌症患者一样，失去了手术的机会，在这种情况下，即便经过化疗，大多数患者的生存期也不会超过一年。但是，拉尔夫·斯坦曼在坚持化疗的同时，还尝试利用自己的研究成果，也就是树突细胞的功能，和科研机构及团队合作开发利用树突细胞传递自身癌细胞抗原的新型免疫疗法，使得自己的生存期，从一开始的几个月延长到了 4 年，甚至在他临终前的几个月，在向诺贝尔委员会做报告时，仍然保持着非常不错的健康状态。

诺贝尔奖有着只颁发给在世科学家的规定，因为诺贝尔奖委员会的评委们并没有觉得他会在几个月后去世，而决定将诺奖颁发给他。但是病魔最终还是没有放过他，他没能活到亲自去领奖的那一天，诺贝尔奖委员会也没有改变当初的决定，而是破天荒地第一次将该奖授予了这位已逝的科学家。

因为他生前也在同时接受常规的化疗，所以他的超长生存期是否与树突细胞疗法有关联，在科学上是无法认定的。所以这一疗法并没有得到推广，也没有得到监管部门的审批。这无形中是不是让很多潜在的可以受益的患者失去了机会呢？政府和监管部门以医疗安全的名义严格审批新药和新疗法，让它们在治疗病人之前要通过层层的官僚程序和临床实验，要经过漫长的等待期。那些本来可以从这些新药和新疗法中获益的患者是不是成为了“看不见的代价”？

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These days, I still can't help looking up information related to cancer, especially pancreatic cancer. Although most of the news was pessimistic, sometimes I felt I could not understand why my father, who had a very healthy and strong body, suddenly became the king of cancer. If it is other cancers, such as lung cancer, which is more common, because of more chemotherapy and targeted drugs, drug resistance can also be sustained for 5,6 years, or even 10 years.

At the same time, I will also search for some information about pancreatic cancer patients. This search only found that there are a lot of Chinese and foreign celebrities suffering from pancreatic cancer, many of which are professional people, such as the Hong Kong star Shen Dianxia, who is more familiar with the post-80s and post-90s, the actor who starred in the "Harry Potter" Professor Snape, and the former CEO of Apple, Steve Jobs.

But Jobs's case is still a special case, he suffered from a very rare and less malignant type of adenocarcinoma, neuroendocrine tumor, according to his wealth is completely curable this disease, but he refused chemotherapy, missed the best cure window, and even then, he fought the disease for eight years. The vast majority of pancreatic cancer patients suffer from ductal adenocarcinoma, and even with the opportunity for surgery, the overall 5-year survival rate is less than 10%.

During the epidemic, Wu Zunyou, a public health expert who frequently appeared on television, was diagnosed with pancreatic cancer during the epidemic. Supposedly, he is a medical professional, and in such an important position, the medical resources available to ordinary people are not available, but after surgery, his survival time is only two years.

Among the celebrities who have suffered from pancreatic cancer, the one who caught my attention the most is Ralph Steinman, a Nobel Prize winner in Physiology or medicine. His prize is the discovery of the immune cell dendritic cells, which play an antigenic role, so he is the leading expert in this field. Although he did not eventually overcome cancer and died, his anti-cancer experience is very worthwhile and very thought-provoking.

Because when he was diagnosed, like the vast majority of cancer patients, he had lost the chance of surgery, in this case, even after chemotherapy, most patients do not survive more than a year. However, while insisting on chemotherapy, Ralph Steinman also tried to use his own research results, that is, the function of dendritic cells, and scientific research institutions and teams to develop a new type of immunotherapy that uses dendritic cells to transmit their own cancer cell antigens, so that his survival period was extended from the first few months to four years, and even a few months before his death. At the time of his presentation to the Nobel Committee, he remained in remarkably good health.

The Nobel Prize has a rule that it is awarded only to living scientists, because the Nobel Committee judges did not decide to give the prize to him because they thought he would die in a few months. However, the disease did not let him go, he did not live to receive the prize in person that day, the Nobel Prize committee did not change the original decision, but for the first time awarded the prize to the late scientist.

Because he was also receiving conventional chemotherapy at the same time, it is scientifically impossible to determine whether his long survival is related to dendritic cell therapy. So it wasn't promoted, it wasn't approved by the regulatory authorities. Does this invisibly miss the opportunity for many potentially beneficial patients? Governments and regulators rigorously approve new drugs and treatments in the name of medical safety, subjecting them to layers of bureaucracy, clinical trials and long waiting periods before they can treat patients. Are patients who could benefit from these new drugs and treatments becoming "invisible costs"?