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March 2000 Now and Forever By Michael J. Katin, MD

There will continue to be an effort to keep this column as timely as IMRT. To this end, it was necessary to erase the material in process in order to address the following.

The biggest news story of the past month was not related to political primaries, natural disasters, or Academy Award nominations, but was the announcement that "Cats" will be packing it in as of June 25. Even without subscribing to the thesis of Joe Queenan's recent book, one would never have expected that "Cats" would make it into the year 2000, as well as "Peanuts," Ronald Reagan, and chemotherapy. This closing again takes away one of the givens in our lives. It is a little-known fact that I write each column dressed in full "Cats" regalia, for reasons unknown even to myself. Maybe it's just as well it's over, since the litter box is getting a bit much.

But back in 1982, when "Cats" opened, things were different. If you wanted to keep current on information about cancer treatment, it was necessary to subscribe to journals, go to national meetings, and keep in contact with your colleagues. Now, if you want to stay ahead of your patients, you need to subscribe to stock market Internet sites, check online news, and keep in touch with your broker.

The profit motive has taken a new turn, in that there is no longer motivation to use treatments that can earn us a living, but that the acceptance of treatments by patients is based on the news releases of the biotech companies to get their stock up. I recently was contacted by a medical oncologist with a patient who wanted to be treated with one company's radiolabeled antibody product since he had read about a patent approval in a market news release. He insisted that it was available for use since he equated the patent approval with the ability to sell the product. Every day we have people with terminal diseases coming in with articles about angiogenesis inhibitors, none of which have yet shown any but sporadic usefulness in humans, since releasing every piece of information about even the slightest evidence of progress will drive that stock up the usual 10 to 20 points, making millionaires out of Gen-Xers while we still have to slog through every day trying to make money by actually working. Eventually when it turns out these products don't do anything, they can then make additional millions shorting the stocks. I'm still not sure where all this money comes from in the first place but I think it's got to be from something productive.

The only comfort we can take is knowing that the stock market does not have the same effect on the decisions made by our government agencies and elected officials. At least, no more than it did in 1982.

email: mkatin@radiotherapy.com