15-03-2025
Sacramento doctor: If not for NIH funding, I wouldn't have survived my leukemia diagnosis
Following a terminal leukemia/lymphoma diagnosis in 2010, my physicians estimated that I would live no more than five to eight years. Today, I am seven years past that expiration date and going strong. I can thank the investments in research made by the National Institutes of Health and other non-profit organizations — notably, the Leukemia & Lymphoma Society — which have allowed me to survive my leukemia.
The current administration's threat to dramatically reduce or delay funding for the National Institutes of Health for many of the most talented researchers and clinicians in the best academic institutions in the nation represents a crushing blow not only to the development of future cancer therapies, but to all of medical research. Without previous funding, I would not be alive today.
As a family physician, I opened my private practice in Sacramento in 1981, caring for patients from womb to tomb. My practice included obstetrics, pediatrics and adult care. This allowed me to experience the full spectrum of emotions that comes with medical work: the joy that comes with the arrival of a newborn, and the deep sadness of having to give a patient and their families the 'talk' regarding serious or fatal medical conditions.
Opinion
I self-diagnosed my own lymphoma. I was in shock and denial — as most people in my situation would be. From that day in 2010 until my treatment began in 2013, I continued my medical practice. When chemotherapy made it too risky for me to work in a medical office, I became the executive research director for the Leukemia & Lymphoma Society, blending my previous expertise into building a national database for blood cancer patients to study their outcomes.
Since my first treatment in 2013, I have survived ten relapses, surgeries, radiation therapy and a dozen medical treatments, including six experimental therapies by way of clinical trials. Each and every one of the medications I have been given — ranging from conventional chemotherapy to targeted immunotherapy to an allogeneic bone marrow transplant — have been funded (at some point in their development) by the National Institutes of Health. These medications may not be household names, and may not be marketed by direct-to-consumer advertising, but they are lifesaving.
My leukemia is not curable because the disease becomes resistant to the therapy given. It can be suppressed: Like playing whack-a-mole, it can be beaten down with the correct cadence of unique treatments by way of new drugs. When I required treatment in 2013, the only U.S. Food and Drug Administration-approved therapies were primarily conventional chemotherapy — a cocktail of drugs called Fludarabine, Cytoxan, Bendamustine and Rituximab, which required months of infusions. At that time, the targeted oral therapies and immunotherapies, which are available today, were only a glimmer in the eyes of doctors who treat the disease.
Today, there are over a dozen FDA-approved therapies to treat my flavor of leukemia. Because I needed many of the drugs before they were approved, I opted to participate in clinical trials, where drugs are tested in the experimental phase prior to FDA approval.
I am alive today because the National Institutes of Health and the U.S. research community have been able to produce modes of treatment about as quickly as my lymphoma morphed. Five of the clinical trials I entered have become FDA-approved therapies, including two rocket science-like therapies referred to as CAR T-cell therapy (treatments that involved taking my white blood T-cells, re-engineering them with inactive HIV and re-introducing them into my system to act as virtual Pac-Men tracking down and destroying leukemia cells).
Research to develop CAR T-cell therapy began in the 1950s with the development of bone marrow transplant technology, taking a leap forward when genetic engineering helped to create the CAR T concept in the 1980s, with the first clinical trials in the 2010s.
I am in debt to non-profit foundations that supported me and funded the incredible research that created new therapies for my leukemia. Philanthropic research funding and academic labs are successful because the National Institutes of Health spent billions of dollars for years to make sure that the U.S. research infrastructure supports innovation and progress. This infrastructure includes laboratory buildings and equipment, clinical trial access and expertise and scientists and care teams.
I have lived the last 15 years believing that each therapy I was given represented a bridge to the next treatment. The longer the bridge, the better the chance there would be a new therapy waiting in the wings. My survival is based on research. With limited funding for the National Institutes of Health, I fear that my life and the lives of others in similar situations will be left with no hope.
Medical research to treat life-threatening diseases has made incredible progress in the past few decades. A reduced investment today means reduced treatment options for far too many future cancer patients.
Dr. Larry Saltzman practiced as a family physician in Sacramento and served as the president and CEO of Insurance Benefit Spot Check, Inc, a company he founded to simplify the complexities of healthcare coverage. He joined the Leukemia & Lymphoma Society as its executive research director to search for patterns of care that produce better outcomes with fewer side effects.
