Dear Readers,

We are starting a new interview series where we ask few questions to people who are making a difference, it can be big, it can be small it doesn’t matter what matters is their contribution to our society. It can be anyone from any walks of life and from any country. Please, do send us suggestions of people whom you think we should interview for this series.

 Dr. Pareek is an award winning neuroscientist and a successful entrepreneur based in Cleveland USA. He has authored several scientific papers, book chapters and reviews for numerous biomedical journals. Currently, Dr. Pareek is working as a senior research scientist at Case Western Reserve University, USA. He is also a scholar of public health in global health issues and health care policy- management.

1. Tell us something about yourself?

I was born in a beautiful city “Jaipur” aka- “Pink City” located in north-western deserts of Rajasthan, India, famous for its rich royal cultural heritage. I was privileged to grow up in a family where our financial adversities never became a hindrance in extending our services to people in need.  My father lived a courageous, hardworking and happy life. We lost him in my early teenage but in this short life span seeing his selfless devotion for others and his impeccable character allowed me to define a purpose of my life. My upbringing allowed me to recognize that we are a minuscule part of this immeasurable universal scheme where the consequences of our actions are not limited to us alone. We can’t see ourselves isolated from this world. We have to retain and feel the compassion and power of this connection and act accordingly. I was fortunate to receive my educational training in one of the best research institutes of India and United States such as Indian Institute of Science, National Institute of Health and Case Western Reserve University in USA. I also received an opportunity to serve on several state and national level executive committees of India’s largest student organization, ABVP. These world class organizations not only shaped my career but also allowed me to interact and learn from some inspirational leaders of their field. Past two decades of my biomedical research, public health and business training have prepared me to understand the scientific fundamentals of health, disease and scientific business enterprise. Currently, I’m working as a senior research scientist and Ad. Prof. of applied social sciences at CWRU, USA. In these roles I lead a team of researchers who are involved in decoding the molecular basis of cancer, immune and neurodegenerative disorders. We recently spun off a biotechnology startup named Modularix, from our basic research lab where we design and develop new drugs to treat above mentioned ailments. The global exposure I received during my educational training allowed me to appreciate the power of distinct cultures and prepared me as a global citizen to harness the power of diversity at my work place. As a faculty of applied social sciences and public health I decided to pass on these learnings to my students. We recently started an initiative of expanding our students learning beyond the boundaries of class room where students from US and India learn from each other by cultural and educational exchange. Today I’m blessed with my beautiful wife Neelima, who is also a cancer researcher and two adorable kids Radha and Devang. We live in the magnificent city of Erie lake, Cleveland and recognize ourselves as proud “Brown-Indians” of this Beliveland.

 2. What is the progress that have been made towards cancer and its cure, if you can explain for our readers?

 While philosophers are fascinated by life, biomedical researchers are more inserted in decoding the mystery of death. For ages humans desire to remain immortal, however, at cellular level every minute millions of cells die and new cells are formed in our body. Dead man tells no tales but dead cells certainly do. This balance of life and death of cells is needed to be orchestrated in a controlled manner and our quest is on to understand this mechanism.  I define cancer as “unrestrained drama of immortal cells causing mortality”.

 There can’t be a single factor attributed to the cause of cancer. There are several intrinsic factors or extrinsic factors which alone or in combination can become the cause of this deadly disorder. Therefore, the diagnosis, treatment, and management of this disease is a complex task.

 Quite often people think that cancer is a modern world disease but the oldest written description of cancer known to exist is by Edwin Smith Papyrus in 3000 BC. The signs of cancer were found on the bones of mummies from ancient Egypt. In 400 BC Hippocrates, the father of medicine used the words “carcinos” and “carcinoma” to describe tumors. Later the Roman physician, Celsus translated the Greek term into cancer, the Latin word for crab.  For the first time in 1190 Moses Maimonides suggested the complete surgical removal of the tumor from roots as the potential cancer treatment. The earliest cancer epidemiology evidence was noticed by Bernardino Ramazzini where he reported the virtual absence of cervical cancer among nuns, and the high incidence of breast cancer within the same population. In 1761, John Hill was the first to recognize the dangers of tobacco use, published “Cautions against the Immoderate use of snuff.”  In 1779 first cancer hospital was founded in Reims, France. At that time the hospital was moved away from the city due to a widespread fear at the time that cancer was contagious. In 1829, Joseph Claude Anthelm Recamier was the first to recognize cancer metastasis.  For centuries we didn’t know much about cancer, however in 20^th century we have made a remarkable progress in diagnosis and treatment of Cancer. In 1915, cancer was first induced in laboratory animals at Tokyo University, by applying coal tar onto the skin of rabbits, leading the way for current cancer research methods. In 1946, Louis Goodman used nitrogen mustards as first chemotherapy to treat Hodgkin’s disease, lymphosarcoma, and leukemias. In 1971, US president Richard Nixon declares war on cancer by introducing National cancer Act. This revolutionized the cancer research by increased funding and resources. The completion of human genome project in 2003 has also paved the path of developing new targeted therapies to treat this disease differently to every individual.

These small but steady efforts of our scientists have made a significant contribution to cancer treatment. Today surgery, radiotherapy and chemotherapy are not the only limiting treatment options for our cancer patients but targeted therapy, drugs delivered by nanotechnology, hormonal treatment, and cancer immunotherapy are new waves of treatments. Researchers and clinicians do not want to leave any stone untouched to treat their patients and also exploring the usefulness of alternative and integrative medicine in disease management. During the 1970s, about 1 of 2 people diagnosed with cancer survived at least 5 years. Now, more than 2 of 3 survive that long.  With improved medicine, available treatment options, and early detection today there are more than 14 million cancer survivors in the United States alone.

Today we know that Cancer begins when cells in a part of the body start to grow out of control. Cancer can develop from almost any type of cell in the body and there are more than 200 types of cancer, develop in 60 different organs with breast, prostate, lung, colon, melanoma, bladder, lymphoma, kidney, thyroid, leukemia and pancreatic contribute to most of the disease incidence. Metastasis is the process whereby cancer cells spread from the site of the original tumor to one or more other places in the body. Interestingly 90% of all cancers suffering and death associated with metastasis and not by benign primary tumors. It is the single most significant challenge to management of the disease.

 About 65% of deaths are caused by non-communicable diseases worldwide and cancer contributes to 15% of them. Today about 13.2 million new cancer cases are diagnosed each year and about 8 million lives are lost per year by cancer. This number is predicted to increase to 22.2 million new cases and 13.1 million deaths, by 2030. That’s comparing to every person in Australia getting cancer every year. Increasing population and increased human life span are also contributing factors to this steady rise in cancer cases. Apart from the disease toll this disease puts a huge financial burden ($290 billion in 2010 expected to rise to $ 458 billion by 2030) on society. Most importantly the cancer case growth rate is much higher in developing countries than developed nations. Cost of implementing strategies to common cancer risk factors in low-to middle-income countries alone can reach to $2 billion each year. Apart from cancer cure one of the biggest challenge is to manage the suffering of cancer associated pain. Today 90% of the world’s morphine (one of the effective pain management drug) is consumed in developed nations (USA, Canada, Australia, New Zealand and some parts of Europe) and therefore, 99% of cancer patients in developing countries die with untreated pain.

 Today Cancer is the second most common cause of death in USA. 1 of every 4 deaths in America is caused by Cancer. Today, 1 of every 2 men and one out of 3 women and 1 out of 285 children will get cancer in their lifetimes. In year 2014 1,665,540 new cancer cases (10,450 children) were diagnosed with about 585,720 reported cancer death (1350 children). This represents about 1,600 deaths per day due to cancer or in other words 1 death per minute. These are quite striking number if you think about it and appear to be one of the biggest challenge of human race in 21^st century. The financial burden of this disease was reported to be $216.6 billion in year 2014 with $86.6 billion for direct medical costs and about $130.0 billion for indirect mortality costs.

3. What would be your advice to people who get cancer and their family members?

The statistics I reported above make it very clear that everyone single of us either encounter cancer in our life personally and/or face this devastating disease through one of our friends or family member in our life time. People who have seen this disease in their family will agree with me that pain and misery associated with cancer engulf entire family at different dimensions. Therefore, I would suggest people to confront this disease rather than escaping from it and/or avoid discussions. Don’t think that this is the responsibility of scientists and doctors to find the cure for this disease. The war against cancer is very huge and we all have to join our hands to fight out this battle and ensure a cancer free human generation in coming years. We all can participate in this journey by reading about it, generating awareness in our social groups, raise and donate funds and last but not the least by living a stress free balanced life, making our food our medicine instead of eating medicine as our food, and integrate our life with nature. We have to stop the exploitation of nature and start to learn the utilization of nature. In fact we should live in such a harmonious way with nature that every single human life contribute to enrich the nature around them. We have to be more vigilant about our every single act and creation. We have to understand that we are a minuscule part of this larger universal scheme and we can’t ignore our responsibility towards every single life on this planet and beyond.

4. What drives you in your work?

I think this life is too short and this war on cancer is too big. I’m one little soldier in the army of several dedicated scientists around the world. I would feel content if my scientific contribution can make a small difference in someone life or bring a smile to the patients and their families suffering with cancer. There are millions of children and adults across the globe that have faith and believe in scientists like me, that one day we will conquer the war on cancer. We can’t afford to let them down. The clock is clicking very fast. By the time our readers will finish reading this article we would have lost thousands of lives battling cancer. Every single minute is important and we can’t afford to lose time in this war. We have come across a long way in this journey and I’m very optimistic that in my lifetime I would be able to see this victory. Moreover, all the fun and excitement the science bring in front of our eyes can’t be described. Every day I learn how little I know and every discovery make me humble enough to appreciate the fact that nature doesn’t reveal its secrets very easily. I feel privileged to be in this job, especially in the era when technology is rapidly evolving and the world’s knowledge and information sits on our finger tips. I have no doubt that this would be that last century of cancer on this earth.

5. What changes should be made in public health systems around the world to better tackle disease like cancer in your opinion?

 Public health has often been defined as a science dealing with the determinants and defense of health at the population level, while clinical medicine deals with multiple maladies and their remedies at the level of an individual patient. Because public health scope is very wide and open, it aims to understand and influence the social, cultural and economic determinants of health as well as to study and structure health systems as efficient channels for health services delivery. Improvements in the health profile of western populations during the past two centuries have resulted primarily from broad-based changes in the social, dietary, and material environment, shaped in part by improved sanitation and other deliberate public-health interventions. In less-developed countries, health gains have begun more recently in the wake of increased literacy, family spacing, improved nutrition, and vector control, assisted by the transfer of knowledge about sanitation, vaccination, and treatment of infectious diseases. These observations remind us that public-health researchers and practitioners, and those in the political and public realms with whom they interact, must take a broad view of the determinants and, indeed, the sustainability of population health.

 Communication, education, and training can enhance the general awareness of people about this disease. Improved programs, policies, and infrastructure can also help in managing this disease more effectively. Focus on life style (Obesity etc.), environmental (Lead etc.) changes, and early detection/screening program will also help in reducing the disease burden.

6. Your message for our readers? 

In order to manage our health, our first focus should be on balancing our body within (physical, emotional and spiritual), then balancing the environment around us, and then balancing our food, respectively. Drugs and surgery should be the last resorts for our health management.  Unfortunately, our current approach to manage health is completely opposite, where medicine have become the first resort of managing health. We have to change this approach before it is too late. Lastly, participate in vibrant biomedical research, public health policy and advocacy by self-study, generating awareness in your community and developing resources for the ideas you care about.