On November 4, 2003, a doctor gave Jon Gluck some of the worst news imaginable: He had cancer — one that later tests would reveal as multiple myeloma, a severe blood and bone marrow cancer.
Jon was told he might have as little as 18 months to live. He was 38, a thriving magazine editor in New York with a 7-month-old daughter whose third birthday, he suddenly realized, he might never see.
“The moment after I was told I had cancer, I just said ‘no, no, no,’” Jon told me in an interview just last week. “This cannot be true.”
The fact that Jon is still here, talking to me in 2025, tells you that things didn’t go the way the medical data would have predicted on that November morning. He has lived with his cancer, through waves of remission and recurrence, for more than 20 years, an experience he chronicles with grace and wit in his new book An Exercise in Uncertainty. That 7-month-old daughter is now in college.
You could say Jon has beaten the odds, and he’s well aware that chance played some role in his survival. (“Did you know that ‘Glück’ is German for ‘luck’?” he writes in the book, noting his good fortune that a random spill on the ice is what sent him to the doctor in the first place, enabling them to catch his cancer early.) Cancer is still a terrible health threat, one that is responsible for 1 in 6 deaths around the world, killing nearly 10 million people a year globally and over 600,000 people a year in the US.
But Jon’s story and his survival demonstrate something that is too often missed: We’ve turned the tide in the war against cancer.
The age-adjusted death rate in the US for cancer has declined by about a third since 1991, meaning people of a given age have about a third lower risk of dying from cancer than people of the same age more than three decades ago. That adds up to over 4 million fewer cancer deaths over that time period. Thanks to breakthroughs in treatments like autologous stem-cell harvesting and CAR-T therapy — breakthroughs Jon himself benefited from, often just in time — cancer isn’t the death sentence it once was.
Our World in Data
Getting better all the time
There’s no doubt that just as the rise of smoking in the 20th century led to a major increase in cancer deaths, the equally sharp decline of tobacco use eventually led to a delayed decrease. Smoking is one of the most potent carcinogens in the world, and at the peak in the early 1960s, around 12 cigarettes were being sold per adult per day in the US. Take away the cigarettes and — after a delay of a couple of decades — lung cancer deaths drop in turn along with other non-cancer smoking-related deaths.
But as Saloni Dattani wrote in a great piece earlier this year, even before the decline of smoking, death rates from non-lung cancers in the stomach and colon had begun to fall. Just as notably, death rates for childhood cancers — which for obvious reasons are not connected to smoking and tend to be caused by genetic mutations — have fallen significantly as well, declining sixfold since 1950. In the 1960s, for example, only around 10 percent of children diagnosed with acute lymphoblastic leukemia survived more than five years. Today it’s more than 90 percent. And the five-year survival rate for all cancers has risen from 49 percent in the mid-1970s to 69 percent in 2019.
We’ve made strikes against the toughest of cancers, like Jon’s multiple myeloma. Around when Jon was diagnosed, the five-year survival rate was just 34 percent. Today it’s as high as 62 percent, and more and more people like Jon are living for decades. “There has been a revolution in cancer survival,” Jon told me. “Some illnesses now have far more successful therapies than others, but the gains are real.”
The dramatic bend in the curve of cancer deaths didn’t happen by accident — it’s the compound interest of three revolutions.
While anti-smoking policy has been the single biggest lifesaver, other interventions have helped reduce people’s cancer risk. One of the biggest successes is the HPV vaccine. A study last year found that death rates of cervical cancer — which can be caused by HPV infections — in US women ages 20–39 had dropped 62 percent from 2012 to 2021, thanks largely to the spread of the vaccine. Other cancers have been linked to infections, and there is strong research indicating that vaccination can have positive effects on reducing cancer incidence.
The next revolution is better and earlier screening. It’s generally true that the earlier cancer is caught, the better the chances of survival, as Jon’s own story shows. According to one study, incidences of late-stage colorectal cancer in Americans over 50 declined by a third between 2000 and 2010 in large part because rates of colonoscopies almost tripled in that same time period. And newer screening methods, often employing AI or using blood-based tests, could make preliminary screening simpler, less invasive and therefore more readily available. If 20th-century screening was about finding physical evidence of something wrong — the lump in the breast — 21st-century screening aims to find cancer before symptoms even arise.
Most exciting of all are frontier developments in treating cancer, much of which can be tracked through Jon’s own experience. From drugs like lenalidomide and bortezomib in the 2000s, which helped double median myeloma survival, to the spread of monoclonal antibodies, real breakthroughs in treatments have meaningfully extended people’s lives — not just by months, but years.
Perhaps the most promising development is CAR-T therapy, a form of immunotherapy. Rather than attempting to kill the cancer directly, immunotherapies turn a patient’s own T-cells into guided missiles. In a recent study of 97 patients with multiple myeloma, many of whom were facing hospice care, a third of those who received CAR-T therapy had no detectable cancer five years later. It was the kind of result that doctors rarely see.
“CAR-T is mind-blowing — very science-fiction futuristic,” Jon told me. He underwent his own course of treatment with it in mid-2023 and writes that the experience, which put his cancer into a remission he’s still in, left him feeling “physically and metaphysically new.”
While there are still more battles to be won in the war on cancer, and there are certain areas — like the rising rates of gastrointestinal cancers among younger people — where the story isn’t getting better, the future of cancer treatment is improving. For cancer patients like Jon, that can mean a new challenge — enduring the essential uncertainty that comes with living under a disease that’s controllable but which could always come back.
But it sure beats the alternative.
“I’ve come to trust so completely in my doctors and in these new developments,” he said. “I try to remain cautiously optimistic that my future will be much like the last 20 years.” And that’s more than he or anyone else could have hoped for nearly 22 years ago.
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