Business: The Education of George Gialamas

The house is grand, of course, but not as lavish as some you’d find in, say, the Highlands or Noll Valley, where turrets or adjacent swimming pools or acres of intricate landscaping compensate for the lack of lakeshore.

Instead, on this mild summer evening the Lake Mendota home of real estate developer George Gialamas and his wife, Candy, feels welcoming and almost intimate. Due in no small part to the fact that here’s George himself: handsome, Greek and seventy-ish, a big man throwing open his arms, giving guests a double-clasped handshake, clapping a passer-by on the shoulder, swinging wide the door from the kitchen to the patio, urging people to sample the hors d’oeuvres.

His doctors say he could have been dead for about two years now. Maybe even should have been; the odds he beat are long, very long. But he is here—still the owner of The Gialamas Company, a member of Madison’s All-Century List and a force in the city’s economic destiny—greeting visitors and helping them wend their way through the house to the reception outside.

Tables skirted in crisp, white fabric beckon from beyond the al fresco bar. There is topiary. And yellow orchids. The green lawn rolls down to the blue lake. Glasses clink, voices murmur, people flick glances at one another’s name badges and introduce themselves. A woman adjusting items on the silent auction table moves the sapphire-and-diamond ring an inch closer to the front. She tilts envelopes that hold Milwaukee Bucks skybox tickets and golf getaway passes to more easily attract the browsers in the crowd.

Everything seems just so. There is not too much or too little of anything. If Goldilocks had been looking for a charity fundraiser that was just right, her story would have ended happily ever after at the Gialamas home.

And yet.

There are signs that something is amiss. Actual signs. Placards professionally designed and printed, with charts and catchy graphics. They are displayed on easels arranged about the patio.

A man in a dark golf shirt stands reading one while he eats. He pauses in mid-bite and then slowly returns a salmon-with-mango-chutney tart to the plate he’s been holding.

“Lung cancer is the second leading cause of death in the United States,” the sign says.

And there it is: the thing that’s wrong. It’s why some of the people here hug and exchange sad smiles. It’s why, despite his hearty handshake, Gialamas seems a bit distracted and a little tense, even though he’d strike anyone as a born socializer. Indeed, he and Candy are among Madison’s best-known power couples and denizens of philanthropy circles from Madison to Washington, D.C. They have held countless fabulous house parties for family, friends, politicians, celebrities, worthy causes and just for the fun of it. But this is a gathering to drum up support for lung cancer research; in front of many people who know him only for his success, Gialamas is going to have to talk about what’s on those signs.

This gracious soiree, it turns out, is also Gialamas’s shot across the bow. He is a man accustomed to making all things large and small happen his way, a man who never saw a problem he didn’t put his shoulder to. Now, as one of a lucky few who survive lung cancer, Gialamas is not so much racing for a cure as gunning for one, even if it means he has to humble himself in the fight.

Which is why, on a beautiful summer evening at a party in his own backyard, George Gialamas steps before the crowd, looks into the faces of his guests, and confesses his sin.

Shame, Shame, Shame

It wasn’t news to anybody in the audience that evening. Gialamas is—make that was—one of the most public cigarette smokers in Madison.
“Nobody could tell me not to smoke,” he recalls, seated in his west-side office a few weeks after the fundraiser. “I was getting warnings yearly from my doctor. My friends told me. My family told me.” He waves a hand to illustrate how he brushed aside everyone’s concern.

Denial is well-known for the role it plays in lifestyle diseases, those largely preventable illnesses caused by smoking, drug abuse, not exercising, overeating, over-drinkinAnne Traynorg, over-everything. Doctors in all walks of medicine see it in their patients every day. But oncologists who treat lung cancer rarely have to deal with it. If their patients have smoked and now have lung cancer, denial has been replaced by guilt and sorrow and crushing shame.

“They say, ‘It’s okay for you to blame me,’” says Anne Traynor, a physician and director of the Lung Cancer Program at the UW Paul P. Carbone Comprehensive Cancer Center. She says patients typically feel so guilty for having smoked that they often distance themselves from their families and feel unworthy of sympathy or even treatment. “And that’s just awful,” she says.

As empathetic as she is, Traynor is even more concerned with a much bigger and more ominous problem. The stigma of smoking is fused to the disease of lung cancer like a second skin. As a result, annual funding for research into how to cure or even treat lung cancer is a pittance: one dollar for every person diagnosed with it. Traynor says that’s the main reason survival rates for lung cancer have barely budged since, well, since lung cancer was discovered.

Today, nearly forty years after a national War on Cancer was declared in 1971, lung cancer is the leading cause of death from cancer worldwide. It is responsible for one in every four cancer deaths, the killer of more people than breast cancer, colon cancer and prostate cancer—combined.

Yet according to the National Cancer Institute, cigarette smoking is what causes nearly ninety percent of lung cancer deaths. If ever there were a disease that should be stigmatized, wouldn’t it be lung cancer? And why should anyone throw money at a problem when nearly everyone can prevent it simply by not smoking?

Traynor refuses the bait. She notes that diabetes, heart disease and other illnesses often caused by unhealthy personal choices are treated without scorn. She cites the fact that fifteen percent of all people diagnosed with lung cancer have never smoked.

“There is no place for judgment here,” she says. “We all make mistakes. Nicotine is a terribly addictive substance. Whether you smoke or not, no one deserves to get lung cancer.”

Budget Deficit

Michael Fiore agrees with Traynor. A professor of medicine and the founder of the UW Center for Tobacco Research and Intervention, Fiore is personally and professionally devoted to helping people stop smoking. Yet he does not view funding as a contest between preventing the disease and curing it.

“The choice is not whether to fund smoking cessation research or fund lung cancer research,” Fiore says. “We have a moral imperative to fund both.”

As Randy Newman sings, “It’s money that matters.”

To illustrate, Traynor’s oncologist colleague at the Carbone Cancer Center, Toby Campbell, contrasts the funding levels and survival rates of breast cancer and lung cancer.

“Twenty-six dollars is provided in research funding for every person diagnosed with breast cancer,” he notes. “Over the last thirty years, the five-year survival rate for breast cancer has increased from sixty-five to eighty-eight percent; during that same time, the five-year survival rate has risen from twelve to fifteen percent for lung cancer.”

Breast cancer is a diagnosis women receive more than twice as often as lung cancer. But lung cancer kills nearly twice as many women as breast cancer does. In total, the American Cancer Society predicts that 40,160 people will die of breast cancer in the United States in 2009 as compared to the (at least) 159,420 deaths that will be attributed to lung cancer during the same time period. In addition, the group predicts the 2009 fate of Wisconsinites as follows:

• Prostate cancer will strike 2,770 men.
• Breast cancer will be diagnosed in 3,480 women.
• Nearly 4,000 people will discover they have lung cancer.

Based on current overall rates of survival, and if they don’t die of other causes:

• Almost all of the men with prostate cancer will be alive five years from now.
• So will more than 3,000 of the women with breast cancer.
• But only 600 or so of the lung cancer patients will still be here—nearly 3,400 of the others will have died of the disease by 2014, most within a span of a two months to two years.

With an audible thud, Traynor lays this discrepancy at the feet of the funding issue. “A direct consequence of inadequate funding of lung cancer research is that lung cancer is the leading cause of cancer deaths,” she says. “We have got to do something about this.”

Let George Do It

Gialamas’s lung cancer was diagnosed in 2006 and confirmed via PET scan before Thanksgiving. All he knew about lung cancer at the time, he says, can be summed up in two words: “You die.”

He waited until after the holiday to tell his wife and grown children of his illness, underwent surgery at the University of Wisconsin Hospital and Clinics, and was home for Christmas. “Maybe we got it soon enough,” surgeon Tracey Weigel told him.

Like all cancer patients living in the Internet Age, Gialamas spent a lot of time online, before and after his surgery, looking up his disease. “I had tons of questions,” he recalls, “and Dr. Weigel answered them all.”

She also invited both Gialamases to an open house at the Carbone Cancer Center some eighteen months after his surgery. Weigel wanted them to see how a new building project was coming along: seven stories tall and the first of three planned towers in the new Wisconsin Institutes for Medical Research, this structure would be devoted to translational research into a variety of cancers. Thanks to federal funding, the Institutes’ breast cancer and prostate cancer research programs would have their own full floors. Lung cancer lost out on federal funding but did receive a $2.5 million state grant, so this innovative program—even confined to only half a floor in the new building—would put lung cancer researchers and physicians who treat the disease together in the space.

Gialamas had spent much of the time since his diagnosis trying to put distance between himself and the notion that he had ever had lung cancer. “I was so focused on getting this thing over,” he recalls. But he says he never lost the feeling that he owed his fellow patients, especially those who hadn’t been as lucky, something more than that. He wanted to help. His instinct was to get busy and build the project. “I see something that needs to be done, I want to grab it by the halter and get it done,” he says.

The Carbone Center had its own builders, of course, and the physical space of the Institutes was well on its way. Instead, Weigel introduced Gialamas and his wife to Traynor. As the director of the program that would be housed in the Institutes, Traynor proposed that Gialamas build something equally important: a fund to match the state grant and lure top scientists to Wisconsin, where they could work in the new lung cancer program and see their discoveries translated into action and treatment, just across the hallway from their labs.

Gialamas was in. First he and Candy became the co-chairs, along with Fred Johnson, CEO of the Credit Union Executives Society, of the Lung Cancer Task Force, a fundraising and advocacy group organized through the UW Foundation and the Carbone Cancer Center. Then they invited friends and business colleagues to that lovely summer reception at their home to kick off a $4 million capital campaign to fund and staff the half-floor at the Wisconsin Institutes for Medical Research. Gialamas wrote a check on the spot to match the first $100,000 raised; Traynor delivered a few remarks and stood next to him as he lifted the veil on lung cancer.

“I think what George said is highly courageous,” she says. “He’s a community leader and respected, with a lot of personal connections in town, in the state and across the country. He’s sort of been dealing with people in one manner all his life and now he’s putting himself out there to increase lung cancer awareness. He has made a very personal commitment.”

In December, the Lung Cancer Program moves into its new digs at the Institutes, and the first of six scientists and six physicians will get to work. Gialamas says that he now knows too much to stay silent about the need to fund lung cancer research. “We patients are very afraid to discuss the disease with anybody,” he explains. “I’m lucky, and I’m glad to be here. So I know I have to make people aware of what lung cancer is.”

Mary Erpenbach is a contributing writer for Madison Magazine.

Find another of Erpenbach's stories on lunch cancer research and treatment here.

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