Is cancer research on the wrong track?

Two stories by Gina Kolata in the New York Times today offer a public forum to researchers who believe that the US has been making “fundamental mistakes” in fighting cancer.

In her front-page story, Kolata writes that although “cancer has always been an expensive priority,” data indicate that the death rate “dropped only five percent from 1950 to 2005.” Meanwhile, “the death rate for heart disease dropped 64 percent in that time, and for flu and pneumonia, it fell 58 percent.” But, “the perception, fed by the medical profession and its marketers, and by popular sentiment, is that cancer can almost always be prevented,” or “if that fails, it can usually be treated, even beaten.” In cancer patients, “difficulties arise when” the disease “spreads, and, often it has by the time of diagnosis,” while “progress has been agonizingly slow” with regard to prevention. According to researchers, the US is “making fundamental mistakes in the way it fights the cancer war,” as “advocacy groups have lobbied and directed research in ways that have not always advanced science.” In addition, “there has never been enough” money “for innovative studies,” they contend, so such “projects often lose out to more reliably successful projects that aim to tweak treatments.”

In her second story, specific researchers attribute the lack of major impact on cancer mortality rates to lack of advances in cancer treatment. In this case Kolata writes that, “Data from the National Center for Health Statistics show that death rates over the past 60 years … plummeted for heart disease, stroke, and influenza and pneumonia,” while “for cancer, they barely budged.” In fact, “the cancer death rate, now about 200 deaths a year per 100,000 people of all ages and 1,000 deaths per 100,000 people over age 65 — is nearly the same now as it was in 1950, dropping only five percent.” According to researchers, cancer death rates “are considered the purest measure” to “assess progress in fighting the disease.” Michael S. Lauer, MD, FACC, director of the division of prevention and population sciences at the National Heart, Lung, and Blood Institute, notes that “with heart disease … there were transforming discoveries in prevention and treatment,” which “led to effective drugs to lower cholesterol and blood pressure, to the use of aspirin, and to smoking cessation programs, all of which reduced the number of heart attacks.” With cancer, however, “equivalent transforming advances have not emerged.”

While there is some journalistic “overstatement” in both articles, The “New” Prostate Cancer InfoLink does generally agree that the bureaucracy of cancer research grant funding has, to a considerable degree, fostered mindsets in which the largest grants keep going to individuals and institutions that are not necessarily demonstrating a committment to “thinking out of the box” about how best to transform the ways we think about the diagnosis and management of prostate cancer, and while the advocacy community has been a major driver behind the increased funding for cancer research over the past 25 years, it has also failed to demand a real commitment to simple, straightforward reporting from the National Cancer Institute about the successes and failures of how all that money has been used.

3 Responses

  1. Why would they fix cancer? There is too much money at stake to be lost.

  2. Dear Chris: I am so sorry to see that you have such a serious case of invasive cynicism. But don’t worry … Even if we are able to “fix cancer,” there is little doubt that humans will find something else they need to have treated instead. To my near certain knowledge, every human ever born has managed to die from something! Of course until comparatively recently, the vast majority of us didn’t manage to live long enough to die from cancer (or Alzheimer’s disease for that matter!).

  3. The National Cancer Institute has a very high motivation to “fix cancer” — the government would earn a lot of points and save a lot of money if cancer were cured.

    I do hear a great deal of cynicism that the pharmaceutical companies would prefer to “treat” cancer than to “cure” cancer, since a successful cancer treatment would represent more annuity income than a cure for cancer.

    However, especially since US companies tend to be focused more on the quarterly bottom line than on the long-term picture, the public relations benefit and the real short-term income from a cure for cancer would put a company in the spotlight on Wall Street and in the press for a generation or more. I don’t believe that any company or university would pull back from announcing a possible cure for cancer.

    The problem is a great deal more complex than any other problem we have yet faced. We are only just now beginning to understand the complexity of the mechanisms unlying cancer, many of which are concealed in the rare diseases.

    Best wishes,

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