Progress in Cancer Treatment
It has been decades since President Nixon announced the "War on Cancer." Progress has certainly been made, but we are all too aware of the distance still to go. There have been a few remarkable discoveries that have saved thousands of lives and truly changed the natural course of certain diseases. I am thinking about Gleevac for CML (chronic myeloid leukemia) and herceptin for her2 positive breast cancers. Unfortunately, many medications which look promising in the lab or even in early trials turn out to be disappointing. It is especially painful when a particular drug receives a lot of media hype and hopes are impossibly raised.
Here is a thoughtful essay from The Washington Times about this issue:
Monday, April 19, 2010
WEINER & BERG: 'Failure' is the wrong diagnosis
Robert Weiner and Dr. Patricia Berg
As 17,000 cancer scientists attend the American Association for Cancer Research (AACR) convention in Washington through Wednesday, their frustration is clear. Mainstream media such as the New York
Times and books including "The Politics of Cancer" and its sequel, "The Politics of Cancer Revisited," assert that we are "losing the winnable war against cancer." Samuel Epstein, the books' author, calls the verdict "unassailable." Mr. Epstein says it's a "myth that there has been any dramatic progress in the treatment and cure of cancer." The Times, meanwhile, in an article by Amy Harmon as recently as Feb. 10, uses negative headlines like "A Roller Coaster Chase for a Cure."
The researchers who inhabit the benches of our laboratories seeking causes, cures, inhibitors and diagnostic tools have, in fact, made enormous strides against the nation's second-leading killer. It is true that cancer still kills 560,000 Americans annually. Nearly one of two men and one of three women
will be diagnosed with cancer. Breast cancer is the leading cause of death for American women between ages 40 and 55. However, progress is incontrovertible. The death rate from all cancers has been dropping 1 percent a year over the past two decades, and there has been a similar 1 percent annual decrease in the rate of new diagnoses, according to a Journal of the American Medical Association briefing at the National Press Club last month.
The work is complicated. Cancer is not monolithic, nor is it a single-cause-and-cure disease. Cancer "encompasses more than 200 diseases," Dr. Margaret Foti, AACR's chief executive, told us. However, Dr. Foti notes the "interlocking relationships among cancers" - what she calls "a cascade of genes. Breakthroughs for one may pay off for others."
Anyone who thinks scientists are boring nerds needs to have seen Dr. Francis S. Collins, the new director of the National Institutes of Health (NIH), at the National Press Club bounding with enthusiasm for his craft. Dr. Collins leads the world's largest health-research organization - 325,000 scientists work with NIH grants. Dr. Collins talked about a "direct line from NIH research to the
life-span increases" that have expanded the average life from ending at 62 to 78 just in the past 50 years. He also spoke of "the awe and wonder of what it means to be a scientist and to cure a disease or discover a gene."
Yet Dr. Collins is concerned about our scientific future: "In the 1960s, after Sputnik, we became passionate about math and science, and it helped us, but we have really slipped. We have gone from No. 1 to No. 18 in the world in high school graduation rate. Eighty-four percent of students say they would rather eat vegetables or clean their room than do their math or science homework. The future of biomedical research is in danger because we are not cultivating the next generation of scientists."
Dr. Collins is infuriated by those who claim there is failure in the nation's efforts against cancer. "We now have smart bombs" - what he calls the genetic and pharmaceutical attacks against the disease. "The incidence of cancer is falling for the first time. Is that failure?" he rhetorically asked us when we interviewed him.
The major television networks' "Stand Up to Cancer" programs over the past year have helped shed light on the progress being made, and a Biomarker Consortium of more than 20 government, patient, industry and academic groups led by Ellen V. Sigal, chairman of the Public-Private Partnerships Committee Foundation for NIH, is maximizing the ability to conduct research. Yet the most dramatic indicators that the Washington region sees of true progress are the breast cancer survivors who run or walk each year in the Komen Race for the Cure and the Avon Walk for Breast Cancer. Two-thousand breast cancer survivors walked with Avon, and Komen's Parade of Pink numbered 3,000 survivors, along with 45,000 participants. These are the daughters, mothers and granddaughters, as well as malesurvivors, who know the importance of research in extending their lives.
From President Nixon's declaration of the War on Cancer in 1971 to President Obama's proclamation that April 2010 is Cancer Control Month and his pointing to his mother's courage in fighting the disease, America has been unified against this deadly illness. We must better support those who seek its causes, prevention, early detection and treatment.
Robert Weiner was chief of staff of the U.S. House Permanent Select Committee on Aging. Dr. Patricia
Berg is director of a cancer research laboratory at George Washington University Medical Center.