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Why Has There Not Been More Progress

Posted 3/24/2015

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  Millions of dollars and gazillions of hours have been spent on cancer research. Why are we not further along? Yes indeed there has been progress. Examples of that include the real cures that have been discovered for a few cancers (e.g. some childhood leukemias) and the multiple often effective treatments that are now available for many cancers. When I came to work at BIDMC (then BI) in 1979, there was exactly one drug available for women with metastatic breast cancer. It was adriamycin and, once it stopped working, there was nothing else to offer. There is now a long list, but there is still no cure. And no prevention.

  It is so distressing when I talk with people who truly believe that there is some kind of medical/pharm conspiracy to withhold a cure because then no one would be making money. (Remember the old military industrial complex?). It is equally distressing when I talk with people who believe that diet and complementary therapies will save their lives and avoid  the toxicities of standard cancer treatments.

  The bottom line is that cancer is one gigantic and complicated problem, actually many problems. There are so many kinds of cancer, so many ways that the body can be compromised, so many things that can go wrong. As a reminder, Ken Burns' The Emperor of All Maladies will air on PBS next week. Watching it will be a crash course in understanding all of this.

  As will be reading this from NPR:

Why The War On Cancer Hasn't Been Won

When President Richard Nixon declared a war on cancer in 1971,
there were high hopes that scientists were close enough to
understanding the underlying causes that many cures were
within reach.
We obviously haven't won the war.
In fact, a prominent cancer biologist argues that the conceptual
framework for understanding cancer has come full circle over the
past 40 years.

MIT biologist Robert Weinberg made that provocative comment
in an essay he wrote last year for the journal Cell. He's a luminary
in the world of cancer and is a founding member of the
Whitehead Institute for Biomedical Research in Cambridge,
Mass.
His argument goes like this.
In the 1950s, medical researchers saw cancer as "an extremely
complicated process that needed to be described in hundreds, if
not thousands of different ways," Weinberg says.
Then, scientists started glimpsing what they thought were
simplifying principles. The first idea, which helped spur the
government's war on cancer, was that viruses were the prime
drivers of human cancers. That proved not to be the case.
As that idea faded, it was replaced by the notion that cancer is all
about wayward genes.

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