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The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.
By Michael Popejoy
October 14, 2014
If you pose this question to cancer researchers, you will not get a straight answer. Saying yes to the question results in the next question, when can we expect the cure to be announced and be available to our doctors? If the answer is no; then we ask, why then are we investing so much funding in sponsored cancer research with so little results?
No laboratory scientist wants to see research funds dry up. Lights out as labs close means unemployment for senior scientists and their young aspiring students. So, it is helpful to keep up the hope that the labs we fund are advancing the war on cancer to some ultimate victory and it is unhappy to report that the march is not really going as expected after all of these decades.
We are just past the first decade into the third century of what can be called modern science. We have made significant strides against many human infectious diseases. However, we have lost ground as these infectious microbes have developed their own resistance to antimicrobial drugs, leading to medicine losing ground in combating these diseases. In a future column, I will be discussing the dangers of MRSA and what we face tomorrow in a potential viral storm.
Cancer, however, is a chronic, noninfectious disease that has plagued mankind. One aspect of chronic diseases is their relationship to individual lifestyles. With public health education and a realized commitment on the part of the public, many devastating chronic diseases can either be prevented or effectively managed. Who in today’s modern society is not aware of the adverse health impacts of smoking, sedentary lifestyles, excessive drinking, unprotected sex, driving while intoxicated and of course, poor diet. All of these issues cause life threatening and life span shortening diseases and suffering. Cancer is one of those diseases related to lifestyle especially habits such as smoking and excessive drinking. I guess we have to ask how much cancer is our own fault, how much of the incidence resides in our genes or how much is just bad luck. The bottom line is that we do have some control over our health behavior choices.
I would propose here that we have a mechanistic rather than a holistic belief in the curative powers of medicine. In other words, we can live the lifestyle of bad choices rather than one of prevention since we depend on the machinery of medicine to cure us. It is expected that the modern medical center and the applied medical/surgical skills of medical practitioners can cure us of what our bad behaviors have wrought upon our bodies. Unfortunately, the return on investment on the billions of dollars of capital investment medicine has made in technology (and research) is appalling low in terms of lives saved. This is not meant to imply that medical technology has not had any positive impact at all. It is only to state that medical technology has not completely overcome the poor health choices we make while expecting medical technology to save us.
So, what about the “cure” for cancer? It is often difficult to understand that the best cure for cancer is prevention. Once cancer is marching through the body, it is a life-long battle ending most often not with a cure, but with death; either by the cancer itself or by the toxic treatment for the cancer or by something else opportunistically attacking the cancer weakened body.
It is hard to accept, and just as hard to communicate to cancer victims that many cancers but many are directly or indirectly the fault of the patient. Yes, there are genetic factors leading to cancer and there are toxic environmental causes. In many unknown pathways, poor health choices, genetics and toxic environments all work together to usher in this devastating disease. For patients who have all three of these disease triggers, I would have to say there is bad luck!
My concern for the readers of this column is what can we do ourselves to prevent cancer? People make poor choices because they assume that if and when “The Emperor of all Maladies” strikes that modern medicine with its expensive technology will save them. Unfortunately, this is all too often not the case.
Why do we choose not to live better in order to live longer and happier disease free? I would propose that we have a mechanistic rather than holistic belief in the curative power of medicine. We are betting our lives on it. Certainly, the hospital, with all of its advanced machinery and applied medical and surgical skills of its practitioners can cure us of what our bad behavioral choices have wrought upon our bodies. Most doctors will tell you this is just not true.
Every major medical center in the modern world employs billions of dollars in advanced medical equipment and knowledge with a return on investment that is appalling. There is an old saying that “an ounce of prevention is worth a pound of cure.” It is tragic to report that millions of people annually die from illnesses and injuries that could have been prevented. Well, how do we define cure—the total eradication of the disease with no recurrence—ever? This absolute level of cure is not possible now or in the scope of our current lifetimes. If an oncologist states a cure is possible, you must pin him down to his definition of what a cure is and then determine if that definition is sufficient to give you comfort and hope. Also, what are the conservative odds that achieving the cure is possible? For instance, in men with prostate cancer, the survival tables illustrate that fully 55 percent of all men diagnosed will be dead in 15 years regardless of which treatment option is selected. If I could do something that could prevent prostate cancer, I would rather do that than risk the odds that I could be possibly cured.
People though play the odds. If you are a smoker, you play the odds that you will or will not get one of the smoking related cancers. And if you get one of the cancers, you play the odds that the treatment is successful. If it is successful, you play the odds that the cancer won’t come back. That is a lot of gambling!
I will be writing more in later columns on research funding, especially funding for many of our catastrophic diseases that seem to elude a successful cure, and how that money is awarded and managed. However, for the time being, it is important to note that universities invest a great deal more in their football programs than they do in their laboratory research programs.