What's wrong with cancer medicine?

In recent decades there has been a plethora of clinical advances--in heart medicine, in stroke, in diabetes and other endocrine diseases, in respiratory illnesses, in infectious disease, in orthopedics--but very little progress in the treatment of cancer. One only has to look around--at his neighbor, at his family member, at his workplace acquaintance, at his friend or loved one afflicted with such major cancers as lung, brain, gastrointestinal, even breast cancer--to know that those major killers have hardly been indented by modern medicine.

To be sure there have been scientific and clinical advances--duly reported by the medical media--made in the field of cancer research, but most of these advances have not resulted in any "transitional" gains that have really advanced clinical cancer treatment.

Yet the public has been made to think we are making great strides in the treatment of cancer. Night after night, week after week, our electronic media announce new scientific discoveries that "promise" to advance cancer treatment. And every so often we are reminded of the large "victories" being made in cancer survival. But one of these victories in overall survival is in "skin" cancer. What we are not told is that included in this category of cancers are "basal cell tumors," comprising by far the great majority of this group of cancers. The survival rate of basal cell cancers is almost 100%, no matter what medical action--if any--is taken. If one subtracts basal cell tumors from overall cancer survival, the overall survival rate dramatically decreases.

Several months ago it was announced that a major advance had been made in breast cancer, decreasing the incidence of this disease in postmenopausal women. But it turned out that this decrease was not due to any new advance but to tens of thousands of women giving up their monthly hormonal replacement therapy (HRT) which was being shown--contrary to their physicians' prior belief--to actually cause breast cancer. Thus this scientific "advance" was not a treatment advance at all but merely a deletion from therapy of a medication causing breast cancer.

Closely related to advances in the treatment of breast cancer are mammograms. Women, especially over 40, are recommended to have yearly mammograms. Mammograms are radiation and this form of radiation is well known for its life-saving benefits, in the form of early diagnosis. What is not so well known--and is at the heart of the continuing heated debate in the medical profession as to whether especially younger women should receive mammograms--is that radiation can also cause breast cancer. Even in the low doses in mammograms. Thus, while mammography's usefulness in the field of early diagnosis is not in dispute, it has been estimated by some epidemiologists and cancer statisticians that a single mammogram actually increases the cumulative likelihood of breast cancer in a woman by 0.3%.

Regional and national cancer fund-raising events--"walkathons," "marathons," "bike-athons," "races," "relays"--and the publicity given them also act to give the impression that the cure to cancer can be imminent. These events attract thousands of participants who contribute funds to the sponsoring organizations, believing sincerely that their efforts may help to bring about the "cure." But the tired truth is that the funds these events raise--reinforcing and strengthening the sponsoring organizations--frequently find themselves in the hands of the same old scientists and researchers, who sit on the same old federal and large private-sector granting (peer-review) committees of our cancer agencies, frequently for the same old projects or variations thereof.

In contrast to the rosy picture painted by our periodic promising communiques in the medical literature and medical media, qualified cancer experts have in fact affirmed that overall cancer survival has not significantly changed in the last 30 years.

What accounts for this woeful lack of progress?

There are two major causes of this tragic situation. One is money, the other is the way cancer funds are distributed. These will be discussed in detail in our next blog.