Kennedy and the War on Cancer

by Bradley Miller on September 1, 2009

With the passing of Senator Kennedy last week, cancer has made its way back in to the news – particularly the “War on Cancer” begun almost 40 years ago by President Nixon (and Kennedy, btw).  Kennedy’s struggle with glioblastoma, a particularly tough brain cancer, was highlighted in the NYTimes last week.  From diagnoses to death, it was a little over a year for Kennedy, which led some to question the effectiveness of the War on Cancer and some stats even show that death rates for cancer have barely budged, despite billions upon billions invested.

But, I’d like to suggest that we have actually benefitted tremendously from this research and investments – in some cancers survival is up and life is often prolonged.  This is mostly due to improvements in radiation oncology and chemotherapeutics and there is a large pipeline of drugs in the works.  However, I’d like to suggest that the most important advance is that all of the invested research dollars have helped us to “know that which we don’t know.”

What do I mean by this?  Cancer and molecular biology have turned out to be much bigger and complex areas than we thought back in 1971.  We now have the advantage of knowing about tumor suppressor genes, apoptosis issues, and oncogenes.  And, as noted by Susan Love in this NYTimes piece, we have now begun to think about cancers in a much more helpful way – even if two cancer cases have the same specific diagnosis (say, breast cancer), at a genetic level  those two cancers could be completely different.  This has massive implications for treatment and other options.  For example, if we knew the exact set of genetic mutations that led to a person’s cancer we’d be able to more accurately target therapies that are specific to their cancer.  Ideally, this would lead to better outcomes and many lives saved – at present the community is calling this personalized medicine.

Companies like Genomic Health are now developing tests to examine the genotypes of individual cancers and help highlight optimum therapies.  This technology is still very, very novel and not well tested – there are many miles to go until they become standard of therapy.  But until then, these new paradigms of thinking about cancer and oncology are direct decendants of the War on Cancer.  To some this effort may seem like a failure or waste of research dollars, but it has yielded invaluable insights, showed us just how large the battle really is and has illuminated the path we’re going to have to take.

Knowing what we don’t know is the victory.

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