Let's Stop the Cancer Epidemic

With limited resources devoted to cancer survivorship, we have to ask ourselves, "What is the best way to spend the money?" Should we devote limited resources to improving methods of treatment or prevention?

A recent article entitled Let's Stop the Cancer Epidemic  makes a strong point. The author, Dr. David Servan-Schreiber, a psychiatrist and professor of psychiatry at the University of Pittsburgh, writes:

"During the 1800s, Europe and the United States experienced several great cholera epidemics. They were everywhere and in each case able to be stopped without the support of antibiotics. At the time, the concept of infectious microorganisms had not even been discovered. But our leaders were far-seeing and strong-willed enough to act on what seemed the most probable environmental cause: contaminated water sources. And they effectively succeeded in arresting the cholera. Paradoxically, had antibiotics existed at the time - and if the people in charge at that time had relied on antibiotics to confront the epidemic as we today count on anti-cancer treatments - they undoubtedly would never have succeeded in stamping out cholera." (my bold highlights)

The author is a two-time cancer survivor, so he has a personal stake in finding better treatments. 

It's a tough question. What do you think: prevention or treatment?

Comments

[Felicity Lenes]

I think we need both -- and that because of the etiology of cancer and less well-understood and traceable causes, that an infectious disease such as cholera lends itself more to prevention than does cancer. (Although I'll grant that before the germ theory of disease, scientists were taking just as much of a shot in the dark as they are now about the causes of some cancers.) Look at China, though, where I worked this past summer -- it's 2008, and at one school where I installed a water filtration system, it was more common for the children to have dysentery and cholera than not. Every 15 seconds, someone still dies from an entirely preventable water-borne illness. It's not necessarily the state of research in the world that leads to results: it is people taking leadership roles and making changes based on the resluts of good research.

In that sense, I think that an underutilized resource is people like you, who push others to think about these issues and DO something about them, and mentor so many aspiring doctors!

Of course, I do think proactive measures like a healthy lifestyle and good attention to primary care are critical -- for anyone, and any disease.

[Jeanne M Hannah]

I agree with Felicity that we need research into both prevention and treatment. One disease that is epidemic today is HPV (Human papillomavirus), for example. Certain strains of this STD cause virtually all cervical cancer. 1 in 4 women has HPV, and of course it spreads exponentially.

Yes, we now have some great treatments for cervical cancer. We also have, because of research, one new vaccine from Merck and another on the way from Glaxso Klein Smith. [We've also got a substantial amount of controversy about how safe the vaccine is, whether it should be mandatory or not, and whether abstinence education would work instead.]

After reading one of Wendy's posts last week, I added to my growing list of posts about HPV prevention. As a family lawyer, I write not only about issues critical to helping parents cope with custody and parenting time issues in their divorces and afterwards, but also about the problems they and their children might encounter post-divorce -- problems that might be prevented.

HPV related articles can be found here with links out to news and research items: http://jeannehannah.typepad.com/blog_jeanne_hannah_traver/2008/12/hpv-changing-teenagers-futures-in-a-heartbeat.html

[Wendy S. Harpham, MD]

Dear Felicity,
Thanks for your interesting comment. My post was asking if limited research dollars should be spent on (1) finding better ways to prevent cancer or (2) finding better ways to treat cancer. Now you've introduced a third issue: (3) taking a leadership role in matters of public health.

All the evidence suggests that most cancers are related to factors affected by lifestyle (such as smoking, alcohol and obesity). So if we spent some of those limited dollars on getting people to eat well, maintain ideal weight, and stop smoking, we'd see a dramatic drop in the incidence of cancer, even if researchers didn't know the underlying biomolecular mechanisms. That is true.

Your answer also suggests that you'd vote for the government to divvy up the research dollars, so some goes to researching causes, some goes to researching treatment, and the rest goes to underwriting public health measures, such as getting people to quit smoking and getting rid of pesticides in food and water.

With hope, Wendy

[Pat O'Connell]

I am inclined to blame money (and greed) for the dearth of research into disease prevention: there is no money in wellness--at least not the buy-myself-a-Learjet kind of spending cash.

Disease prevention pays off only in long-term savings, primarily to the government and individuals. It doesn't pay off for the drug companies at all.

So I think we need to concentrate public funding primarily, if not exclusively, on wellness and prevention research.

Greed will continue driving the private sector to brew up its expensive disease treatments, just as it always has.