Taking Sides Assignment #2
Stacy G. Anderson
April 3, 2014
Thursday Night Class At Miller Campus
Professor Ryan Barney
Are We Winning the War on Cancer?
Yes?
John R. Seffrin, President of the American Cancer Society (ACS) boldly states in his opening line,
“Ladies and Gentlemen – we are winning!” and formulates his opinion on the fronts of science, public
health and public policy but is equally as quick to remind us that it is not enough when dealing with the
monster that will “kill more people in the world this year than HIV/AIDS, tuberculosis and malaria
combined.”
He says, “For the first time – we can today state that we are winning the war on cancer and
what is even more, we now know essentially what it will take to finish the job eliminating cancer as a
major health problem – first here in the US and then worldwide.” This opinion is based largely on our
database of increased knowledge which encompasses a better understanding of the disease, better
tools with which to prevent it, finding better cures and early detection practices.
His positive outlook is quickly shrouded, however, as he launches into an impassioned plea for
continued support citing what he sees as four major facts:
1 – Based on evidence, we know what it will take to win the war on cancer.
2 – We can eliminate cancer in this century IF we do the right things.
3 – Failure to intervene will allow cancer to become the leading cause of death in the US - and
probably the world - by 2018.
4 – Thus eradication of the world’s most feared disease is a matter of choice, priority, resources
and resolve.
He also notes that science, public policy nor public health measures can get us to where we
need to be. “We’ve unraveled the mystery of cancer but have not translated it into what we DO.” In his
opinion, the “doing” includes providing equal access to lifesaving cancer advances to all nations, take
immediate action towards tobacco companies who prey upon the uneducated and young, redouble our
efforts, promote prevention into public policy and standard practice nationwide and drive state of the
art cancer care at the community level.
If these measures are taken, he predicts a continuation of the course set upon by the ACS in
1913 whereas “cancer has been transformed and is today potentially the most preventable and most
curable of the major life-threatening diseases facing humankind”.
No?
Physician and Professor of Medicine Reynold Spector, in his discourse titled “The War on
Cancer: A Progress Report for Skeptics” states that the gains made against cancer have been limited at
best and that in all actuality, very little progress has been made in the war on cancer.
He states that most cancer cases and subsequent data have been “cherry picked by researchers
with which there has been some progress but do not discuss the failures”. And although progress has
been made with funding through legislature like the 1971 National Cancer Act and educational
advancements through the Human Genome Project, cancer remains vastly untouched and out of our
reach.
He cites detection bias by pulling resources from reports like the Center for Disease Control and
Prevention’s US National Health and Statistics Mortality Data listing cancer as the second leading cause
of death only behind heart disease and publication bias by showing actual reports from The ACS’s own
death and survival statistics and definitive or probable causes of cancer.
He follows up by pointing out that cures make up a very small percentage of the whole cancer
problem and that these positive outcomes are due mainly to earlier diagnosis, surgical therapies or
other variables like changes in food preservation contributing to the decrease of stomach cancers.
He notes that other cancers like pancreatic cancer are still devastating and as of yet, we still do
not truly understand the causes of most cancers. He furthers his position by saying, “The pharmaceutical
industry cannot make real progress until we understand the mechanisms and molecular causes of
cancer so that industrial, academic and governmental scientists have rational targets for intervention”.
He concludes by stating that if we had a better understanding of cancer, we could make truly “smart”
drugs that would help us finally eradicate this menace.
My Side
Cancer is a subject I am very impassioned about. Fourteen members of my family have dealt
with cancer. Eleven have died age 65 or younger. One was 66. And two have had to deal with the
implications prior to age 40 – myself included.
My maternal grandfather died at age 60 in 1973; barely a year after the National Cancer Act was
enacted in 1971. There were 10 children in his family and 8 of those died before age 65 prior to 1990. All
were breast, esophageal or digestive system cancers. My mother died in 2008, age 63, of stomach
cancer.
My paternal grandfather died in 1981 from a melanoma that was not biopsied after surgery and
quickly spread in the ensuing years. He was 62. My father died in 2004 at age 61 of a nerve sheath
sarcoma that was aggressive and spread to his lungs which caused his ultimate death. My Aunt passed
away this last February, also of a sarcoma that developed in the back of her thigh and despite the best
efforts of her doctors, spread to her lungs causing her demise.
She outlived them all. She was 66.
I myself, prior to Christmas, had a glandular tumor removed that had formed in my neck.
I give this history simply because for me, knowledge is power and as John Seffrin states, “Today,
we know more about cancer than ever before. We understand many of its causes, we know how to
prevent it, and we increasingly know how to cure it, especially in its early stages”.
He is right. As a close by stander watching the processes by many a bedside in many a hospital
room, I have seen the advancements in early detection and the tools that help with this incredibly
important factor, understanding family histories, correlational links and treatments.
The problem lies though in the fact that cancer is an evolving disease because we as humans –
our foods, our environments and our circumstances have evolved and it’s hard to keep up when it’s
impossible to catalogue all possible variables and interactions in our modern day.
Reynold Spector wisely points out, “The pharmaceutical industry cannot make real progress
until we understand the mechanisms and molecular causes of cancer so that industrial, academic and
governmental scientists have rational targets for intervention. We will make no progress if there are five
hundred or more genetic abnormalities in a single cancer cell. Where would we begin?”
Case in point, my maternal grandfather’s family all lived in Delta from 1951-1957. That is also
where my mother grew up. Nuclear testing in the 1950’s in the Nevada desert created particulate
matter that when ingested, years later was found to be a carcinogenic – cancer causing. All the people
living in certain areas at that time were classified as Down-winders. My maternal grandmother’s family
also lived in the same town. There were five brothers and my grandmother who was raising her family in
Delta. All of her brothers lived well into their 80’s and 90’s including my grandmother who was almost
95 and her mother who was almost 97. Of my mother’s siblings, three are still living. One died at birth
and is buried in Delta but the remaining three are nearing their 70’s and 80’s and still in remarkable
good health! My mother was the one who took most after her father’s side of the family in her physical
characteristics.
She must’ve taken after them genetically too.
In this one case study alone, we learned that cancer was caused and accelerated by the nuclear
fallout but it also showed me that there HAS to be a genetic propensity as well otherwise all of my
family on my mother’s side would either be dead or alive.
My father’s case on the other hand, was simply a “freak occurrence” in which no genetic
relationship has been found in his specific type of cancer. My grandfather’s case and eventual death was
due to negligence on the part of the doctor who did not biopsy the surrounding tissue where the
cancerous cells were removed. He had early detection and still it was not enough.
But it could have been.
John Seffrin makes some good points in that we do know many more carcinogens and risky
lifestyles that contribute to cancer growth than we did before. He is also correct in that the war against
tobacco is indeed a valid one since as he points out, “it is the only consumer product to kill more than
half of its regular users being responsible for 4.9 million deaths in 2006 alone”. He is also correct that we
have made great strides in early detection practices and policies but need to make those available to
many more at the community levels. He states, “Our ability to make a difference in the lives of people
touched by cancer increases exponentially when we help pass laws and establish public policies that
secure investments in research and prevention and access to quality health care”.
Dr. Spector also makes very valid points and backs them up with charts, statistical data and
figures showing through information gather through the Department of National Health and Statistics
Centers for Disease Control and Prevention that cancer, even after a concerted effort for decades is still
the second leading cause of death leading him to believe that the optimistic view on who is winning this
war is media induced by publication biases brought on by detection biases.
My theory is the same as my father who was the first in the world to be treated with SR186 in
the treatment of aggressive sarcomas. He said, “I know it won’t help me, but I’m hoping that what they
learn long after I am gone will help the next guy down the road.”
And thankfully, we do know a lot thanks to the many members of my family who have
contributed to cancer research both as guinea pigs and monetarily. Since I began this journey with my
family in 1973, we do know A LOT about early detection practices and despite what Dr. Spector says, this
is the first battle won in this war. We have better tools to help us with that process and even though we
still have a long way to go with the treatment and cure rates, more are living simply because we
understand how to catch it when the naked eye can barely even distinguish that something is amiss. We
know how to avoid certain carcinogens (do we use asbestos or lead paint anymore or perform nuclear
testing where people can be affected?). Some cancers like various forms of breast, cervical and
testicular cancers have been beaten due to these early detection and treatment practices and that’s
saying a lot for those who still have their family members with them.
I agree with Dr. Spector that there is still much to do on this front so we can better understand
the mechanisms and molecular causes of the disease in order to finally conquer cancer by specifically
targeting it with smart drugs and therapies. We need a better grasp on the genetic/environmental
relationship and other factors so we can understand why they make things go so horribly wrong in the
cellular development process. We also need to explore the body’s own defense systems (stem cells and
T-cells) to see if they can be reinforced to combat this modern day killer.
But I also hold onto the hope along with Mr. Seffrin that we are winning this battle and although
there are so many varying factors and variables to contend with, the first step to overcoming an enemy
is knowing who it is and its characteristics like what drives it, its strengths and weaknesses, and why
does it prey on certain victims? And we have done much of that!
As they say, the journey of a thousand miles begins with one small step. We have taken that
step and many more since 1973 and even though our journey may not yet be over, we need to
remember that there is an end and it’s only a matter of time.
I personally hope that it will be in my lifetime and I that I will have the legacy – thanks to those
who have gone before me – of being the first to beat it and live to tell the tales for many a year to
come…