November 14, 1995
Web posted at: 4:20 p.m. EST
Senior Medical Correspondent Dan Rutz
WASHINGTON (CNN) -- In 1971, President Richard Nixon declared war on cancer. Almost 25 years later, the war is still being waged. But is modern medicine winning the fight?
Three-year-old Claire Thomas could be at home dancing around her playroom, instead of dancing in her hospital room, if scientific research already had won the war by finding a cure for her leukemia. Claire's mother, Sandi Thomas, says troubling questions about her daughter's disease go unanswered for now. (88K AIFF sound or 88K WAV sound)
On the other hand, if modern medicine wasn't winning the war, however gradually, Claire might not even be here.
"The war on cancer is kind of middle of the road right now," Thomas said. "It's just amazing those that are making it and are living, whereas 10 years ago these children weren't living at all."
Half full or half empty? The cup of progress against cancer is in the eyes of the beholder.
Where dramatic gains have been made, especially against childhood leukemia, there is genuine relief and a certain pride.
"We're talking about cure rates now in some kinds of childhood leukemia that are in excess of two-thirds, around 70 percent. That really is progress," said Dr. Andrew Yeager of Atlanta's Egleston Children's Hospital. "That's compared to maybe 35 percent 25 years ago and compared to zero, 40 to 45 years ago. So this is really progress."
But most cancers strike adults, usually without notice. Often as not, the best minds in medicine are unsure why one in three Americans is destined to get cancer, or whom among us it will strike next.
Around the 15th anniversary of President Nixon's war on cancer, Dr. John Bailar of the University of Chicago published a negative assessment of the battle in an article titled "Progress against Cancer?" (152K AIFF sound or 152K WAV sound) Not much has happened in the nine years since to change his mind. "There hasn't been very much progress in terms of how cancer affects people," he said. "The death rate has gone up. The incidence rate -- that is, the risk of getting cancer -- has gone up. The survival rate of patients who get cancer has probably improved a little bit, but not very much."
Bailar thinks modern medicine needs to change its strategy "to put most of our efforts into a search for ways to prevent cancer so that treatment is never necessary."
Others disagree. "We still have to ask patients and the country to be somewhat patient," said Dr. Harmon Eyre, the chief medical officer for the American Cancer Society "But we are making steady advances."
Eyre blames the lack of breakthroughs on the sheer complexity of the problem.
The basic strategies for treating cancer, which include surgery, radiation, and chemotherapy, are the same now as they were 25 years ago. But there have been improvements in each area. Surgery is less disfiguring, radiation more precise, and the drugs more potent.
"The mortality rate or death rate from cancer, which is the one that is most likely used, and the one Dr. Bailar used, is beginning to decline," Eyre said. "Death rates from cancer in the United States in 1992 were lower than in '91 and '90. This represents a watershed trend change in America. It's the first time we've been able to see a decline in death rate."
Eyre also promises better things to come. Scientists are finally at the verge of learning how normal cells turn into cancer, and he says the discovery of genes that promote cancer growth opens new windows of opportunity. "All cancer is caused by a combination of our genetic inheritance and our environmental exposure, damaging genetic material," said Eyre. "When we learn the interaction between those two and learn how to determine what a person's genetic risk is, then we will be able to individualize interventions to prevent cancer, to detect cancer, and to treat it."
But the billions of dollars already invested in the war haven't been enough. Even though Congress is in a cost-cutting mood, at least one member calls for new spending and new policies in the war against cancer.
"I think that both with regard to AIDS and cancer and any other life-threatening disease, we ought to make available to people as quickly as possible drugs and other therapies that may extend their lives and not wait until we know with certainty that something is going to be effective," said Rep. Henry Waxman, D-California.
For Lorna Pais, that "something" was a stem cell transplant for an especially aggressive form of breast cancer. Her insurance company called it experimental and wouldn't pay. So Pais borrowed against her house for a chance at a $50,000 cure.
"If it takes going to court, if it takes selling everything I own, I'll do it for a good chance," Pais said. "I think this is a good chance for me."
Many people with cancer share Pais' view that progress delayed is progress denied. They're calling on lawmakers to insist that promising treatments get to the bedside sooner. Pais said she doesn't have the time to wait for the medical establishment to officially approve her experimental treatment. (144K AIFF sound or 144K WAV sound)
For those waging the war on cancer today, tomorrow's breakthroughs don't matter. Their urgency flows from our common instinct and desire for an abundant life.
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