Cancer: The War We Really Need to Fight

Warrior 05

Progress has been made in War On Cancer, but we face many challenges

We seem to be waging war on many fronts: drugs, crime, illegal immigration, drunk driving, Afghanistan, Iraq, terrorists in general, terrorism on airplanes in particular. But our most serious war -- the one most likely to affect all of us -- is one we are still losing: The War on Cancer.

We all face many possible dangers in our lives, but the risks vary. Chances are you won't encounter a terrorist, or even be in a bad accident. But cancer will undoubtedly touch your life -- it is the second leading cause of death in the U.S. The American Cancer Society estimates almost 1.5 million cancer cases, contributing to more than 560,000 deaths in 2009.

Actually, our risk of cancer has increased over prior generations, ironically because we live longer. Nearly 1 in 2 men and more than 1 in 3 women will be diagnosed with cancer. Several types of cancer are highly lethal and remain non-responsive to current therapies: pancreas, liver, ovary, lung, brain.

There's been progress, but cancer needs continued improvement in prevention, detection and treatment, according to a commentary in the March 17, 2010 issue of JAMA, a theme issue on cancer. From 1991 and 2006, experts document a 15.8 percent decrease in the age-standardized death rate from all cancers. From 1999 and 2006 there was an almost 1 percent annual decrease in the rate of new cancer diagnoses6.

One of the biggest successes is the reduction in cigarette smoking in the U.S. mainly thanks to education. From 1990 and 2006, nearly 40 percent of the decrease in the cancer death rate of men was from a reduction in lung cancer mortality. There have also been improvements in the early detection and treatment of a number of cancers, and the prognosis is excellent for most cancers when they are diagnosed while still localized.

Cancer is not an easy killer to conquer. There more than 100 different anatomical and histological cancer subtypes, and many of these have multiple molecular variants with different prognosis, clinical features, and susceptibility to treatment. The inherent genetic instability of cancers allows them to change rapidly and generate clones that are resistant to treatment, or even camouflaged from host defenses.

It has become clear that no single silver bullet or therapeutic arsenal will win this war. But even though the challenges are be daunting, the authors write that the tools to fight cancer are more sophisticated and better defined. It is essential to move forward on multiple fronts simultaneously, addressing the entire spectrum from primary prevention to early detection, treatment, and palliation.

The report helps medical professionals understand that the war on cancer has become considerably broader and more complex over time. Although progress has been made, the number of people affected by cancer will increase due to our aging population.

Editor's Note: If we are going to be "at war", shouldn't it be against the health enemies that really kill us?