The War Against Cancer

Twenty-five years ago, former president Richard Nixon declared war on cancer by signing the National Cancer Act. Amidst the publicity for the anniversary of the Act last week, there appeared articles in Time, Scientific American and other journals all proclaiming setbacks as well as significant strides forward, most notably the decline in the overall cancer death rate. However, in an otherwise benign piece from November 25 ("Cancer: The Good News"), Time reported that "the bad news is that all those billions spent on research in basic science may have had little to do with [the decline in cancer deaths]. Doctors have still not found a magic bullet against cancer, and it is becoming increasingly clear that they probably never will."

Although it is true that the majority of the decline in cancer deaths is due to prevention, it is unduly pessimistic to assume that doctors will probably never find a cure for cancer. It is even misleading to say that because we haven't found the magic bullet, we have not achieved anything in fighting the disease. Medicine does not involve only two options: cure or no cure. Instead, alleviation of symptoms, improved quality and extension of life aids sufferers when no cure exists. However, an even more disturbing implication of the article is that because basic research has not turned up the cure in these twenty five years, research has been of little value. Although basic research does not carry the glamour of a cure to a disease, that research always provides the backbone of any significant discovery or invention.

Basic research often takes time to show up in practical uses. The transistor was invented in 1947 by scientists studying solid-state circuits but was only put into radios in the 1960s. Now, life without the transistor is unimaginable. Nuclear magnetic resonance (NMR) was discovered in the 1940s but was not used as a medical imaging device until the 1970s (now called magnetic resonance imaging). Now MRI provides a significant diagnosing device for doctors. Numerous applications can spring from single basic research discoveries, but those applications are not obvious before the research. Applied research usually takes basic research and puts it to use, and therefore seems much more worthwhile to fund.

Outside of scientific circles, basic research is oftentimes unheard of and considered "curiosity-driven activities,"as Sen. Barbara Mikulski (D-Md.) put it. That phrase evokes images of mad scientists pouring together chemicals and creating technological break-throughs such as flubber (flying rubber), as in the 1961 movie "The Absent-Minded Professor." What the phrase ignores is that basic research provides much of the knowledge for cures today. In the very same section of Time that depreciates basic research, the Telomere theory is described, a new theory of aging. This theory suggests that aging is a result of the progressive shortening of DNA within the body's cells. Now this theory could hardly be possible without the discovery of DNA itself, a result of basic research. When Francis and Crick searched for DNA, they had no idea of the possibilities ahead. However, without their discovery, bacteriophages and insertion of human genes into bacteria would not be possible or even thinkable. This process now produces human insulin within bacteria, thus allowing diabetics to avoid the side-effects of animal insulin and providing a cheaper source of the drug.

This Time article ignores the significant steps taken in understanding the mechanisms of cancer so that we may look for a cure. A cure for cancer is not as simple as a cure for throat infection, because cancer comprises over 100 diseases throughout the entire body.

However, basic research has brought clearer understanding of the common mechanisms of cancer. Now two categories of genes that contribute to cancer when mutated have been identified; and genes have already been found which can lead to a quicker diagnosis of altered tissue and pre-cancerous lesions. Ignoring these discoveries in the article violates the understanding of the public who may be unaware that the fundamental mechanisms of cancer are understood much better than they ever were before. It conveys the impression that the $35 billion spent over the past 25 years has come to naught.

The media has a responsibility to paint a true picture of the importance of basic research, especially cancer research. Medicine can eliminate few diseases completely with a magic bullet as it did polio (which the World Health Organization believes has been eliminated through vaccines.) But it can significantly improve the prognosis for patients, as it does for diabetics who can lead a near-normal lifestyle without a cure. In this war against cancer, we do not have to decimate the enemy to win. Each small achievement is a victory.

Tanya Dutta's column normally appears on alternate Tuesdays.