The war on cancer: failure of therapy and research

Abstract

A generally-held beliefby both the medical profession and the lay public is that therapeutic medicine greatly affects health. Providing more hospital beds, doctors and resources is viewed as the path to improve health. Therapeutic medicine is of much benefit to sick people. However, with the exception of several highly contagious infections, it has not reduced the incidence of disease. This generalization applies particularly to cancer. Despite this fact most ofthe expense and effort devoted to the management of cancer is directed towards early diagnosis (screening) and improved therapy. Evidence has steadily accrued that this strategy is essentially a failure: little impact has been made on the toll taken by the major cancers. The failure of therapy, coupled with the realization that the overwhelming majority of cancer is related to environmental, particularly lifestyle, factors, dictates that prevention should be our foremost aim. It follows, therefore, that cancer research should concentrate on those environmental factors which may cause or prevent cancer. Instead, most research looks at either the detailed mechanisms of cancer formation or else investigates new types of therapy. Medicine should admit its severe limitations in therapy and redirect itself. Using the fruits of an expanded research programme into such areas as diet and exercise, medicine should strive to apply this knowledge to cancer prevention.