Page 5 - 82013-HL-1-7.indd

August 28-29, 2013 CANCER HEALTHY LIFE 5
By PETER KORN
Pamplin Media Group
Clifton Leaf has come around to a he-
retical belief — that the discovery of
Gleevec as a leukemia cure has been
among the best and worst develop-
ments in the war on cancer.
Before Gleevec, the war, officially declared
in 1971 when President Richard Nixon and
Congress pushed through the National Can-
cer Act, had been more like a series of skir-
mishes. Over the past 40 years, by the ac-
counts of most cancer experts, if there has
been a war, humans have been mostly on the
losing side, despite an estimated $100 billion
spent to fight cancer in that period.
There are no sure bets in the world of can-
cer, not even with data.
About 1.7 million Americans now are diag-
nosed with cancer each year.
The increase in cancer cases is about
three times greater than the increase in the
U.S. population in recent decades. Much of
that increase is due to advances in detection
that allow physicians to spot cancers earlier.
But some of it is due to advances in treat-
ment of other diseases. People aren’t dying
as much from infections, heart disease and
the like, so they are more likely to eventually
get cancer.
The age-adjusted death rate from people
who get cancer has dropped about 13 percent
in the last 40 years, but some researchers ar-
gue that the crude rate — the percentage of
people who die from cancer — is a more ap-
propriate marker. The crude rate for cancer
actually has risen.
Even the most optimistic cancer research-
ers will admit that progress over the past 40
years has been disappointingly slow.
Dr. Walter Urba, director of cancer re-
search for the Providence Cancer Center,
graduated from medical school in 1981, and
he recalls thinking huge advances in the
fight against cancer were just a few years
away.
“We all had very high hopes,” Urba says.
“The naiveté of the brand-new cancer doctor
was a failure for all of us to understand how
complex the underlying processes are that
result in a cell becoming malignant.
We did not have the scientific underpin-
nings.”
Today, Urba is struck by how little doctors
knew about cancer back then. “Often in
those days
people talked about a cure for cancer like
it was one disease. Cancer is hundreds of
diseases,” he says.
But Gleevec, discovered by Oregon Health
& Science University oncologist Dr. Brian
Druker, gave doctors, patients and research-
ers new hope. It represented the first suc-
cessful targeted cancer therapy — a drug
that could intercept a mutated protein re-
sponsible for blood cells continually replicat-
ing themselves, and stop a cancer in its
tracks.
And it left the body’s healthy cells undis-
turbed. Finally, scientists had a weapon that
might turn the war’s tide, a new way of at-
tacking cancer. The drug was even featured
on the cover of Time magazine in 2001.
Gleevec has been saving the lives of thou-
sands of sufferers of chronic myeloid leuke-
mia (CML) for more than a decade. A few
other targeted therapies have had success,
but mostly in the years since Druker’s dis-
covery, researchers have learned that almost
all other cancers are more complex than
CML and can’t be so easily tar-
geted.
That’s why Leaf, author of
“The Truth in Small Doses:
Why We’re Losing the War on
Cancer — and How to Win It,”
is among those who believe
that the research emphasis on
targeted therapies has led to
false hopes and neglect of oth-
er important approaches to
fighting cancer.
Leaf would like to see researchers spend
more time looking at ways to prevent cancer.
He favors research to uncover biomarkers
that can identify aberrant cells before they
have turned into complex cancers. Then, he
says, new therapies could be used to keep
those cells from becoming cancerous.
There have been a few advances in cancer
prevention. Cervical cancer mortality has
fallen as surgeons have learned to remove
pre-malignant lesions. The human papillo-
mavirus vaccine for teens and young adults
can prevent cancer of the cervix and throat.
Some statins — taken to lower cholesterol
levels — have been associated
with lower cancer rates.
In fact, Leaf thinks researchers
shouldn’t be looking for the next
Gleevec. In his view they should
be looking for a cancer treatment
version of statins — drugs that
can prevent heart disease. But
curing those already stricken
with cancer, he says, is a much
more attractive research quest
than trying to prevent disease in
large numbers that might never be measur-
able. Nobody can quantify, for instance, how
many fewer heart attacks take place each
year because people take statins, or a daily
dose of aspirin. So cancer prevention, Leaf
says, gets relatively little federal funding.
40years of cancer research
The War on Cancer:
slow Progress
U.S. age-adjusted death rates 1970-2010
(per 100,000 population)
1970 2010 change
heart disease 493 179 64% drop
Stroke 148 39 74% drop
cancer 199 173 13% drop
Source: National Center for Health Statistics
Gleevec, discovered in Portland, represented the
first successful targeted cancer therapy.
“We have to
view cancer as
a continuous
struggle.”
— Jashi Alumkal,
OHSU oncologist
CONTINUED / Page 6
■ Despite Gleevec and other innovations, progress in the war on cancer has been slow
DREAmSTImE PHOTO
A magnified cancer cell. Even the most optimistic cancer researcher will admit that progress over
the last 40 years has been disappointingly slow.