The Galaxy of Diseases We Call Cancer

Written by Skip Miller

President Richard Nixon never declared “war on cancer.” The country already was fighting one war and it was named Vietnam. It did not need another, no matter how lofty the objective. Nixon, ever the craft politician, knew that. The country did, however, need a righteous cause to champion. Something that would rise above the harsh rhetoric of culture bashing and a looming recession.

That was the backdrop of Jan. 22, 1971, when Nixon delivered his State of the Union message. Part of what he said was this:

“I will also ask for an appropriation of an extra $100 million to launch an intensive campaign to find a cure for cancer, and I will ask later for whatever additional funds can effectively be used. The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease. Let us make a total national commitment to achieve this goal.” 

It would be 11 months before Congress passed and Nixon signed the National Cancer Act. The $100 million was shipped to the National Cancer Institute, sending the United States of America on its way to Nixon’s trumpeted goal of becoming the healthiest nation on the planet.

One of the most important elements of the NCA called for establishing regional cancer centers where research, clinical trials and treatments could be conducted. There would be two such centers in Virginia. Virginia Commonwealth University’s Massey Cancer Center received its designation in 1974. The University of Virginia center was added in 1987.

There are now 66 centers not only linked in the crusade against cancer, but sharing information and research data that no one center could ever hope to generate. Centers where faith joins hands with 21st century science and one man’s cure is another man’s dream.

May we bow our heads for a moment of silence on this 40th anniversary of the ballyhooed cancer campaign. May we acknowledge the billions of dollars spent fighting a malady neither Nixon nor his scientific advisers understood, one that now infiltrates one out of every two men and one out of every three women.

War? Some 58,000 American soldiers died in Vietnam. Just last year, in 2010, 569,490 Americans died from cancer, according to the American Cancer Society. More than 570,000 will die this year, including more than 14,000 Virginians.

By the year 2025, more than 20 million new cases of cancer will be diagnosed. Seniors will be the hardest hit as the diseases continue to morph from occupational hazards to old age consequences. No, Nixon did not declare war. He mobilized the medical community to take on a growing health crisis of bubonic plague proportions.

World Health Organization states more than 30 percent of 7.6 million worldwide cancer deaths—some 2.3 million—could have been avoided. How? Proper diet and exercise and a smoke-free lifestyle.

Almost immediately we learned that the cancer Nixon wanted to attack never existed. There would be no vaccination or magic pill because cancer is a class of more than 100 diseases sent to battle by a myriad of causes and substances. Not only can cancers invade any part of the body, individual treatments are as different as finger prints.

“Can we find a cure for cancer?” echoed Aleea Farrakh Khan of the National Cancer Institute’s media relations department. “That question is impossible to answer. Cancer is not a single disease. Therefore, there is no single cure.”

Dr. Gordon Ginder, director of VCU’s Massey Cancer Center, says preventing cancer is a more reasonable goal than curing it.

Since 1971 medical research has recognized and categorized dozens of cancer diseases, he says. “We started by dividing cancers into categories of where the disease originated. The categories were parts of the body such as the lungs, liver, breast.”

Lo, though I walk through the Valley of the Shadow of Death I will fear no evil …

In 1974 the five-year survival rate for childhood cancers was 62 percent, according to the National Cancer Institute. A quarter of a century later the survival rate stood at 81 percent. Today, 95 percent of testicular cancer is cured. The reverse was true in 1977, when 95 percent of the patients died within a year of the diagnosis.

Still, progress is viewed as baby steps by a public that demands quantum leaps. The public has been told cancer will be cured. Watching a half million people die is not a cure. Reading the books and the interviews and watching the documentaries of the rich and famous are not cures. We didn’t sign on for that pathos. We want cures.

“The fact is we don’t have the ability to cure all cancers,” Ginder said. “What we can do is control cancer. We can change what have been lethal diseases into manageable diseases.”

Reaching that understanding has been an ongoing process that has been helped along by technology. In 1971 scientists looked at a tumor. Today’s scientists look at molecules and proteins and cell makeup that was only theory 40 years ago. Like astronomers staring at the Milky Way, the more they look the more they see.

Cancer, mostly, is the cost of being civilized. While making our lives easier and more comfortable, industry and science produces a group of by-products named carcinogens. We refine gasoline and that produces benzene. We build nuclear reactors to make electricity and that turns loose a host of things that make us sick. We breathe in the exhaust and fumes emitted by anything with a combustible engine and that gives us cancer. Not happy with that, we kill ourselves with tobacco and alcohol.

In short, we have soiled our environment and it is killing us. Not killing as in the guns of a jungle ambush. Killing as in an infiltration that could take two or three decades to blossom into a terminal disease.

The lag between the exposure and the disease can be three or four decades or more. The Vietnam veteran who was exposed to the Agent Orange defoliant 40 years ago only now may become the terminally ill cancer patient.

For centuries medicine has understood the health risks of occupations such as mining, ore smelting, oil refining, and blending chemicals. We have compiled a list of carcinogens—cancer-causing substances—but we move ever-so-slowly in banning those substances from our environment. Cigarette smoking is a major cause of lung cancer deaths, yet cigarette smoking is legal. Every day we navigate a minefield of enough chemicals and gunk to nauseate the grim reaper.

What we have not done, Ginder says, is figure out exactly what causes the trouble. What is it that makes one cell behave so badly? What creates a rogue cell that literally divides and conquers?

“The hard part is identifying the bad actors,” he says. What is the pathway that gives the bad actors access to healthy cells? “That’s an interesting problem that needs more research,” Ginder says.

A February 2011 fact sheet compiled by the World Health Organization (who.int/mediacentre/factsheets) states more than 30 percent of 7.6 million worldwide cancer deaths—some 2.3 million—could have been avoided. How? Proper diet and exercise and a smoke-free lifestyle.

“Those are the big factors,” Ginder says. “We should eat more fresh fruits and vegetables and less canned goods and processed meats.”

Somehow, that simple message gets lost in translation. A quarter of all Americans believe very little can be done to reduce the risk of cancer, according to a position paper released by Cornell University in early September. One of the authors, Jeff Niederdeppe, proposed training local journalists in ways to improve reporting about cancer causes.

And then there is that demon in the background, the one named money.

More than $50 billion in cancer medicines will lose patents in the next three years. They will go from valuable exclusive rights of specific companies to generic stuff that can be produced by anybody. They will go from soaring profit makers to busy work. With no profitable reason to continue to produce the drugs, companies are turning to the hunt for the next blockbuster.

The result is a growing shortage of some drugs that “are still very effective,” Ginder says. “Some are in short supply now. We’re making sure supplies go to the people who need them the most.”

Ginder calls the situation “unintended consequences” and says it is easily fixed. “It requires all sides come together and work it out.”

Big business also is being accused of shunning other cancer treatments that do not involve expensive drugs.

A clinical trial funded by the Alliance of Cancer Gene Therapy involved removing T cells from a patient, genetically altering them to recognize and attack cancer cells, and then returning them to the body. This procedure was done on three patients suffering from chronic lymphocytic leukemia. After 10 months, two of the patients had no sign of malignant cells. The other’s tumor had shrunk 75 percent

And that’s where it stalled. More clinical work is needed. Dr. Carl June of the Alliance says both the drug companies and the National Institutes of Health have refused to finance the trials. So the great promise of this cancer weapon has gone untapped.

Charlatans past are the reason for the wary approach, Ginder says.
Searching for a cure or a relief from cancer can reach a hysterical intensity as patients and family members reach out for anything that smells of hope. Mega doses of vitamin D will work. Drink more tea, eat more tomatoes, go to Mexico.

“There are those who would take advantage of that desperation,” Ginder says.

That kind of desperation was wholesale in 1971 when the National Cancer Act formed panels and advisory boards, built the National Institute of Health facility, created the cancer centers and created a by-pass budget—it does not have to be approved by Congress—that is now more than $5 billion per year.

When Ginder stops and looks back, he sees the achievements and the progress. He does not do that often, however. He is too focused on the next step to marvel at where he or cancer research has been.