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LIFELONG HEALTH- Tome on Cancer Shows the Vast Progress Made PDF Print E-mail
Written by Dr. David Lipschitz Creative Syndicate   
Thursday, 28 June 2012 02:09

"The Emperor of All Maladies: A Biography of Cancer" is a medical masterpiece written by oncologist Siddhartha Mukherjee, a researcher and clinician who describes in Pulitzer Prize-winning detail the history of cancer from its earliest recognition thousands of years ago to the present.

There was a widespread belief in the second half of the 20th century that cures for all cancers were a possibility. This occurred thanks to the remarkable ingenuity and bravery of basic scientists and clinicians. The advent of anesthesia made radical surgery to totally remove cancer from the body possible. The discoveries that poisonous compounds were able to kill cancer cells made medical treatment a reality. And while irradiation and excessive X-rays led to death and suffering, appropriate harnessing of this powerful tool created yet another approach to directly target and kill cancer cells. Early efforts at treating leukemia in children and Hodgkin's disease led to the disappearance of the cancer and eventual cures for some patients. Spurred by these early successes, savvy and astute scientists, entrepreneurs and philanthropists formed the American Cancer Society.

The organization used marketing and lobbying skills to increase public awareness of cancer, creating hope that a cure for all cancers was possible and persuading Congress to declare a war on this disease by investing huge sums of money focused on eradicating cancer once and for all.

This frontal attack led to great advances in our understanding of cancer and medical treatments. However, this knowledge has come at a price. Many patients suffered greatly when exposed to surgical and medical treatments that were truly brutal and often futile.

For a long time, there was a strong belief that the only way to cure common cancers (lung, colon and breast) was to become even more aggressive therapeutically. More and more drugs were given that led to total destruction of bone marrow, severe infections, bleeding, nausea and numerous other symptoms. Death was prevented by keeping patients in totally sterile environments and by bone marrow transplants that eventually allowed the patient to recover.

During this time, desperate patients demanded ever more aggressive treatment in the hope for a cure. A whole industry developed around this approach to care, and sadly, the effort was fueled by the rare but unscrupulous clinical scientist who reported amazing results that later turned out to be false.

The most egregious was by a South African clinician who falsely reported that aggressive treatment cured most women with widespread breast cancer. For most cancers, this approach failed, but for others (leukemia, lymphoma, multiple myeloma) the benefits are significant.

With time, therapies have become more nuanced and less aggressive. They are aimed at not only finding a cure but also at improving the quality and quantity of life. And insights into patient and family suffering — physically and emotionally — have led to a greater understanding of the importance of palliative and end-oflife care that respects the dignity of every patient as his disease becomes terminal.

Cancer is not one disease. For a number of tumors, greater understanding of the biology of the disease is leading to new breakthroughs and continued hope that a true cure is just around the corner. For others, treatment remains difficult and progress is slow, but researchers are optimistic that new approaches will be found to improve outcomes for patients.

There must be a continued commitment to prevention, such as smoking cessation, improved public health, vaccines to prevent infections that can cause cancer, changes in diet and removal of carcinogenic compounds and pollutants from the environment. And while the exact benefits of early detection are occasionally controversial, the evidence is compelling that screening for the common cancers saves lives.

Recent research indicates that the number of cancers globally will almost double by 2030. Much of the increase is related to the improved economies of many nations, leading to a longer life expectancy and a greater risk of cancer. And the kinds of cancers found in the developing world are becoming more like those found in America, namely lung, colorectal, breast and prostate cancer. Based on what we now know, the best strategy to attack this challenge is to strive for better treatments and improved screening and prevention.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging."

Last Updated on Thursday, 28 June 2012 02:11