Are We Too Optimistic About Progress in Cancer?
A giddy smile has taken hold of the faces of many oncologists and cancer patients. They have good reason to grin, for three reasons:
- We could be on the way toward doing away with the cancer biopsy. Researchers reported that a “liquid biopsy” blood test that’s possible due to advanced genome sequencing can find tiny pieces of cancer DNA in a patient’s blood. If the approach proves successful, oncologists could quickly determine whether a treatment is working or if the patient’s medicine should change for a variety of cancers, including lung, colon and blood.
- A Silicon Valley startup has its sights set on disrupting the genetic screening market for breast and ovarian cancers by offering a much less expensive genetic test.
- Two huge clinical laboratories, Quest Diagnostics and LabCorp, are working with French scientists on an effort called BRCA Share, which pools data to increase knowledge of BRCA1 and BRCA2. These are two genes that can determine the likelihood of contracting breast cancer.
Great news, right? Looking only at these announcements, the answer is an unqualified yes. Despite the safety issues, unknowns about whether the procedures and tests will work, and the challenges of who and how to pay for these advances, the research pushes us closer to the peak of extending the lives of patients suffering from horrible diseases.
Outside this research, however, and in my view, this week has handed us a dose of reality.
The American Cancer Society, using data collected by the CDC, found a murky picture of cancer progress, especially when it comes reducing some of the most common risk factors, including smoking, diet, not exercising, obesity and proper screening. About 1.6 million Americans will receive a cancer diagnosis this year (this excludes the more than 14 million Americans believed to be living with cancer) and 170,000 are expected to die from lung cancer. Smoking, clearly the biggest risk factor for lung cancer, has decreased substantially from 23.5 percent to 17.8 percent today, but that figure means millions of adults are still at risk, particularly those in lower socioeconomic classes.
The good news, of course, is that for diseases like lung and breast cancers, we’ve made great progress. Still, some important questions remain:
- What role can (or should) pharmaceutical and biotechnology companies play in helping reduce the risk factors that lead to the cancers they treat?
- How will we reward the companies developing innovative therapies that have the potential to transform the diagnosis and treatment of cancer?
- Can we find the right public and private partnerships to create a meaningful reduction in risk factors like smoking, obesity and lack of exercise?
So, are we too optimistic about our progress in cancer? I don’t believe we are, but we have to remember that advances in treatment mean nothing if we can’t prevent more cancers from occurring in the first place. Only then will we reach the cancer mountaintop – eliminating cancer from our vocabulary.