Cancer will kill some 555,000 Americans this year. Among the victims so far: Dan Case, older brother of AOL Time Warner (AOL ) Chairman Steve Case. An investment banker in Silicon Valley, Dan died in June at age 44 of a brain tumor, a year after it was detected. "When Dan was diagnosed, I was very surprised to learn that no one knows what causes brain cancer or how to cure it, despite decades of work," says Steve. Instead of waiting passively for the inevitable, the Cases founded Accelerate Brain Cancer Cure last year, aiming to apply "results-driven strategies" to research. Steve now realizes no one organization, company, or government initiative can stop this scourge. As he told a Senate committee a few weeks before his brother died: "The only way we can find a cure is by working together."
Case's frustration is understandable. The three-decade-old War on Cancer has cost the federal government more than $50 billion for research, and private industry has kicked in billions more. But the body bags keep piling up, and the statistics are even worse than had been assumed: The National Cancer Institute (NCI) discovered in October that incidents of the five most common cancers, thought to have leveled off since 1997, have done the opposite. Once the figures were revised, rates of lung, breast, prostate, colon, and skin cancers all steadily increased. Today, one in three people will develop cancer in his or her lifetime, and half of them will die within five years of diagnosis. In 10 years, cancer will likely surpass heart disease as the leading cause of death in the U.S.
There's no way to gloss over these grim numbers. Remarkably though, most oncologists feel hopeful rather than helpless. Cancer treatment is finally on the verge of a transformation. This is no premature pronouncement about a cure. To be frank, most doctors in this field no longer use that term. Instead, oncologists envision a more realistic--and attainable--containment strategy. They're convinced that within five years it may be possible to use a windfall of new, precisely targeted drugs to keep cancer in check while patients live longer and relatively symptom-free lives, much as insulin is used to contain diabetes.
This is no pipe dream. Over a dozen new drugs have been accepted by the Food & Drug Administration for expedited review, each meant to replace chemotherapy. "We'll start to see an impact, and by that I mean prolonging of life, in the next five years," says Dr. Lee M. Ellis, an oncologist at M.D. Anderson Cancer Center in Houston. Further out, the outlook is more heartening. "Within 15 years, we should see major changes in many cancers resulting from the treatments we're working on now," says Dr. Robert C. Young, president of Fox Chase Cancer Center in Philadelphia. "That's lightning speed in cancer research."
Patients may feel they've heard all this before. Back in the 1980s, interferon and interleukin-2 were heralded as magic bullets, only to produce little or no impact. The latest drugs are far more promising, but they must contend with cancer's nefarious tendency to develop resistance to almost any drug.
Still, oncologists are confident that this time they won't be disappointed. The past several years have yielded a wealth of insights into the mechanisms that turn healthy cells into killing machines. Researchers now have the understanding they need to gum up the works of these cancer cells. Some 170 pharmaceutical and biotech companies are running clinical trials for over 400 innovative cancer drugs--far more than for any other disease category. As these drugs wend their way through the testing process, stories from the front lines of patient care signal that cancer could one day be a disease we can live with, not die from.
Ann Marie Reynolds, a 45-year-old nurse living near Albany, N.Y., had a persistent cough in August, 1999. Never having smoked, she wasn't unduly concerned. After a few weeks, she went to her doctor, and the news was about as bad as it can get: Reynolds had an advanced case of lung cancer. This disease is responsible for far more deaths than any other type of cancer--and less than 10% of its victims are non-smokers. In the next 12 months, Reynolds tried four different toxic chemotherapy drugs. Nothing worked, and by November, 2000, there were tumors in her liver. Her lungs were so blocked that she needed oxygen almost constantly.
Copyright 2002, by The McGraw-Hill Companies Inc. All rights reserved.
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