We cannot rely on advances in molecular biology to beat the scourge of cancer. So argues journalist Leaf, who got interested in the subject via the impressive success story of the drug Gleevec, which effectively delivers targeted cancer therapy to certain leukemia patients.
This was a special circumstance, the author learned after meeting the CEO of Novartis, the company that developed the drug, in 2002; Gleevec represented a radical therapeutic advance, but most cancers are more complex than leukemia. Even though his professional expertise was in finance and business journalism rather than science (he has been executive editor of Fortune and other magazines), Leaf was fascinated by the implications of this story; since then, he has conducted interviews with more than 1,000 people, including oncologists, geneticists, doctors and patients. Over time, he writes, he came to understand that there was no quick fix for cancer. While advances in oncology, especially early diagnosis, have reduced the risk of dying from cancer, the incidence of cancer is increasing as the population ages, imposing a growing social burden. More Americans will die from cancer over the next 15 months than the total of combat fatalities since 1775, writes Leaf, attributing that daunting statistic to a dysfunctional "cancer culture.” He dates the problem to the National Cancer Act, passed in response to President Richard Nixon's call for a war on cancer. Funding was increased, but rather than establish an institution modeled on NASA, dedicated solely to eradicating cancer, Congress assigned the responsibility to the National Institutes of Health, with a mandate to support university research through competitive public/private partnerships. This system fosters bureaucratic inertia and aversion to risk. While hopeful that future scientific advances will occur, Leaf believes that the system must be revamped now, arguing that free exchange of information and a major upgrade in preventative medicine are the keys to improvement.
An important evaluative study meriting serious public discussion.