I must admit, it can be exciting to read about the latest developments in cancer research in the news. There is so much happening in the field of oncology that it’s tempting to imagine a future without cancer just around the corner.
For instance, scientists at Northwestern University have reported that they have found what they call an ancient kill switch in cancer cells. According to the researchers, they may be able to use this mechanism to force cancer cells to kill themselves in multiple ways simultaneously.
Not only that, a revolutionary new form of cancer treatment known as CAR T-cell therapy has swept up the scientific community in an excited fervor. By manipulating the T-cells of the cancer patient’s own immune system with gene therapy and then reinjecting them back into the patient, researchers have successfully destroyed tumors in people who had lost all hope.
According to various news reports, this treatment was so promising that the U.S. Food and Drug Administration (FDA) has recently given it the green light for production and distribution, making it the first use of medicinal gene editing to be available for patients in the United States.
“We’re entering a new frontier in medical innovation with the ability to reprogram a patient’s own cells to attack a deadly cancer,” FDA Commissioner Dr. Scott Gottlieb stated after approving the treatment.
As with anything that’s showered with positive attention by the media, however, it’s not as simple as it appears. All the hype surrounding cancer research is actually blinding us to the reality that we are not winning the war against cancer. In fact, despite what headlines may claim, we are nowhere close to actually finding the cure for cancer.
While such a claim may sound needlessly pessimistic, it is vital to view the current trajectory of cancer research within the context of its larger history. For one thing, cancer has been around for a very, very long time. This immortal and terrifying disease has been around for all of human history, with fossil evidence and ancient manuscripts dating its pervasiveness as far back as 1600 B.C. Needless to say, countless attempts have been made by renowned scientists and medical experts across human history in a collective effort to understand and combat this disease. In recent memory, the most notable collective endeavor is America’s War on Cancer, which was launched by President Nixon in 1971. From that moment on, the United States has devoted increasingly intensified efforts to find a cure.
Over the past 40 years, the U.S. has poured a total of more than $500 billion into winning this war. Even now, that war continues to escalate. In 2017, the National Cancer Institute (NCI) received $5.389 billion for the fiscal year, which is $174.6 million more than what the organization received in 2016. In addition, we have around 260 different nonprofit organizations in the United States that raise money for cancer research and treatment. Together, those nonprofit organizations have budgets that top $2.2 billion.
This should be good news, though, right? All of that money is going towards a worthy cause, after all. Indeed, that much is undeniable. However, the problem is that all that money is translating to very little substantive progress in terms of developing a permanent solution. So far, we have made great strides in understanding the nature of cancer cells and how they behave in general. Unfortunately, utilizing that knowledge to create a reliable treatment has so far proven to be much more difficult than anyone had realized.
Despite receiving billions of dollars in funding and conducting countless expensive and laborious drug trials, scientists have yet to develop anything that can meaningfully increase a patient’s chances of survival, much less actually cure the disease. In fact, a recent study published earlier this year reported that two-thirds of all cancer drugs that were approved in the past two years showed no evidence of extending survival at all (USA Today, “Dozens of New Cancer Drugs Do Little to Improve Survival,” 02.09.2017).
When President Nixon announced the War on Cancer, he vowed that cancer would be cured by 1976. Today, cancer remains as deadly as ever. According to the World Health Organization, one in six deaths in the world in 2015 was caused by cancer, resulting in a total of 8.8 million deaths. As a result, cancer is still the second leading cause of death globally, just behind heart disease. However, the death toll from heart disease has decreased significantly over the past several decades. In fact, between 1950 and 2005, the death rate of heart disease dropped by 64 percent. In contrast, the death rate for cancer fell by a mere five percent during that same time period. That’s how little progress we have made, even with billions of dollars in funding supporting decades of scientists’ focused research.
Of course, the last thing I want to do is discourage further cancer research. Despite the rather bleak odds, there are still benefits in continuing this line of inquiry and searching for other treatment options. The point I’m trying to articulate is that the news you hear about regarding cancer research tends to be so overly positive that they often fail to accurately depict the reality of the situation. No matter where you look, every new insight is a “major breakthrough,” and every new test product is “a miracle in the making.” By exaggerating successes, the media has effectively deceived the general public into believing that the cure for cancer is just around the corner.
Case in point: CAR-T therapy. Remember how I mentioned earlier that this method of cancer treatment showed promising results? When news sources learned that the FDA approved its use in the United States, they became ballistic with excitement. They issued articles about the miracle of CAR-T therapy, with headlines such as “Latest Car-T Therapy for Cancer Signals New Era for Life-Saving Treatments”, “New Gene Therapy for Cancer Offers Hope to Those With No Options Left”, and “Cancer’s Newest Miracle Cure”. In typical fashion, all these articles feature heartwarming stories of cancer patients miraculously being saved by this revolutionary new treatment that will surely stop cancer in its tracks.
What these articles fail to mention is that CAR-T therapy can be incredibly dangerous because it needs to bring your body to the brink of death in order to save you. While the genetically engineered T-cells spread and kill the tumor cells, the patient undergoes a series of intense side effects that are so sudden and severe that a team of top specialists must remain on standby to keep the patient alive.
And sometimes, not even that is enough. So far, several patients have died from neurotoxicity complications during the clinical trials, and experts still haven’t pinned down the exact cause of their deaths. Because CAR-T therapy is so risky and complex, experts warn that it’ll take years before a treatment like this is safe for patients to use. It is certainly not the miracle cure that the media is making it out to be. It’s not even effective against all cancers; CAR-T therapy has mainly been used to treat leukemia but struggles against solid tumors like sarcomas and lymphomas.
Does this mean that CAR-T therapy is a lost cause? Absolutely not. Medical experts are justified to claim that this immunotherapy treatment is a legitimate revolutionary breakthrough in a field that has largely stagnated over the past several decades. This is a major accomplishment, and the cancer survival stories prove that fact. But the issue is that for the past 40 years, the media has consistently trumpeted the end of cancer with every trivial development. By bombarding the public with overly exaggerated tales of successes, the media has essentially deluded the country into believing that we are winning the war against cancer and that all cancer patients have a good chance of not only surviving but also returning to their normal lives. But such rose-colored views are far from the truth and have broken families apart.
As Dr. Otis Brawley, the chief medical officer at the American Cancer Society, explained, “We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless…[Some choose a medicine that] has a lot of hype around it and unfortunately lose their chance for a cure.”
It’s already heartbreaking for patients and their loved ones to learn that they have cancer. It feels infinitely worse to undergo several “life-saving” treatments performed by doctors at the country’s best hospitals only to learn that none of it actually works. Consider the tragic story of Michael Uvanni and his brother James, a patient with skin cancer. After hearing about all the miracle treatments that were supposedly available and seeing happy commercials of cancer patients hugging their grandchildren, they felt confident that the odds were in James’ favor. That optimism led to crushing disappointment when his health continued to suffer, even after trying immunotherapy and several other experimental treatments. Three years after his diagnosis, James passed away from metastatic melanoma.
“I thought they were going to save him…You get your hopes up, and then you are dropped off the edge of a cliff. That’s the worst thing in the world,” confessed Michael Uvanni.
This sort of duplicitous optimism, unfortunately, permeates through the entire field of oncology. While newspapers hype research results to attract readers, drug companies make outrageous promises to boost sales and hospitals draw in paying customers by appealing to their hopes and overstating their accomplishments. Many scientists have also fallen victim to this mindset, often exaggerating the successes of their own research results to attract investors. Back in 2003, Dr. Andrew von Eschenbach, the director of the National Cancer Institute, announced the possibility of “eliminating suffering and death due to cancer by 2015.” Even President Obama contributed to the illusion when he announced the Cancer Moonshot project in 2016 by saying, “Let’s make America the country that cures cancer once and for all.”
Given all these overly positive messages, it’s no wonder that so many cancer patients believe that their lives are guaranteed to be saved, only to feel crushed when they learn the awful truth. Let’s be clear: There is no miracle cure for cancer. According to the American Cancer Society, the percentage of people who are alive five years after being diagnosed with stomach cancer is 29 percent. For lung and bronchus cancer patients, the number is 18 percent. For pancreatic cancer patients, it’s 7 percent. Patients with metastatic melanoma typically die within a year of diagnosis. Despite what you may hear, immunotherapy can cause fatal immune system attacks on the lungs, kidneys, and heart. There are no approved immunotherapies for breast cancer, colon cancer or prostate cancer. Not only that, studies have found that immunotherapy only benefits about 10 percent of all cancer patients.
As grim as all this may be, we must remember that not all hope is lost. That said, the last thing cancer patients need right now is to be blindsided by all the fanfare that seems to accompany every piece of cancer news.
Originally published on October 26, 2017, in The Miscellany News: Cancer research advancements overstated