Set­ting the record straight on can­cer re­search

Writer’s claim that the war against can­cer has failed us does not stand up to scru­tiny

The Hamilton Spectator - - COMMENT - STEVE BUIST The Hamil­ton Spec­ta­tor Steve Buist is the Spec­ta­tor’s in­ves­ti­ga­tions ed­i­tor. He has writ­ten sev­eral mul­ti­part se­ries on can­cer and in 2014, he was named the best can­cer re­porter in a world­wide com­pe­ti­tion spon­sored by the Euro­pean School of O

First things first. I’m not a doc­tor, and I’m cer­tainly not an on­col­o­gist, so do with that in­for­ma­tion what you wish.

I do have a de­gree in bi­o­log­i­cal science, for what it’s worth, and I’ve writ­ten a lot about can­cer in the past 18 years, which has given me the chance to learn much about the sub­ject from some of the best re­searchers around, in­clud­ing those right here in Hamil­ton.

Science is the process of gath­er­ing in­for­ma­tion through the on­go­ing ap­pli­ca­tion of crit­i­cal think­ing. Science is about ev­i­dence and test­ing that ev­i­dence stren­u­ously and ob­jec­tively.

I be­lieve in ev­i­dence-based medicine. I also be­lieve in ev­i­dence-based jour­nal­ism.

Re­cently, the Spec­ta­tor pub­lished an opin­ion piece with the provoca­tive head­line, “War on can­cer, like the one on drugs, has failed us.”

The piece re­lied heav­ily on in­nu­endo, con­spir­acy the­o­ries and pseu­do­science rather than ev­i­dence. I think it was ir­re­spon­si­ble, bor­der­ing on dan­ger­ous — the type of piece that falls right in line with the anti-vac­cine train of mis­guided rea­son­ing.

Among the piece’s most ab­surd state­ments: that there is no known cure for can­cer, that we should stop look­ing for a cure for can­cer, that Big Pharma is sit­ting on a cure for can­cer (which seems con­tra­dic­tory to the first two points), that peo­ple don’t die of can­cer, and that 75 per cent of doc­tors would refuse chemo­ther­apy them­selves. Where to even be­gin? Let’s tackle the last point first, which the au­thor stated came from “one sur­vey” he had seen.

Yes, you can find that head­line on the web, most of­ten on sites pro­mot­ing nat­u­ral reme­dies or, worse, un­proven al­ter­na­tive can­cer treat­ments.

It turns out that, upon closer in­spec­tion, the 75 per cent fig­ure has been taken out of con­text — in­ten­tion­ally, per­haps — from a sur­vey that asked doc­tors a very spe­cific ques­tion about a very spe­cific type of harsh chemo­ther­apy for a very spe­cific type of in­cur­able can­cer in its ter­mi­nal stage. That’s ir­re­spon­si­ble.

No cure for can­cer? That will come as a sur­prise to the many men who have been treated suc­cess­fully for tes­tic­u­lar can­cer, which has a 97 per cent sur­vival rate, or prostate can­cer, which has a 96 per cent cure rate. For women with breast can­cer, nearly 90 per cent of them can ex­pect to be cured.

Over­all, two out of three can­cer pa­tients will now sur­vive at least five years, the amount of time nec­es­sary to be deemed a cure. That’s up sig­nif­i­cantly from about 50 per cent two decades ago.

Could medicine be do­ing bet­ter? Sure. The war on can­cer has been dis­ap­point­ing, if a 100 per cent cure rate is seen as the goal.

But part of the prob­lem is that we’ve given one la­bel — can­cer — to a dis­ease with a cou­ple of hun­dred dif­fer­ent types. It’s not sur­pris­ing that find­ing so­lu­tions to hun­dreds of dif­fer­ent prob­lems has proven to be a chal­lenge.

There is no one can­cer and what’s be­come clear is there’s no one magic bul­let that erad­i­cates it.

Big Pharma sit­ting on a cure un­til they fig­ure out how to mon­e­tize it, “as has been ru­moured for years,” ac­cord­ing to the au­thor?

That’s out there with the faked moon land­ing type of con­spir­acy the­ory.

Look, I’ve been plenty crit­i­cal of the phar­ma­ceu­ti­cal in­dus­try in the past but that’s a level of cyn­i­cism even I can’t com­pre­hend. It’s also highly in­sult­ing to the peo­ple who have to treat can­cer ev­ery day.

Do you think some­one is sit­ting on a cure for heart dis­ease be­cause they’re try­ing to fig­ure out how to mon­e­tize it? Os­teo­poro­sis? De­men­tia? Di­a­betes?

Why would any­one think can­cer is dif­fer­ent?

Be­sides, there’s al­ready a sim­ple and ef­fec­tive way to mon­e­tize these things — prove that they work and the world will beat a path to your door. Can you imag­ine what would hap­pen to the stock price of a com­pany that an­nounces it can cure can­cer?

Oddly enough, there is one point we do strongly agree on — not enough is done to pro­mote the pre­ven­tion of can­cer.

More than half of all can­cer cases are pre­ventable. Chang­ing our be­hav­iours — no smok­ing, more ex­er­cise, bet­ter di­ets, less drink­ing, pro­tec­tion from the sun — could se­ri­ously re­duce the can­cer bur­den.

But it still means a sig­nif­i­cant chunk of can­cer can’t be pre­vented.

What’s the sug­ges­tion? That we sim­ply throw our hands up in the air and wish these peo­ple the best of luck? Chas­tise those who de­vel­oped a can­cer that could have been pre­vented?

A sig­nif­i­cant chunk of heart dis­ease and di­a­betes is also pre­ventable. Should we rail against those peo­ple as well?

Pre­ventable or not, treat­ments are still needed.

And fi­nally, peo­ple do die from can­cer. Too many peo­ple.

All the more rea­son why the war on can­cer must con­tinue.


Can­cer re­search is about ev­i­dence and test­ing that ev­i­dence stren­u­ously and ob­jec­tively and can’t be judged by in­nu­endo, con­spir­acy the­o­ries and pseu­do­science, writes Steve Buist.

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