A World without Cancer

September 1, 2012
Despite recent advances in the understanding of cancer at the molecular level, a radiologist argues that the war on cancer as presently waged is unwinnable. Currently, writes Cuomo, our research system is fraught with duplication of effort, conflict of interest, drive for personal gain and far too little oversight. Although billions of dollars have been spent since 1971, when President Nixon declared war on cancer by signing the National Cancer Act, an estimated 1.6 million new cases will be diagnosed this year and hundreds of thousands will die. The author charges that government and academic research efforts have been fragmented, with little collaboration and too much bureaucracy. Her answer: Make cancer prevention a top priority by establishing a National Cancer Prevention Institute under the National Institutes of Health to coordinate research. Cuomo takes a sharp look at the problems with our present screening methods, the inconsistency in doctors' recommendations for them, the misleading information they may provide and the harm they can cause. Current treatment options--surgery, radiation and chemotherapy--are not only brutal in their side effects, but enormously expensive, with drugs leading the way in pushing up costs. Further, many expensive drugs, some of which are quite profitable to the doctors who prescribe and provide them, do little to prolong life. The author asks the pharmaceutical industry to redirect its efforts into better tools for preventing cancer through early detection, effective vaccines and new means of protecting the immune system. Cuomo also offers some common-sense advice to individuals on steps to take to lower the risk of cancer--i.e., taking better care of their own health through exercise, diet and avoiding tobacco; teaching their children to do the same; and advocating for a safer environment. A harsh view of current efforts to battle cancer, certain to alarm patients and anger many researchers and clinicians.

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October 1, 2012
Radiologist Cuomo deems the war on cancer a stalemate at best. Her opening sentence is a salvo: The system designed to study, diagnose, and treat cancer in the United States is fatally flawed. She believes the expectations of actually curing the disease have been replaced by a clinical resignation to living with it as a chronic illness along the lines of diabetes or hypertension. She's not happy with the triad of treatment options for cancersurgery, chemotherapy, and radiation, satirized as cut, poison, and burn. Cuomo finds fault with their toxicity, expense, and often minimally beneficial long-term results for individuals with advanced malignancies. She cites one study showing that cancer patients who received palliative care survived about three months longer, with less depression, than those who obtained standard therapies. She offers recommendations emphasizing prevention. Change behaviors linked to a raised risk of cancer. Lower exposure to medical radiation and environmental contaminants. Get cancer-preventing vaccines. Consider screening for selected types of the disease. In sum, Cuomo makes a convincing case for changing the culture of cancer.(Reprinted with permission of Booklist, copyright 2012, American Library Association.)