Cured. A cure for cancer. I've heard that scientists have the cure for cancer but that pharmaceutical companies are hiding it from the public because if a cure is found, they won't make money. Let's analyze this statement.
"Cancer": What type of cancer? Cancer is a group of disease, not a single disease. Breast cancer differs from lung cancer which differs from brain cancer which differs from blood cancers. And then if we look at a cancer that develops in a specific tissue- like the breast- we see that even breast cancer is not a single type of cancer. It is actually another group of diseases that all get lumped under one category based on the tissue it originates from.
Advances in molecular biology have taught us that not all breast cancers are the same. There are differences that occur at the DNA and protein level that affect how the disease advances. Within breast cancer, there is HER2+ or HER2- disease, hormone receptor positive or negative disease, and then the most aggressive which is triple negative disease. Then there are other considerations- does the woman have a mutation in the BRCA gene? What stage is the cancer? A woman with hormone receptor positive disease has a better chance of living with the disease than a woman with triple negative disease. Why? No one really understands the biology behind why one cancer is more aggressive than another, but we begin to see patterns as they uncover different subtypes of the disease.
"Pharmaceutical companies are hiding it": So we have established that a cure could not be a single magic bullet cure, because there are many different types of cancer with many different markers and characteristics. Pharmaceutical companies study drugs that they hope to be cures every day. Let's go back to the example of HER2+ breast cancer. Scientists noticed that 10-20% of all breast cancers are positive for the HER2 receptor and this receptor is involved in communicating growth signals to a cell telling it to grow and multiply. They thought that if they could stop this communication, it could stop the growth of the cancer and eventually cause it to disappear. Targeting the HER2 receptor is a form of "personalized medicine" and in theory, should have worked in 100% of patients with HER2+ breast cancer. While this drug is very effective, it does not work in 100% of HER2+ breast cancer. Why? Because every individual is different and no two people have the same cancer. There are so many factors to consider - from simple things like age and health to complicated things like co-expression of other genes and redundancy in cell signaling pathways. One size fits all does not work in cancer as a whole, and it does not appear to work for a particular subtype of cancer either.
It takes up to 20 years and costs nearly one billion dollars to bring a single drug to market. When scientists come up with new ideas to target a specific type of cancer - like HER2 positive breast cancer - they don't hold back progress because it might cure people, they push it forward. Only by the time it reaches Phase I/II/III trials in humans some 7-15 years later do the companies realize that the drug is not the cure they hoped for, but it does work in a large number of women. Should they stop development of this drug just because it does not work in every single women with HER2+ breast cancer and start from scratch? No of course not. Tell a women with Stage IV HER2+ breast cancer that they only choice for treatment she has is chemotherapy and that once she has exhausted all options, she has no choice because a cure has not yet been found. If there is a new advancement, that drug has a place in the arsenal of drug weapons a doctors has in the war against the cancer in their patient, even if it is not a cure.
"Because they won't make money": What? If a company found a cure to a cancer type, why would that prevent them from making money? They would charge a horrendous amount of money for that cure. And a cure does not mean people would not continue to develop the cancer. In the US alone, according to the American Cancer Society, about 207,090 new cases of invasive breast cancer will be diagnosed in women in 2010. If we look at HER2+ disease being 10-20% of all breast cancer cases, that is at least 20,709 new cases per year eligible for a "cure" to HER2+ breast cancer. Until we slow down our metabolism by eating less, stop aging, stop putting pollutants into the earth, our bodies and the atmosphere, and prevent DNA mutations and replication errors, people will continue to develop cancer. And as long as people are developing cancer, they will need the drug. Companies will continue to make money with a cure. And then they will move on to another cancer type and try to find a cure there. On top of that, if the drug is considered a cure, they will eliminate the competition. If they eliminate competition they can charge whatever they want for the drug. It is the best situation to be in and what a company wants. Why would they prevent a cure from being made public? Some say because it will cut of research funding.
But that doesn't make sense - why would grants be cut off if a scientist found a cure? If they found a cure, it is more likely that any grant they submit will be funded for any new project - because the lab will be highly reputed and trusted to produce results. The more positive results and publications a company or academic lab has does not decrease funding, it increases it.
The problem is not that pharmaceutical companies are hiding a cure. The real problem is, how will we know that a person is cured? A cure means that the cancer is gone and will not come back. A patient that is in "complete remission" is a person that shows no signs of the disease, but doctors are hesitant to use the word cured. That is because as long as we are living, there is a risk of the cancer coming back. People can be in remission for 10 years or more, but still they are not considered cured. How can we ever guarantee that the cancer will never come back? If a doctor declares a patient is cured, and the cancer rears it's ugly head again, that doctor could be accused of malpractice.
People with certain types of cancer treated with specific drugs - like CML treated with Gleevec or Stage II breast cancer treated with surgery - have no signs of the disease for many many years. It could be said that their cancer has been cured - but really, what we say is they are in remission. There needs to come a time when we realize that the "c" word is a dirty word that may never be used in the medical practice...but that does not mean that some patients have not achieved it. In the end, once someone is diagnosed, they will always be living with this disease. Read this CBS news story to find out about doctors that are hesitant to use the word cure.
Now I am not saying that pharmaceutical companies are only in the business to purely help people - of course they are corporate entities out to make money, just like any industry. But putting their work down does not help the progress. And yes, progress is slow - but that is because our bodies are a vast uncharted universe that is only beginning to be discovered. For every pathway or gene function that is discovered, many more that exist. And we cohabitate with the environment around us, the earth we call home - which is also always changing and impacting our bodies in ways we do not even know. We need to acknowledge that our bodies and the biology that rules it are more complicated than we could have ever imagined. We need to recognize that while our basic genetic code is the same, it is the individual differences in expression that make us unique and make our diseases unique - whether it be due to the way we live our lives (Colorado mountains vs. Los Angeles smog or couch potato vs. gym rat) or our internal processes that we may not have control over (inherited genetics)- even though we may have the same basic disease on the surface.
Scientist and pharmaceutical companies are not hiding the cure from you. They are losing mothers, fathers, brothers, sisters and friends to the very same cancers that you are losing people you love to. They themselves are developing cancers, just like you. Scientists are just as frustrated and baffled that they have not been able to find the magic cure.
We need to accept the fact that we may never find a "cure." We need to acknowledge the strides forward we make in this war against cancer - and that may mean, living for the next 20 years with a cancer that remains in remission, but is never considered cured. Pharmaceutical companies and scientists are not out to deceive you - we are all in this battle together.
The opposite of cure is disease or problem. And just because a "cure" has not been found does not mean we are still with the problem. Some great advances have been made in some types of cancer. Let's change our attitudes to the fact we are living, and even though a war has been waged inside of our bodies, we will strive to live with cancer. We will use the tools we have to make our lives better and we will not let it destroy us. With that attitude in mind, in some cases we have found a cure for now, and we will keep marching forward in attempt to discover the next great miracle in science to help people with cancer live longer.
On a separate but relevant note, I would like to acknowledge the life and passing away of a brave, graceful, and amazing woman who openly shared with us the pains in her life to help us grow - whether it be the death of her son, her husband's affair and fathering of an illegitimate child, or a battle with breast cancer. "She accepted her life and always moved forward. She wrote that at times, the wind didn't blow her way, but she said she was still able to stand in the storm, adjust her sails and move forward." RIP Elizabeth Edwards
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