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Cancer expert warns of too-great expectations

MICHAEL VALPY

From Thursday's Globe and Mail

Latest comment posted at 10:54 AM EST 30/09/08

Challenges are ‘incredibly complicated,' U.S. Nobel laureate says, and breakthroughs will occur one by one ...Read the full article

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  1. Ricky Bobbie from Canada writes: Hmmm... perhaps the over-expectations of the public are influenced by the various over-promises that cancer can be cured or 'conquered' - claims made by vested interests seeking money? In reality, this disease is a collection of many diseases and no two cancers are likely exactly the same. Progress is being made but it will be incremental and will probably lead to better control rather than cure. Prevention isn't much of an alternative either, since there are so many factors that contribute to the etiology of the disease that only weak associations can be made. We're all getting older, cancer (and cardiovascular disease and neurodegenerative diseases) are increasing because of that.
  2. Robert Mermelstein from Vancouver, Canada writes: Professor Varmus is entirely correct ('right on the money') in his address of cautioning the public of expecting rapid and large breakthroughs in cancer research. The easy problems have been solved and lots of tough ones remain to be solved.

    As a retired scientist I am surprised how often the public has been fed high expectations of success and 'over-promises'. It is high time for most scientist to learn from successful people the importance of 'under promise and over-deliver'!!
  3. Sun Ra from Canada writes: Most cancer research is an incredible waste of money. We might as well say it and get it in the open. Most in the indsutry already kow this.
    The cure is in prevention not treatment. Diet, lifestyle, environment, etc. all play a major role in cancer development. But there's no money to be made in that, so the 'cancer cure' industry just rolls along, collecting millions of dollars every year, decade after decade, always promising hope (just around the corner) without making any real tangible difference.
    Wake up, do the research, read the literature, change your life, change our culture and society. Understand why cancer develops and you'll find the preventive answers to cancer.
    Don't give money where it will not make any difference, except lining the pockets of misguided organizations and unscrupulous individuals.
  4. David C from Canada writes:
    Nice that a distinguished researcher has finally said what everyone in the field has known for years.

    Of course he waited until he reached his peak ... you don't really hear the scientists who are begging for grant money being so forthright...

    The reason that prevention isn't a well developed field is because no money has been put towards properly researching it (and probably never will be). Doesn't mean you can't figure a lot of it out yourself...
  5. Rob Bairos from Toronto, Canada writes: I think one to take into account is the exponential rise in accumulated knowledge and how we as a society consistently fail to appreciate this when thinking long term.
    The genome project itself was expected to take 15 years to complete, but was done in 3 due to advances in several fields. It is wrong to predict future rates of success based on current rates.
  6. Pamphleteer . from Canada writes: Sun Ra from Canada writes: Most cancer research is an incredible waste of money. We might as well say it and get it in the open. Most in the indsutry already kow this.
    The cure is in prevention not treatment.

    --

    Absolute, total nonsense. Not all cancer is caused by poor lifestyle choices. Some causes are genetic, some are simply inexplicable. Try telling me that Lance Armstrong needed to lead a healthier lifestyle.

    Since when does any rational, truth seeking person suggest that scientific progress is undesirable? Cripes, if scientists had your attitude we'd still be dying of polio.
  7. NOTAFAN OFTHEFEDS from Canada writes: Sun Ra from Canada writes: Most cancer research is an incredible waste of money. We might as well say it and get it in the open. Most in the indsutry already kow this. The cure is in prevention not treatment. I agree with your point that cure is in prevention the rest you say is garbage. Take examples of success in treatment, I know people that have died from cancer and people that ahev lived. In the 70's a diagnosis of small cell lung cancer was sure death! Today up to 40% go past 5 years if it is limited...my uncle is one of them. My mother beat thyroid cancer the kid across the street did as well...over 30 years ago, my best buddy beat leukemia. All of them treated, all living. On the other hand I have lost a couple friends. Regardless, look at what is happening, nano technology, new discoveries, shared knowledge with devloped economies(more research), stem cells, adaptive virus, new forms of chemo, gamma knifes, etc. You go die in the corner if you get cancer...me I will fight!
  8. NOTAFAN OFTHEFEDS from Canada writes: Sun Ra from Canada writes: Most cancer research is an incredible waste of money. We might as well say it and get it in the open. Most in the indsutry already kow this. The cure is in prevention not treatment. I agree with your point that cure is in prevention the rest you say is garbage. Take examples of success in treatment, I know people that have died from cancer and people that ahev lived. In the 70's a diagnosis of small cell lung cancer was sure death! Today up to 40% go past 5 years if it is limited...my uncle is one of them. My mother beat thyroid cancer the kid across the street did as well...over 30 years ago, my best buddy beat leukemia. All of them treated, all living. On the other hand I have lost a couple friends. Regardless, look at what is happening, nano technology, new discoveries, shared knowledge with devloped economies(more research), stem cells, adaptive virus, new forms of chemo, gamma knifes, etc. You go die in the corner if you get cancer...me I will fight!
  9. Trudeau's Apricot poodle from Canada writes: For years rising expectations have not been fulfilled. Unfortunately the advertising campaigns soliciting funds for research are unable to show much for the time effort and money expended. Time to regroup and start being very honest in what has been done and can be expected. The public will support honesty in science. No more spin from the doctors.
  10. Joe Fiorito from Canada writes: Males control the world and there are more of them.

    So let's eliminate breast cancer and let the males deal with THEIR problem.

    Just my opinion.
  11. Nickstar One from Canada writes: “....when scientists give support to that simplistic notion, which they are likely to do because it's the way of raising money, they create an expectation that's very hard to meet....'
    Tell that to the social engineering dolts controlling the UN's WHO and their legions of asinine Ban fanatics who are all about 'raising money'.
  12. Bobby Dy from Canada writes: Sun Ra, apart from smoking and obesity, which are obvious and are not going to be eliminated any time soon, prevention via lifestyle is not going to be effective. What holds more promise is chemoprevention. The huge story in cancer right now is Vitamin D. The reductions seen in studies so far surpass anything out there. While you compel people to read the literature, it would seem that the literature that you are reading comes from web sites with agendas rather than bona fide scientific literature.
  13. Bobby Dy from Canada writes: Remarkable progress has been made but the solution is nowhere near in sight. Misrepresentation of the significance of research is something that is being driven by a handful of atypical scientists with narcissism problems and by administrators who feel that there is a need to make a splash in the media in order to maintain public support for research. What the public needs to know is that, in the school of understanding our biology, we are only in kindergarten. There is a great deal that needs to be done to understand our basic biology and too much emphasis is currently being placed on translation at a time when our lack of understanding of our basic biology limits our ability to successfully translate the work to a clinical setting.
  14. L M from Vancouver, Canada writes: Drug companies are not interested in finding a cure for cancer. They are interested in selling more drugs. A real cure doesn't do them much good.
  15. Lawrence Hutchinson from Houston, United States writes: Pamphleteer . from Canada writes: Absolute, total nonsense. Not all cancer is caused by poor lifestyle choices. Some causes are genetic, some are simply inexplicable. Try telling me that Lance Armstrong needed to lead a healthier lifestyle

    Exceptions do not make the rule. Testicular cancer is exceedingly rare -about 7900 cases in the U.S. in 2007. Lung cancer incidence: 213,000 cases.
  16. Lawrence Hutchinson from Houston, United States writes: L M from Vancouver, Canada writes: Drug companies are not interested in finding a cure for cancer. They are interested in selling more drugs. A real cure doesn't do them much good.

    Statements like this demonstrate a profound ignorance of the goals of most cancer therapy as outlined in the article. Cure in the case of many cancers means a drug that keeps people alive. Just look to the manufacturers of anti-HIV drugs and see how much money they are making by doing this. A cure does not mean that people will no longer need to take some type of drug in order to keep the cancer at bay. Therefore, there IS an incentive to produce more effective drugs.
  17. North of 49 from Canada writes: Who invented the pills we take? Oh guess what? It's those evil drug companies who are not interested in finding a cure. Statements like these are extremely hard to swallow.
  18. Pamphleteer . from Canada writes: Lawrence Hutchinson from Houston, United States writes: Pamphleteer . from Canada writes: Absolute, total nonsense. Not all cancer is caused by poor lifestyle choices. Some causes are genetic, some are simply inexplicable. Try telling me that Lance Armstrong needed to lead a healthier lifestyle

    Exceptions do not make the rule. Testicular cancer is exceedingly rare -about 7900 cases in the U.S. in 2007. Lung cancer incidence: 213,000 cases.

    --

    It was an example you dolt. Cancer can strike anyone at anytime and it frequently does. You're not immune just because you lead a healthy lifestyle.
  19. dreaming of a green party majority from London, Canada writes: Hunt for the cure, run for the cure, walk for the cure-a constant and unrelenting media blittz for a cancer enterprise which seemingly never has enough money-everyone in the' know' knows that using the word cure is misleading and gives false hope. We must promote prevention and divert this money to healthy life style projects. What has all this research money actually accomplished-nothing for tens of years!
  20. Den Lombard from United States writes: Lawrence Hutchinson from Houston, 'Statements like this demonstrate a profound ignorance of the goals of most cancer therapy as outlined in the article.' Read on: ------------------------ From: Cancer drug pipeline on the rise UPI.com HealthBusiness July 12, 2006 | STEVE MITCHELL [Quoting Katie Siafaca, spokeswoman for New Medicine. New Medicine, Inc. is an information services company specializing in consulting and analysis within the biotechnology, healthcare and pharmaceutical industries.] 'They did not go after cancer in the old days because it didn't seem like a place where you could make a lot of money,' she said. But that has changed because cancer drugs can now be very expensive, with some costing tens of thousands of dollars per patient, and many patients will receive multiple drugs during the course of their disease. The use of second- and third-line therapies 'has made chemotherapy a very big business because one patient may have three or four different treatments before they expire,' Siafaca said. In addition, a lower rate of efficacy and a higher rate of side effects can often be acceptable in this arena, particularly in advanced cancer patients with no other options. 'A lot of drugs all they do is extend life by several months but you can still make money off it,' she said. ------------------------- The goals of most Drug companies is not about a cure, but to squeeze as much profit from the cancer patient before they 'expire'.
  21. Gudrun Dekker from Vernon, Canada writes: Gabor Mate, author of 'When the body says no', draws an interesting parallel between emotional repression and many types of cancer and auto immune deficiency diseases. It is a good read for anyone and motivation for us all to find emotional balance in our lives to prevent illness.
  22. Anti Fascist from Canada writes:
    Elect a government that will regulate and enforce regulations.

    Clean Water

    Clean Air

    Healthy food supply free of cancer causing agents.

    Quality health care, education for our kids and income security

    These are the things that will help prevent cancer.

    What have the fibs and cons done in this regard? Precious little, and only after someone dies.
  23. Sue City from Canada writes: Sun Ra - are you mad?

    If cancer research did not exist, there would be no treatments for the disease and it would be a death sentence. People do survive cancer, and only because researchers found a way to keep them alive.

    So many ignorant posters on G&M. I have to stop reading the comments...
  24. dreaming of a green party majority from London, Canada writes: Sue you have missed the point -try to read the comments by one of the worlds premier cancer researchers Bert Volgelstein recently in Science who suggested that the complex nature of cancer mutational changes suggest that cancer cure research is a fools game-thats the point!
  25. rm r from Canada &, United States writes: I'm a scientist working on non-health-care related research. We have research contracts with fixed time limits, clearly defined problems, approaches and deliverables. Funding is competitive and our funding sources have the expectation of some kind of yes/no result or meeting some other kind of defined progress milestone. Our research group has been very successful, but if we didn't provide results we would lose our funding and eventually our jobs. This is why I can't understand how a cancer researcher can stand up and tell everyone not to expect anything. Where can I get funding for my research with no expectations? More and more I get the impression of health-care research as just people playing in a sandbox. But seriously, I suggest that perhaps the problem is that health-care and cancer research in particular has become too high profile. Every kid in science or engineering at university nowadays wants to have some kind of bio-this or bio-that in front of their degree. My impression is that the reason why health-care research is so complex and thus often elicits what can only be described as a hairy-fairy sandbox approach is because it is a multi-disciplinary problem in which it is next to impossible to isolate particular variables. So maybe the reason why cancer research is stalled is because we haven't made sufficient progress in other scientific disciplines. Perhaps the next cancer breakthrough will only occur after some other enabling non-health-care technolgy has been developed. In short, if, as the article states, we no longer have expectations for progress in cancer research, then lets shift funding to areas in which we can expect progress, and revisit the cancer problem later on when we have more tools in our toolbox.
  26. Jenny any Dots from Canada writes: I read a great essay once on the cure for old age...the answer was cancer. Our bodies mutate and eventually, if we don't die from a heart attack or a stroke, we will all die of cancer. Certainly research should continue but to think there will ever be a cure is naive.
  27. Lawrence Hutchinson from Houston, United States writes: Pamphleteer . from Canada writes It was an example you dolt. Cancer can strike anyone at anytime and it frequently does. You're not immune just because you lead a healthy lifestyle.

    Therefore, why bother trying to improve the odds against developing cancer by avoiding known carcinogens? Yes, I can see the logic.
  28. A A from Winnipeg, Canada writes: I lost my little sister to Colon Cancer in 1993. Actually it was a Morphine overdose by the doctors. The cancer never spread as they said it had. Now, I have a friend who had last year (July 4th) after a bike accident was diagnosed with brain cancer. That day he had shunts put into his head to drain brain fluid. He was in the hospital for 30 days, he went under the gamma knife, he has had chemo and just before his one year was up they found another tumor. He is now on Steroids, and higher dosages of chemo and on so many other pills I don't even know what they are. He is extremely lucky to be living in Winnipeg because we do have the Gamma Knife. The money people donate to cancer care is remarkable and the care has come along way. I know there is no cure out there for any of the cancers but, it does take time to find a cure if there is a cure. My sister gave up, my friend is fighting doing whatever it takes to live. I think with Prayers, the fight to live, love, and the help of the scientists all combine is what makes a person live or die.
  29. ALASTAIR JAMES BERRY from Nanaimo BC, Canada writes: How many broken hopes have there been in the ETHICAL FIELD and the ALTERNATIVE MEDICINE FIELD? Hundreds of thousands I'll warrant...........Diagnostic techniques that were guaranteed to give early diagnosis(and hence hopefully lead to early effective treatment) have time and time again proved worthless in improving the actual death rate from the disease. The value of PSA's and even mammograms is still moot and many treatments seem to have little or no beneficial effect, when the final death rate is considered. On the Alternative Medicine side we have seen Private Cancer Treatment falicities and therapies come and go. H3 pregnant mares serum in the 30's, followed by the Hoaxey Cancer Clinic in Texas, in the 40's,Krebiozen and Laetrile more recently. Sadly, all labelled in the end, 'INEFFECTIVE'. As yet we are only treating the disease symptomatically and in only a tiny fraction of the cases do we know anything about the cause. Certainly tobacco smoke causes lung cancer and increases the chances of smelter workers,asbestos workers and fibre glass workers developing the disease(ACTUALLY A CONSTELLATION OF SIMILAR DISEASES) Until we understand the causes of cancer and remove or modify them there is really very little hope that much will change in the actual mortality figures associated with this disease.
  30. scamp the from Canada writes:
    I really wonder about death by 'old age'

    If we cure cancer and learn to manipulate cells to that degree, where would we draw the line between cells that just decay due to 'old age' and stating those are various diseases.

    Or do we just keep treating everything has a disease until we have human beings that live forever?

    It is a question of ethics of course. I don't really know the answer, but I fear we haven't even discussed it in society.
  31. Ken Johnson from Canada writes: Translation- No one really yet knows what causes cancer. We know what happens afetr teh cell mutatesbut we still don't know why they mutate
  32. Wayne Spitzer from Faywood, United States writes: To L.M from Vancouver, Den Lombard from the U.S., and others. Do you really believe that the scientists who work for the pharmaceutical companies don't have family, friends, and loved ones who die from cancer? I worked in research for a drug company for 30 years. The head of our cancer research division died from pancreatic cancer. Do you think for a moment that he didn't want to find a cure? I don't know of a single research colleague who would not give his right arm to be part of an effort to develop a cancer drug that would save lives. Read the article. Varmus is a highly respected expert - it isn't easy, and progress is slow. Support cancer research. Your life may depend on it.
  33. Anne D from Canada writes: I for one was the lucky recipient of the newest slate of breast cancer drugs, administered through a clinical trial, that was funded through funds collected for breast cancer research. I participated not because it would necessarily help me, but to provide important conclusions about the best possible care for breast cancer patients.

    I would urge everyone to continue to give generously. As the primary article suggests, it is the base hits and doubles that provide a measure of security in knowing that at least going forward, even with a diagnosis as frightening as cancer, that newer and more effective treatments will continue to be developed over time.

    I was cautioned to treat cancer as a chronic condition. In other words, there is no cure...only treatments. Yes, diet, lifestyle, excercise are good preventive measures, but barring these, effective treatments continue to be needed, and research is one way of ensuring that these are developed.
  34. Kim Philby from Canada writes: I support cancer research with my dollars, but I'm not optimistic that a cure, either a true cure or a way of suppressing the chronic illness so that it does not meaningfully affect the patient's life, will be found.

    I'm glad for those people who apparently have managed to rid themselves of the disease, but it seems the cost is often high, particularly for children (learning impairment from chemo, the possibility of later cancers because of radiation).

    I freely admit I find it a very scary disease.
  35. Roop Misir from Toronto, Canada writes: By the looks of it, cancer will never be conquered. It's like a cat and mouse game...

    Why?

    For the same reason that no one has ever come up with a realistic dietary regimen that causes permanent weight reduction in obese people.

    But don't get me wrong. Raising funds for cancer research is wonderful.... Imagine how many scientists and physicians earn their livelihood by engaging in ongoing cancer-related ' research'.

    Please advise otherwise!
  36. D D from writes: The scepticism and cynicism expressed in this talkback is depressing. First, as far as cancer research is concerned, the modern cancer era really only started about 40 years ago. That is not very much time, yet what has been accomplished in terms of understanding the nature of the disease is remarkable. Cancer is extraordinarily complex. It is many diseases with many causes and many drivers. Dr. Varmus was one of the pioneers in identifying the mutated oncogenes that drive the disease. The fact that we can identify these genes and are now generating drugs thast specifically target them is a remarkable achievement and is starting to have real effects on patient survival. Look up Gleevec to see where the field is heading. Why does it take so long? It is the requirement to do extensive, properly controlled clinical trials to test each new therapy. Clinical trials are a good thng. They protect the population from treatments that might be dangerous or ineffective. However they are crazy expensive and time-consuming since the survival endpoint takes at least five years. The additional complication is the fact that most cancer therapeutics work best in combination with other drugs. Combinations must also be properly tested before they become the standard of care. I would encourage every cancer patient to participate in clinical trials if possible. It could be the most important thing they can do to help find better treatments.
  37. Sarah Bee from Canada writes: I'm very pleased with the reseach that has been done to date. Even if the victories are comparatively small when looking at cancer as a giant umbrella, they have saved countless lives. My mother died of a form of brain cancer that was a certain death sentence in 1978 and I have no memory of her as a result. Today, that form of brain cancer is highly treatable and my sister lives on after having been diagnosed and treated for it 4 years ago. My great aunt died of colon cancer in 1988. My aunt has just come through treatment and there is no sign of the same cancer left in her body. Events like the well-meaning but completely naive 'Stand Up to Cancer' televised event on September 5th distract people from supporting those organizations that are already established and have made advances to treat and cure those cancers in which they specialize.
  38. E MacM from Canada writes: cancer is a billion dollar industry, the meds and treatments are making someone rich why cure it when you can find drugs to control it and make a fortune.
    Cancer can be beaten and should have been a long time ago but that wouldn't be a smart business move would it.
  39. Gogh Forit from Canada writes: I think cancer is like weeds growing through concrete or asphalt. You can pave over the spot eliminating the growth but within time cracks develop and eventually the weeds are back. I think this applies to cancer and while medical technologies and research have made inroads in better treatment and diagnosis of the various forms of cancer, science hasn't eliminated any cancers, only had success previously mentioned. Cancer is some ways like our 'evil twin'
  40. Peter S from Toronto, Canada writes: Who's fault are these expectations? 'Run for the Cure', 'Conquer Cancer', 'Let's make Cancer history.' All slogans of cancer-based organizations who, coincidentally, are constantly soliciting funds. There will never be a cure for cancer. There is far too much money to be made. At best we'll get a treatment - something that requires you to pay huge sums every month just to stay alive and keep the pharmaceutical companies rolling in cash.

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