Magazine article Insight on the News

Cancer Cure Is Elusive, but Therapies Hold Hope

Magazine article Insight on the News

Cancer Cure Is Elusive, but Therapies Hold Hope

Article excerpt

With no magic bullet in sight, scientists are working to control the disease, probing its genetic basis. The latest good news -- cancer deaths are declining for the first time in 18 years.

Judah Folkman had no idea he was about to become a media megastar. The reclusive Harvard University researcher had toiled in relative obscurity for decades, and his theory of starving cancerous tumors, first proposed in the 1970s, had been ridiculed by colleagues. But a front-page article in the New York Times in May 1998 changed all that.

"A cautious awe greets drugs that eradicate tumors in mice" the headline read. The story contained the usual cautions -- that success in mice does not necessarily translate to success in humans, and treatment for humans was months, if not years, away -- but those caveats were overshadowed by a stunning remark from Nobel laureate James Watson, overheard at a dinner party: "Judah is going to cure cancer in two years."

Word from researchers today is that cancer may never be cured, despite the hype surrounding new breakthroughs. But perhaps it can be controlled so that people may be able to live relatively normal lives. "One aims for the cure, certainly, but we would do well to simply delay the progression of the cancer" says Stephen Baylin, associate director for research at the Johns Hopkins Comprehensive Cancer Center in Baltimore. "You could live with cancer, as long as you knew it wouldn't spread. I think that offers the greatest hope in the near future, to slow the progress of cancer."

Vice President Al Gore's call in June for doubling federal cancer-research funding underscores the continuing national concern about cancer's toll. But much has changed since President Nixon declared war on the disease in 1971. The aim then was to focus the United States' potent scientific-research efforts on a single goal, much like reaching the moon in the 1960s. But 28 years later, winning the war seems as elusive as ever. Cancer remains second only to heart disease as the leading cause of death in the United States.

There has been considerable progress, to be sure. A diagnosis of cancer no longer means certain death -- some 8.2 million Americans are cancer survivors. When caught early, many forms of cancer, such as those of the breast and prostate, can be eliminated, enabling patients to live normal, healthy lives. Overall, the number of new cancer cases and cancer deaths in the United States declined from 1990 to 1995, the first reduction after 18 years of steadily rising rates.

Health officials believe the declines are linked to increased screening, advances in cancer detection and treatment and reductions in cancer-causing behaviors such as smoking. But as Americans live longer, they boost their odds of developing cancer.

"Cancer is a disease of aging," says Lamar McGinnis, an Atlanta surgeon and American Cancer Society consultant. "Our cellular structures are exposed to environmental impacts, to the sun, to the foods we eat. And the older we get, the longer time they have to be damaged."

An estimated 1.22 million people will be diagnosed with cancer this year, and about 563,100 are expected to die, according to the latest American Cancer Society figures. In fact, one of every two men and one of every three women will develop cancer at some point in their lives.

Decades of cancer research have revealed a simple but potent fact: Cancer is a case of good genes gone bad. "Dr. Watson's discovery of the structure of DNA really was the key that opened the door to our understanding of cancer at the genetic level" says McGinnis.

Researchers probing the genetic basis of cancer in the early 1980s discovered that certain mutated genes cause cell division to go haywire. They named these genes "oncogenes" from the Greek onkos, meaning "mass." Normally, another class of genes, called tumor suppressors, detects a mutation and orders the cell to either repair itself -- or to self-destruct. …

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