July 2010

Give Peace a Chance

By Michael J. Katin, MD

"War, huh, yeah, What is it good for?" Edwin Starr, 1969

On January 22, 1971, in the State of the Union Address, President Richard M. Nixon proposed a new offensive against a dreaded disease: "I will also ask for an appropriation of an extra $100 million to launch an intensive campaign to find a cure for cancer and I will ask later for whatever additional funds can effectively be used. Let us make a total national commitment to achieve this goal."

On October 7, 2001, President George W. Bush announced: "On my order, U. S. forces have begun strikes on terrorist camps of al Qaeda, and the military installations of the Taliban regime in Afghanistan. The collective will of the world is with us."

As of this past month, the involvement in Afghanistan has lasted 104 months, with news agencies noting that this has passed the Vietnam conflict as the longest war in United States history.

Not quite. As of last month, it has been 473 months since declaration of the War on Cancer.

Since that time, more has been spent fighting cancer than on the wars in Afghanistan and Iraq combined. This includes expenditures for research, treatment, supportive care, laetrile, procrit, and shark cartilage. The estimated number of Americans dying from cancer since 1971 is 21,645,000. In contrast, treatment has resulted in the demise of 38,220,738,200,000 cancer cells.

Despite this disparity in casualties, cancer continues to contend due to its ability to recruit new cells to the cause and its outstanding resiliency to fight back against every type of treatment modality.

There has definitely been progress in the war since 1971. The five year relative survival rate in 2010 is estimated to be over 68 per cent, whereas in 1971 it was 40 percent. Regardless of controversy over the significance of the calculated survival rate, this shows remarkable improvement. Nonetheless, the war is till far from over and putting more resources into it may be prohibitive given the status of our (and the world's) economy. It may no longer be possible to try to fight wars in Iraq and Afghanistan and against Cancer all at the same time (whatever happened to the War on Poverty, let alone the War on Drugs?).

Peace efforts may not always be successful, but maybe it's time to reassess the drain on resources required to continue the War on Cancer and try to reach an understanding.

How can this possibly be done? One approach might be to try to negotiate with some of the more reasonable types of malignancy, such as low grade lymphomas and early stage prostate cancers, or, perhaps, an outreach to in situ carcinomas or carcinoids might be successful.

If we could change our attitude that the only good cancer is a cured cancer, this might allow the more dormant cancers to gain faith in our sincerity and carry the message to the more radical cancers. If may never be possible to reason with glioblastoma multiforme, but we'll never know until we try.

One approach would be to concede certain territories (for example, allowing no cancer treatment for persons living in the upper Midwestern states) or perhaps give assurance that there will be a two-year moratorium on 2nd and 3rd line treatments and salvage protocols. An additional benefit would be a decrease in Social Security recipients, helping to bring this system into solvency .

It may be difficult to convince cancer to work with us, after what we have done. We have attempted to kill cancer cells by poisoning them. We have used slash and burn techniques (surgery and radiation therapy). We have deprived them of their food supply (VEGF inhibitors ). We have sent predator drones at them (Zevalin, Bexxar). We have tried to cook them and freeze them. We have used Star Wars weaponry (proton beam). We have even gone after their young, by removing dysplastic cells from the cervix and polyps from the colon. After all this, can we not be accused of genetic cleansing? Or even gene-ocide?

As if that were not bad enough, consider the collateral damage resulting in the death or injury of trillions of innocent bystander cells. Not only does that make victory more difficult, but some of the surviving cells may even join the enemy.

If negotiations prove to be successful, there could be a new era in inter-cellular relations. If must be emphasized, however, that any attempt by humans to circumvent the truce could have unfortunate consequences. Cancer will undoubtedly have millions of agents ready to strike back if given the signal.

Sleeper cells.