- The Washington Times - Sunday, December 23, 2001

WASHINGTON The "war on cancer" is 30 years old today. Total victory is nowhere in sight.
The cost, in terms of deaths and dollars, is staggering. Since President Nixon signed the National Cancer Act into law on Dec. 23, 1971, more than 12 million Americans have died from cancer.
The government has spent more than $45 billion on cancer research.
But while medical science has conquered other diseases, "the big C" is still very much with us.
Each year, 1.4 million Americans are diagnosed with cancer, and 560,000 die from the disease. That's 1,500 people a day; 40,000 a month.
Half of the men and one-third of the women in America will have cancer in their lifetimes. One-fourth of all Americans will die from cancer.
The overall rate of death from cancer is as high today as it was 30 years ago roughly 200 deaths per 100,000 population.
Within the next 10 to 15 years, unless there is a dramatic medical breakthrough, cancer will become the leading cause of death in the United States, overtaking heart disease.
Despite the enormous toll, many battles have been won.
Testicular cancer and Hodgkin's disease rates have dropped nearly 70 percent. Breast cancer deaths per 100,000 people have dropped 14 percent. Death rates from cancers of the cervix, stomach, uterus, colon, bladder, thyroid and larynx also are down.
Professional cyclist Lance Armstrong may be the poster-child of hope for cancer victims. Despite a near-death brush with testicular cancer, Mr. Armstrong recovered and went on to win three grueling Tour de France bicycle races.
An estimated 8.5 million Americans are cancer survivors.
New discoveries are targeting the way cancer works and ways to block individual cancers. Earlier this year, the federal Food and Drug Administration moved with breakneck speed three months of clinical trials to approve the first drug targeted to a specific cancer: Gleevec, a therapy for chronic myeloid leukemia.
The problem is that cancer unlike, for example, polio takes nearly 100 different forms.
"In each and every cancer, there's likely to be a different part that's broken," said Dr. Brian J. Druker, director of the Leukemia Center, Oregon Health and Science University and lead investigator for Gleevec. "In each and every cancer, we've got to figure out what part's broken before we can fix it."
The war has not been won, but successive battles have gone our way.
"Since 1971 we indeed have made enormous progress," said Dr. Alan Rabson, acting director of the National Cancer Institute. "Although we have not cured all cancers, we are curing more than ever before and we are making it possible for people with cancer to live longer with a higher quality of life."
In its 2001 Cancer Progress Report, the National Cancer Institute's former director, Dr. Richard D. Klausner, noted that Americans are more in tune with potential causes of cancer such as smoking, poor diet and lack of exercise and are more likely to receive cancer screenings, which can detect early stages of malignancy.
The earlier a cancer is caught, the better chance a patient has of surviving.
But there are disturbing trends in the opposite direction, Dr. Klausner noted. Smoking has, until very recently, been rising among teen-agers.
People are taking fewer precautions against sun damage, and skin cancer rates are skyrocketing.
At a recent forum marking the 30th anniversary of the Nixon declaration of war on cancer, a panel of experts found some glimmers of hope but warned that much more needs to be done and much more needs to be spent before the war can be won.
The forum was sponsored by the American Association for the Advancement of Science and the Americans for Medical Progress Educational Foundation.
Former Rep. Paul Rogers of West Palm Beach, Fla., now a lawyer in Washington, recalled the battle over cancer research. The National Cancer Institute was created and signed into law in 1937 by President Franklin D. Roosevelt.
In 1970 a blue-ribbon commission recommended the establishment of an independent national cancer authority which could "effect a moon shot, like that which occurred with NASA," Mr. Rogers said.
After months of wrangling, Mr. Rogers was able to reverse a prior Senate action that would have removed the cancer institute from the National Institutes of Health.
The result was that the cancer institute stayed in NIH, but with an independent budget approved by the White House.
When he signed the bill into law, Mr. Nixon said, "I hope that in the years ahead that we may look back on this day and this action as being the most significant action taken during this administration."
In an accompanying statement, Mr. Nixon said "this legislation can mean new hope and comfort in the years ahead for millions of people in this country and around the world."
The war rhetoric may have been overblown, said Dr. Samuel E. Broder, who headed the National Cancer Institute from 1989 to 1995 and is now executive vice president for medical affairs at Celera Genomics.
"We need humility," Dr. Broder said. "Cancer cells are unimpressed by rhetoric, bravado, slogans or hype."
While cancer can strike anyone, the poor are less likely to get early screening and detection of their cancer. That lowers their chance of survival.
"Cancer outcomes reflect sociopolitical status rather than biology," said Dr. Otis W. Brawley, professor of medicine, hematology and oncology at the Emory University of Medicine and director of the Georgia Cancer Coalition Center of Excellence at Grady Hospital in Atlanta.

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