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Sorry, but So Far War on Cancer Has Been a Bust

The views expressed are those of the author and are not necessarily those of Scientific American.


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I recently got into an argument, again, about cancer.

The occasion was a talk by one of my colleagues at Stevens Institute, philosopher Gregory Morgan, on the fascinating history of research into cancer-causing viruses. In the Q&A, someone commented on how far science has come in understanding cancer’s causes.

With my usual kneejerk negativity, I lamented that all our knowledge about oncogenes, oncoviruses and other cancer catalysts has not translated into significant reductions in mortality.

Others in the audience objected that they knew people whose lives had been saved by better tests and treatments. They expressed incredulity when I said that cancer tests and treatments might be hurting more people than they helped.

So I thought I’d assemble some basic facts on this issue, especially since that gives me a chance to draw attention to excellent new books–by journalists Dan Fagin and George Johnson, two old friends–that underscore cancer’s persistent intractability.

I’ll get to Fagin and Johnson soon, but first some background information. Cancer journalism usually hails alleged advances, but in 2009 Gina Kolata of The New York Times provided a blunt reality check, “Advances Elusive in the Drive to Cure Cancer,” that five years later remains all too relevant.

Kolata asserts that “the grim facts about cancer can be lost among the positive messages from the news media, advocacy groups and medical centers, and even labels on foods and supplements, hinting that they can fight or prevent cancer.”

In 1971, she recalls, President Richard Nixon declared war on cancer, vowing that the disease would be cured within five years. Since then, the National Cancer Institute has spent $105 billion on research, and other institutions—private, public and non-profit–have spent many billions more.

Kolata acknowledges some genuine advances, noting that “a few rare cancers, like chronic myeloid leukemia, can be controlled for years with new drugs. Cancer treatments today tend to be less harsh. Surgery is less disfiguring, chemotherapy less disabling.”

But the overall death rate for cancer—adjusted for the aging of the U.S. population—has fallen by only five percent since 1950, Kolata points out. During this same period, the death rate for heart disease plummeted 64 percent and for flu and pneumonia 58 percent.

The decline in the cancer mortality rate since 1950 has not been steady. The rate actually increased from 1950 through the early 1990s and then began dropping. In other words, the mortality rate rose for two decades after Nixon’s declaration of war before dipping downward.

The decline in mortality rates since the early 1990s has been credited to improved tests and treatments, but Kolata tossed cold water on these claims last year. “The much touted recent drops in some cancer rates,” she writes, “were mostly attributable not to cancer breakthroughs but to a decline in smoking that began decades ago–propelled, in part, by federal antismoking campaigns that began in the 1960s.”

This view is corroborated by a 2010 Skeptical Inquirer article, “The War on Cancer: A Progress Report for Skeptics.” Reynold Spector, professor of medicine at Robert Wood Johnson Medical School, provides charts (which I have reproduced) showing how a rise and fall in smoking preceded the rise and fall of the death rate from cancer, and particularly lung cancer. Citing Kolata’s 2009 article, Spector agrees with her that “the war on cancer has not gone well.”

Cancer-research boosters often state that people are surviving cancer for longer periods. But that is because men and women are being screened more frequently with higher-resolution tests and hence being diagnosed with cancer at earlier stages. They are living longer after diagnosis, not living longer in absolute terms.

Spector explains: “First, if one discovers a malignant tumor very early and starts therapy immediately, even if the therapy is worthless, it will appear that the patient lives longer than a second patient (with an identical tumor) treated with another worthless drug if the cancer in the second patient was detected later.”

Indeed, as I have reported repeatedly on this blog, most recently in February, there is an emerging scientific consensus that mammography, the PSA (prostate-specific antigen) blood test and other screening methods have been overprescribed—and often lead to unnecessary treatment.

Men diagnosed with prostate cancer because of a PSA test are 47 times more likely to get unnecessary, harmful treatments—biopsies, surgery, radiation, chemotherapy—than they are to have their lives extended, according to one recent study. Another found that as many as 33 women diagnosed with breast cancer after receiving mammograms receive unnecessary treatment for every woman whose life is saved.

Last year a group of oncologists acknowledged that Americans are being over-tested and over-treated for cancer. These problems have led to calls for more emphasis on prevention—and that brings me to the books of Fagin and Johnson. Both books, to different degrees, raise questions about how far we can go toward preventing cancer by identifying carcinogens and expunging them from our environment.

This year Fagin won a Pulitzer Prize for his book Toms River: A Story of Science and Salvation, about a New Jersey town ravaged by industrial pollution. The meta-theme of Fagin’s book is how extraordinarily difficult it can be to trace cancer clusters to specific environmental factors, even the kind of egregious pollution produced in Toms River.

The linkage of cancer to tobacco smoking was a triumph of epidemiology that has been hard to replicate, according to Fagin. Noting that public-health investigators eventually showed that children in Toms River had an elevated rate of cancer, Fagin remains cautiously optimistic that epidemiology can produce worth-while results, which can guide prevention efforts.

But in a review of Fagin’s book for Slate, Johnson suggests that even the small surplus of cancer cases in Toms River might have resulted from chance. “Each year,” Johnson writes, “about 1.6 million cases of cancer are diagnosed in the United States, and epidemiologists regularly hear from people worried that their town has been plagued with an unusually large visitation. Time after time, the clusters have turned out to be statistical illusions—artifacts of chance.”

Even the famous Erin Brockovich incident has been “debunked,” Johnson says. “Hexavalent chromium in the water supply of a small California town was blamed for causing cancer, resulting in a $333 million legal settlement and a movie starring Julia Roberts. But an epidemiological study ultimately showed that the cancer rate was no greater than that of the general population. The rate was actually slightly less.”

In his 2013 book The Cancer Chronicles, Johnson depicts cancer as a consequence of entropy’s inexorable but unpredictable degradation of our extraordinarily complex genetic underpinnings. It is not surprising, he says, that attempts to link cancer to specific environmental factors have produced slim results.

Just last month, Johnson reported in The New York Times that there is little evidence that we can reduce our risk of cancer by eating certain foods and avoiding others.

“About all that can be said with any assurance,” Johnson writes, “is that controlling obesity is important, as it also is for heart disease, Type 2 diabetes, hypertension, stroke and other threats to life. Avoiding an excess of alcohol has clear benefits. But unless a person is seriously malnourished, the influence of specific foods is so weak that the signal is easily swamped by noise.”

Cancer has killed people I love at an early age, so I am as desperate as anyone for progress. Sometimes I feel like a jerk when I tell people how little progress we’ve made, especially after they tell me stories about loved ones who have triumphed over cancer. But if we are to have any chance of overcoming this terrible disease, we must face it squarely.

Illustrations: Reynold Spector and Skeptical Inquirer.

About the Author: Every week, hockey-playing science writer John Horgan takes a puckish, provocative look at breaking science. A teacher at Stevens Institute of Technology, Horgan is the author of four books, including The End of Science (Addison Wesley, 1996) and The End of War (McSweeney's, 2012). Follow on Twitter @Horganism.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. rshoff2 6:10 pm 05/21/2014

    It reminds me of astrophysics. A whole bunch of speculation that amounts to a hill of beans, practically speaking.

    Discoveries are good only when we do something productive with them!

    Link to this
  2. 2. SJCrum 7:39 pm 05/21/2014

    There were two very interesting, and also very hidden, items in this article, that I believe truthfully were not hidden intentionally by the author, but truly do reveal what is going on with cancer.
    The second one was in the graph that actually revealed how the drop in cigarette smoking caused a decrease in cancer, and only in the years after people started smoking less. The point of this is that cancer is caused, by one source of two, by inhaling the live virus that are still in tobacco after the drying process. The virus then enter the DNA atom structure inside living body cells, and that then causes tumor growth.
    Just for information, the second, and even greater cause of virus being able to get into body cells, is by eating raw broccoli.
    So, the graph was EXTREMELY REVEALING. By the way, chewing tobacco actually caused a young male in his twenties to have the entire lower jaw on one side of his face surgically removed. And all because the tobacco virus was in constant contact with his gums, and then it invaded the cells.
    The first item that was barely seen in the article was a wording that indicated CONTINUAL TREATMENT. Note the first word of “continual”. An article in another magazine stated that EXPERTS in the field of cancer have described cancer as being undeatable, and therefore a CHRONIC disease. Chronic means endless treatments.
    By the way, a truly interesting fact is that, you might note, POLIO is non-existent now. And, guess why that is? The reason is even in the 1950′s the experts new enough to kill the polio virus and then to make a vaccine with the dead virus in it. the point of this is that the body’s defense system takes the dead virus into the right cells and then bonds it to an open bond location in the DNA atom structure, and that bonding then makes it impossible for any invading living virus to bond there.
    The truth is that a SAME type of vaccine could be totally made to prevent all types of cancer also. But, what was intelligent science even in the 1950′s is totally not able to even be close to being done now.
    So, why do you think that is? Maybe it’s the 100 billion dollars in endless profit that would be lost. But, hey, that’s just a guess also, huh? DUH-UH!!!!!!!!!!!

    Link to this
  3. 3. Petra 8:18 pm 05/21/2014

    Progress in cancer like much else in medicine requires a proper diagnosis and amongst myself and my two best girlfriends all of us were told we didn’t have cancer when we did. Friend #1 died three years ago. Her doctor told her the abdominal pain she had was from being fat, yeah, it was the 25 pound tumor that caused the weight gain, so you get the picture.

    To say I’m hopping mad, you bet I am and just passing my 7th year anniversary of surviving cancer X’s 2 I’d like to fire the idiot doctors though I wonder how many more are out there.

    Come back when you’ve sorted through the malpractice cases.

    Link to this
  4. 4. RussDill 9:12 pm 05/21/2014

    I think the author shouldn’t be throwing so many bricks in his glass house. As death rates for things like heart disease, and automobile accidents drop, more and more people will live to get cancers. However, since the 1970, cancer mortality (per 100,000) rates for those under 20 have dropped 30%:

    http://www.nature.com/nrc/journal/v12/n11/fig_tab/nrc3370_F1.html

    Link to this
  5. 5. Jerzy v. 3.0. 5:01 am 05/22/2014

    @RussDill
    I wonder if rising occurence of cancer is only due to the drop of other mortality, or also increasing polution and chemicals in environment?

    Link to this
  6. 6. rshoff2 10:13 am 05/22/2014

    jerzy&russ, it addition to those things you and others mentioned, I notice that people are now dying as a result of their bodies being worn out by chemo, not by the cancer itself. Even years post chemo. I wonder how or if that fits into statistcs. They died prematyrely, but not of cancer.

    Link to this
  7. 7. rshoff2 10:14 am 05/22/2014

    prematurely

    Link to this
  8. 8. rshoff2 10:24 am 05/22/2014

    Instead of targeting our cancerous cells for destruction, perhaps we should own them get them back in line. Or support our bodies own anti cancer mechanisms.

    Link to this
  9. 9. SJCrum 4:23 pm 05/22/2014

    To Petra – To prevent a reocurrence of cancer don’t use tobacco or eat raw broccoli at all. Frozen or cooked broccoli is fine.

    Link to this
  10. 10. SJCrum 4:37 pm 05/22/2014

    A ROCK-SOLID proof that cancer is FACTUALLY caused by live virus entering human bodies is as follows.
    Note that the tumor growth is not only rapid, but it involves growing tumor cells that are EXTREMELY LARGE. the reason for the larger size is that when a virus is bonded to an open bond location of an atom in a cell’s atom structure DNA rung, and the body’s defense system cannot kill it, there is a unique reason as to why the growing tumor cells are HUGE.
    The reason is because the body’s cell growth process involves making a DUPLICATE of the existing cell. To do that it has duplicate the extremely powerful virus that is attached also. To do that it takes a far larger cell growth.
    So, WHY DOES THIS FACT PROVE VIRUS ARE INVOLVED? Because there is, for one thing, a HUGE thing that has invaded the original cell, and for another, that object is VERY POWERFUL. And, for a third, virus are the only thing that exists that can cause that situation, other than the also extreme energy in nuclear detonated neutrons that cause a very similar type of tumor growth also. Neutron tumors obviously are not caused by virus, but the similarity of the tumors proves the highly powered types of body cell invasion that virus can have.
    So, tumor SIZE factually proves cancer is caused by virus that get into body cells.

    Link to this
  11. 11. SJCrum 4:48 pm 05/22/2014

    To rshoof2 – As for chemo, the only purpose for it is to STOP all cell growth in a body. This includes cell growth of new cells, but the chemo is primarily to stop cancer cell growth so the tumor growth can be treated.
    What occurs with chemo is that the blood stream is so full of chemical atoms that it is impossible for the pancreas to find all of the four atom types that are needed to build the insulin strings that are later taken to new cell growth locations, and then are used inside the cells to build the inside DNA atom structure.
    So, that is all chemo does.
    As for people dying from the chemo, that doesn’t occur, but what does happen often is that the patients are so discouraged and worn out by all that is involved with the endless chemo and surgery that they just give up.
    Also, you can bet a zillion dollars, and win, with the almost certain fact that all of those people are also heavily smoking to calm their nerves and to cope with everything, or even to eat healthfully by consuming more of the assumed healthiness of broccoli. By the way, it is healthy, but not with living virus in it.
    So, that is why it appears that chemo might be killing them. It isn’t, chemo is just chemicals in the blood stream that block all cell growth.

    Link to this
  12. 12. SJCrum 4:53 pm 05/22/2014

    To rshoff2 – As far as helping our bodies to fight against cancer, the first item is to not use tobacco or eating raw broccoli, and that to help the body by not being overwhelmed by way too many virus inside the body. the body’s defense system can kill invading virus, but not endless “tons” of them.
    So, that is an enormously huge way to help our defense systems.

    Link to this
  13. 13. Mendrys 12:28 am 05/23/2014

    SJCrum,

    Can you provide any links to studies that have shown a correlation between eating raw broccoli and cancer? I don’t believe you and this type of trolling is pernicious as some gullible people out there may actually believe you.

    Link to this
  14. 14. LarryMoniz 12:42 am 05/23/2014

    As I wasn’t familiar with his byline, I was amazed that someone in the academic community would contradict a colleague. No wonder. Mr. Horgan is a colleague of mine — a fellow journalist. Admittedly, I’m older than he is and no longer on staff anywhere. But unlike some other career fields, being a reporter/writer is what we do, it’s who we are. I’m delighted to see Mr. Horgan tell it like it is. Good job.

    Larry Moniz, multiple award-winning journalist, author and publicist
    LARRYMONIZBOOKS@YAHOO.COM

    Link to this
  15. 15. SJCrum 6:53 pm 05/23/2014

    To Mendrys – Can you think of a reason WHY anyone would write something negative about what I have described since there hasn’t been any success AT ALL in the endless decades of cancer research? And, since even the chart in this article shows TOTALLY that cancer of one type had decreased ONLY after people started SMOKING LESS.

    Another item is that I have written MANY descriptions about how all cell disease occurs, and even why tumor growth is so HUGE and growing so FAST.

    The POINT is WHY are you so skeptically against my writings, and especially calling my writings TROLLING, WHEN the greatest experts in the supposed world have TOTALLY FAILED to even come up with ANYTHING at ALL?

    So, what is the exact opposite of trolling that you are involved in? What do you think that itty bitty reason might be? I might be the greatest genius in the world, and have just found a PHD-level of the greatest science discovery in the world, and you are trying to flush it down the toilet like wildfire.

    So, your accusations are based on what? Where is the real science to base your anti-trolling on? Or, (hee, hee), are you an anti-troll troll?

    By the way, would you like me to write your exact name right here, and include your social security number, and your great aunt’s name on your mother’s side? Gee whiz, I could even describe which agency that you work for. How about a start. Your name is James Franklin Pierce. Your social security number is 509-2863-4519. Your great aunt on your mother’s side is, well there are actually three, but hey, why not write all of their names to get the real point of ultra-wow here across. Ann, Grace and Lucille, and their last name was O’Reilly. And, for the last itty bitty item that you TRULY do NOT want me to write, as far as which agency you work for is something that my totally despicable self will refrain from doing. You NASA dork. Isn’t it fantastic how they use that totally concealed name? Yeah, just between my despicable self and YOU. We know, don’t we? Yeah well, be thankful that none of your great aunts wore bloomers of any type. As for that, no they didn’t. Hey, that’s a fact. And no, I didn’t peek.

    Link to this
  16. 16. NiceHorses 5:09 pm 05/24/2014

    @SJCrum:
    Asking for a study or even a lab test of raw broccoli naming any such virus is perfectly reasonable.
    Your rants and personal attacks on anyone who questions you are not, and seem pathological. I am sorry you are in discomfort, but surely you have some level of basic humanity that tells you your behaviour is not acceptable?

    Link to this
  17. 17. rshoff2 2:35 pm 05/25/2014

    We are all in this together. Good days, bad days, and any other day. Each of us are unique and identical at the same time. We are clones with unique perspectives, insights, abilities, and limitations. If there is any gift to being cog on the wheel, it’s that we have the opportunity to be self-aware and the fact that we are cogging along side each other. It joins us in truly amazing ways.

    I was in fact concerned about broccoli, as it is truly my favorite vegetable -after the tomato wars I always find myself questing what exactly a vegetable is! Thank you, I am now assured that it will continue at the top of the favorites list.

    As far as creative thinking, where would we be without it? The bell curve says it all. As far as defensiveness, it’s a trap that that I find myself in far too frequently, and it leads nowhere.

    Link to this

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