Sunday, October 6, 2019

The First Cells

I rarely write about positive events in mainstream medicine but the Wall Street Journal's Review section recently featured a great front-page essay from a new book titled The First Cell and the Human Costs of Pursuing Cancer to the Last.  You may have been impressed with all of the decreases in cancer rates since 1990 but the reality is that we've simply returned them to where they were in the 1930's, before the growth of cigarettes (and I would add processed foods).  Today the newest methods to treat cancer that are generating the most research and expense tend to be focused on treating the worst cases -  chasing after the last cancer cells in end-stage patients.

The book, to be published October 15th, calls for a paradigm shift.  We need to focus instead on the first cancer cells to prevent the growth of the disease in healthy patients.  (What a concept!)  This prevention would be the cheapest, fastest and safest alternative to the current treatment protocols of "slash, poison and burn."  Cancer is much too complex to be solved with simple reductionism that tries to match each cancer with the proper drug which is why 95% of new cancer drugs fail to receive FDA approval and the other 5% barely deserve it.

The last paragraph of the essay sums it up:  "What's missing from today's discussion of cancer is the admission that current strategies have failed and we need to take a 180-degree turn.  We now invest a lot of effort into finding minimal residual disease.  Why not apply the same rigor and focus to finding minimal initial disease?  Cancer research has been promising hope and delivering disappointments for a half-century.  Instead of letting cancer grow into its end-stage monstrosity, let us assemble our resources to pre-empt that battle and strike instead at cancer's root: the first cells."

Maybe there is hope in mainstream medicine if more doctors accept the reality ot medicine today.  After all, this proposed attitude shift sounds a lot like what's been done by complementary and alternative medicine for hundreds, even thousands, of years.

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