Much has transpired in the 40 years since President Richard Nixon announced that finding a cure for cancer would be one of his administration’s top priorities. World leaders, wars, and technologies have flared and faded; nations have changed their names and borders; and one can access nearly every corner of the world with a modem and a mouse. Yet a cure for cancer continues to elude us.
It was January 22, 1971, when Nixon stood before Congress and delivered the historic State of the Union Address in which he said, “The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease. ” That evening, Nixon pledged more than $100 million toward the campaign to eradicate cancer and called for a “total national commitment. ”
In his speech, Nixon never uttered the phrase War on Cancer, nor did this now-iconic phrase appear in the National Cancer Act of 1971, which Nixon would sign before the year was out. Yet it was clear that battle lines were being drawn. At the signing ceremony, Nixon called the Act “the most significant action taken during this administration.” He also invoked the specter of war, noting that “more people each year die of cancer in the United States than all the Americans who lost their lives in World War II.”
Congress also invoked combative terminology when discussing cancer. Both bodies unanimously passed resolutions that described “the conquest of cancer [as] a national crusade to be accomplished by 1976”—a year selected not because anyone believed the deadly foe could be vanquished so quickly but because it coincided with the 200th anniversary of the Declaration of Independence.
Forty years later, cancer continues to take prisoners and rack up casualties, but does this mean that the war has been lost? Leading voices in the oncology community share their views on where we stand in the War on Cancer and where they believe we are headed.Otis W. Brawley, MD
Chief Medical Officer
American Cancer Society
Hematology, Oncology, Medicine, and Epidemiology
Atlanta, GeorgiaDr Brawley is a global leader in the field of health disparities research. He has advised the FDA, the National Institutes of Health, the US Surgeon General, and the Centers for Disease Control and Prevention, and served as assistant director for the National Cancer Institute.
We have had dramatic declines in mortality from a number of cancers. The risk of death from colorectal, lung, and breast cancer has declined more than 30% since the early 1990s. We should be pleased with this progress but not satisfied, as we can do better.
The future will focus on development of better ways to prevent cancer and better screening technologies. A greater emphasis is being placed on developing predictors of the biologic behavior of cancer. It has become clear that there are some tumors that can be diagnosed today that fulfill our traditional microscopic definition of malignancy, but these cancers are not genetically programmed to spread and cause harm. The field of genomics offers great promise for this. This is the ability to assess the genetic makeup of a tumor and determine its future biologic behavior. There will soon be a day in which we will screen and diagnose a man with prostate cancer or a woman with breast cancer and tell them that it is the kind of cancer we should watch and not the kind that we should treat.Kathryn Kolibaba, MD
Northwest Cancer Specialists
Affiliate of the United Network of US Oncology
Vancouver, WashingtonDr Kolibaba has been a practicing oncologist/ hematologist for more than 15 years. She sees patients at the Vancouver Cancer Center and is a well-known specialist in blood cancers.
Funding of cancer research and advances in molecular biology have resulted in continuous progress in the War on Cancer. Unraveling the complexities and understanding the aberrations in cancer cells in the first 25 years of the “War” has produced a growing armamentarium of targeted therapies today. Recognizing biologically distinct subtypes of disease has led to long-term control and/or cure of previously rapidly fatal malignancies. Herceptin and imatinib are shining stars in the crown of such progress. The key to future progress and therapeutic success will be not only identifying subpopulations of cancer types driven by particular “druggable” pathways, but targeting cancer stem cells. Drug development will continue to be more difficult, with a need to identify relevant small patient populations to develop targeted agents. Further progress will also require the development of inexpensive, rapid tests to identify the “target of vulnerability” in each person’s cancer cells, matching the right drug to the individual cancer.Nicholas Vogelzang, MD
Chair and Medical Director
Developmental Therapeutics Committee
US Oncology Research Medical Oncologist
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada