ARE WE WINNING THE WAR ON CANCER

By Setareh Motezamen, Annete Sonnenburg, Greg Garner, Wyatt Shosted, Jarred Taylor, Donny Harding, Sean Neilson

Cancer Facts

As of Late, cancer has become one of the leading causes of death in the United States. It is second only to Heart diseases. According to studies done in 2006, cancer was responsible for 559,888 deaths in the U.S. alone. It was 23.1 percent of all deaths in the U.S., and it is above Influenza, Pneumonia, accidents, and Cerebrovascular disease. It is obvious that we are not wining the war on cancer.

Cause of Death No. of Deaths % of All Deaths

1: Heart Diseases 631,636 26.0

2: Cancer 559,888 23.1

3:Cerebrovascular Disease

137,119 5.7

4: Chronic Lower Respiratory Diseases

124,538 5.1

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=EfWReFsL9V4v2M&tbnid=vFKuOmKUogPT_M:&ved=0CAUQjRw&url=http://science.psu.edu/news-and-events/2012-news/Wang5-2012&ei=Vw_cUfvAOOaVyAGrsICwBA&bvm=bv.48705608,d.aWc&psig=AFQjCNHkA2MKlehs6zGYBXyldrnsABDNTA&ust=1373462644899202

Detection bias #1 Discovers a malignant tumor

early And

Starts therapy immediately /even ifTherapy is unsuccessful.

This will appear that the patient will live longer.

Than a second patient With an (identical tumor) diagnosed

At a later stageWill not appear to live as long as

patient #1

Usually found with smaller tumors

Especially in the Breast and Prostate

Otherwise would not harm the patient

if left untreatedBut

Can lead to unnecessary surgery and sometimes mutilating therapies

Detection bias #2

Methodological Issues

Surgery – Any surgery is dangerous; combined with unqualified surgeons, mistakes, complications.

Chemotherapy – Nonspecific; killing sensitive, normal cells especially in the intestine and bone marrow.

Radiation – Nonspecific; killing sensitive, normal cells especially in the intestine and bone marrow.

All The Above – With no guarantee cure, Usually life changing, associated with a decrease in the quality of life.

Common Therapy for Cancer

Partial Response Complete Response –

No Median Survival –The

length

Diagnose Response

Pharmaceutical companies –Are in it to make money even stating a genuine concern for cancer cures, the bottom line is where the real concern, finds its truth.

Doctors/Specialists –Necessary for the industry but mostly driven by the Pharmaceutical and Insurance companies

Therapy –With early detection some therapy is acceptable, however Insurance companies and government need to place policies, making this available and affordable to everyone. Including early treatment facilities, diagnostic testing, palliative care, non evasive treatment.

War on CancerAre we winning?

Publication Bias Pharmaceutical

IndustryPositive studies

(especially those funded

by pharmaceutical companies)

Tend to be published

while

Negative studies do not Figure 1. Percentage of published studies that

reported positive results. Open bars, no pharmaceutical industry involvement; hatched bars, pharmaceutical industry involvement; solid bars, pharmaceutical industry authorship.

Nearly one-third of cancer studies had financial conflicts of interest

Cancer TherapyCriteria for Utility of Cancer

Therapy(Fojo and Grady 2009, J. Nat’l Cancer

Inst.)

1. Meaningful prolongation of life or cure (mortality)

2. Improvement of quality of life (symptoms)

3. Value of treatment (compared to cost)

Treatments Surgical removal of

the tumor and cure (preferred) Requires complete

removal Early detection

Chemotherapy (Chemical/Medication) & Radiation Therapy Mild to devastating or

even fatal side effects Some metastatic

cancers cured; very small percentage

Few are turned into chronic diseases that require daily treatment

Early detection and diagnosis Benefits of screenings Examples (Breast Cancer and Prostate

Cancer) Cost-benefit analysis results must be

reasonable Some treatments used exclusively to

counter symptoms from the disease Cost prohibitive for potential outcome?

Factors

Smart Drugs

Bevacizumab

CancerEvidence for

Prolongation of Life; time*

Bowel/Rectum Yes, four months with other drugs

Lung No

Breast No

Kidney No

Brain No

why has the war on Cancer failed Since President Nixon declared the war on

cancer in 1975, more people are diagnosed with cancer every year and more people are dying than ever before. The percentage of people dying has remained constant since the war on cancer began. Most treatments (except surgery) are nonspecific cell killers and not smart. The complex biological processes that form this disease make finding a cure a difficult challenge.

What should we do now 1. Prevention (cancer prevented) a: Stop smoking (lung; other) b: Minimize hormone replacement therapy (breast) c: Vaccines 1) Hepatitis B (liver) 2) Papilloma virus (cervical, anal, penis) d: Eliminate Helicobacter with antibiotics (stomach) e: Prevent contracting AIDS (sarcoma) f: Chemoprophylaxis 3) finasteride (prostate) 4) tamoxifen (high risk breast) g: Decrease alcohol (liver, esophagus) h: Decrease obesity (many types) 2. Screening for a. Cervical cancer b. Colorectal cancer c. Breast cancer 3. More knowledge of cancers' causes and better animal models 4. Better drugs-once appropriate targets identified

References http://www.ehow.com/

about_5656786_cancer-hard-treat-cure_.html#ixzz2YCL95Vk7

http://www.ehow.com/about_5656786_cancer-hard-treat-cure_.html#ixzz2YCObcgAh

Rethinking the War on Cancer, Bailar, John, Issues in Science and Technology, National Academy of Science. http://www.issues.org/19.4/updated/bailar.html Accessed 7.31.08