If you do not get cancer, you are not going to die from it…

AICR, Cancer Prevention: Putting it Together

The estimate of the American Cancer Society is that in 2015, 312,150 men and 277,280 women in the U.S. will die from cancer. This death toll is equivalent to that resulting from three 747s airplanes crashing DAILY.  If this hypothetical flight tragedy were to take place every day, and we knew how to prevent up to 75% of the passenger deaths, do you think that we would not have acted immediately?  And yet, despite the fact that we know how to prevent up to 75% of all cancers from occurring, we, as a society, do not act upon our knowledge.  By not implementing cancer prevention, we consciously fail more than 1,000 people every day.

What is cancer prevention? It means blocking or eliminating the factors that cause the disease, or detecting the disease before it becomes incurable. It has been estimated that we can prevent up to 75% of all cancers with what we know today. Therefore, even without further advancement in cancer research, we could have a major control over the disease. Why are we not doing it?
 

One answer comes from the recent PBS documentary“The Emperor of All Maladies”.  At approximately minute 41 in part three, Dr. Robert Weinberg, one of the most prominent cancer researchers today, states that although prevention is one of the most powerful approaches against cancer, researchers like him tend to disregard prevention because it is not “intellectually stimulating and exciting.” Further, he explains: “Persuading somebody to quit smoking is ultimately a behavioral, a psychological exercise, has nothing to do with molecules and genes and cells. And so people like me are essentially uninterested in it, in spite of the fact that stopping people smoking will have vastly more effect on cancer mortality than anything I could hope to do in my own lifetime.”

In addition to not being “intellectually stimulating,” cancer prevention is not financially stimulating.  Dr. Vogelstein and his colleagues think that: “The reasons that society invests so much more in research on cures for advanced cancers than on prevention or early detection are complex. Economic issues play a part: New drugs are far more lucrative for industry than new tests, and large individual costs for treating patients with advanced disease have become acceptable, even in developing countries. “We should applaud the courage of these cancer researchers, who finally named one of the major reasons for the lack of cancer prevention: lack of profit.  


Profit and myopic focus on cure rather than prevention dictate the effort of most U.S. cancer researchers, the pharmaceutical industry, the government-supported National Cancer Institute, and even national “non-profit” organizations that many of us support, such as the American Cancer Society (ACS) and the American Association for Cancer Research (AACR).  The small fraction of their budgets dedicated to prevention proves that cancer prevention is the “unwanted child” of these organizations. In 2015, AACR cancelled their annual “International Conference on Frontiers in Cancer Prevention Research.” I suspect that the attendance became so low in the past few years that it makes no sense to organize this meeting on an annual basis. According to ACS, approximately 13.6% of its budget in 2012 went for cancer prevention information and education; meanwhile, 26% went for supporting the functions of the organization. Even our taxpayer/government-supported National Institutes of Health do not emphasize cancer prevention.

The only prominent U.S. organization that still takes the war on cancer seriously is the American Institute for Cancer Research (AICR), with 100% of its effort dedicated to prevention.  AICR (in partnership with the World Cancer Research Fund International) is one of the few world organizations that consistently reach out to the population with recommendations on cancer prevention.

If the structure of our society is geared toward treatment rather than prevention, and yet, only prevention could make a major difference, what should we do? Should we start a relentless campaign on educating everyone about healthy lifestyles? Should the government and the health insurance companies offer incentives for cancer prevention adherence or impose disincentives for non-compliance? What is the right direction?