I found this article in Scientific American, a sort of status report on the War on Cancer, interesting:
Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media. The costs of cancer care have surged 40 percent in the last decade, from $125 billion in 2010 to $175 billion in 2020 (projected).
Research funding has also surged. The budget of the National Cancer Institute, a federal agency founded in 1937, now totals over $6 billion/year. That is a fraction of the total spent on research by nonprofit foundations ($6 billion a year, according to 2019 study), private firms and other government agencies. Total research spending since Richard Nixon declared a “war on cancer†in 1971 exceeds a quarter trillion dollars, according to a 2016 estimate.
Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress†and millions of “cancer deaths averted,†as the homepage of the American Cancer Society, a nonprofit that receives money from biomedical firms, puts it. A 2016 study found that cancer experts and the media often describe new treatments with terms such as “breakthrough,†“game changer,†“miracle,†“cure,†“home run,†“revolutionary,†“transformative,†“life saver,†“groundbreaking†and “marvel.â€
There are more than 1,200 accredited cancer centers in the U.S. They spent $173 million on television and magazine ads directed at the public in 2014, according to a 2018 study, and 43 of the 48 top spenders “deceptively promot[ed] atypical patient experiences through the use of powerful testimonials.†A 2014 study concluded that cancer centers “frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability.â€
Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media. The costs of cancer care have surged 40 percent in the last decade, from $125 billion in 2010 to $175 billion in 2020 (projected).
Research funding has also surged. The budget of the National Cancer Institute, a federal agency founded in 1937, now totals over $6 billion/year. That is a fraction of the total spent on research by nonprofit foundations ($6 billion a year, according to 2019 study), private firms and other government agencies. Total research spending since Richard Nixon declared a “war on cancer†in 1971 exceeds a quarter trillion dollars, according to a 2016 estimate.
Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress†and millions of “cancer deaths averted,†as the homepage of the American Cancer Society, a nonprofit that receives money from biomedical firms, puts it. A 2016 study found that cancer experts and the media often describe new treatments with terms such as “breakthrough,†“game changer,†“miracle,†“cure,†“home run,†“revolutionary,†“transformative,†“life saver,†“groundbreaking†and “marvel.â€
There are more than 1,200 accredited cancer centers in the U.S. They spent $173 million on television and magazine ads directed at the public in 2014, according to a 2018 study, and 43 of the 48 top spenders “deceptively promot[ed] atypical patient experiences through the use of powerful testimonials.†A 2014 study concluded that cancer centers “frequently promote cancer therapy with emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, costs, or insurance availability.â€
Cancer has spawned a huge industrial complex involving government agencies, pharmaceutical and biomedical firms, hospitals and clinics, universities, professional societies, nonprofit foundations and media. The costs of cancer care have surged 40 percent in the last decade, from $125 billion in 2010 to $175 billion in 2020 (projected).
Research funding has also surged. The budget of the National Cancer Institute, a federal agency founded in 1937, now totals over $6 billion/year. That is a fraction of the total spent on research by nonprofit foundations ($6 billion a year, according to 2019 study), private firms and other government agencies. Total research spending since Richard Nixon declared a “war on cancer†in 1971 exceeds a quarter trillion dollars, according to a 2016 estimate.
Cancer-industry boosters claim that investments in research, testing and treatment have led to “incredible progress†and millions of “cancer deaths averted,†as the homepage of the American Cancer Society, a nonprofit that receives money from biomedical firms, puts it. A 2016 study found that cancer experts and the media often describe new treatments with terms such as “breakthrough,†“game changer,†“miracle,†“cure,†“home run,†“revolutionary,†“transformative,†“life saver,†“groundbreaking†and “marvel.â€
What’s the reality behind the hype? “No one is winning the war on cancer,†Azra Raza, an oncologist at Columbia, asserts in her 2019 book The First Cell: And the Costs of Pursuing Cancer to the Last. Claims of progress are “mostly hype, the same rhetoric from the same self-important voices for the past half century.†Trials have yielded improved treatments for childhood cancers and specific cancers of the blood, bone-marrow and lymph systems, Raza notes. But these successes, which involve uncommon cancers, are exceptions among a “litany of failures.â€
The article continues with a discussion of mortality rates. IMO a fair report would say that the results are mixed. Some effective treatments have been developed for some cancers. The progress on other cancers is negligible.
I guess what you think of the results of the “war on cancer” depends on your own experiences. If you, your child, your spouse, or your parent are alive today because of it, you probably think it was worth every penny. The answer is likely the same if you’re a medical professional.
As a pathologist buddy of mine puts it, everybody dies of something. The older you get, the more likely it is to be cancer. I think there should be more consideration of what constitutes a good death rather than in simply prolonging life. There are hard deaths and easy deaths and cancer can be a very hard death. Maybe that’s just me.
I wasn’t really sure what the purpose of the piece was. There are all sorts of possibilities including battlespace preparation for a prospective national debate over “Medicare for All”.
I read it as advocating a less invasive, “first, do no harm” approach to cancer care based on hard facts and much less hype and marble tile for the executive suite. I concur and decided that when the inevitable occurs opt for a morphine drip than yet another go round of potions, glossy ads from cancer centers and watching those I care about get drained.
I hold an even harsher view. I don’t think that Medicare (whether the current variety or a putative “for all”) should cover measures beyond palliative care at end of life for the elderly. No heroic measures.
What would happen to the candidate/party who advocated that cause?
Hmm, would that apply to my recent visit from the old man’s friend, pneumonia? One ER visit, two office visits, two shots, hand full of pills at a tax payer cost of about $9.8K. Much better now. Then I recall a cat with a brain tumor who I had euthanized never he lost his ability to walk and eat, a dog with a spinal cord GSW, also euthanized. Neither had a life ahead of anything but pain and misery.
I don’t know how you felt, (glad you’re better), but when I had pneumonia I literally didn’t care. I was that exhausted. Just wanted to sleep.
I’m glad you’re better as well. To answer your question bluntly I would say antibiotics and office visits—yes; ER visit—it depends but probably; lung or heart transplants—no.
My sense is that the guy is looking at our ROI on the bevy of new cancer drugs. They have gotten very expensive over $100, for treatment, but they offer little help.Often extending life for only a month, but a really crappy month with fatigue, pain and vomiting.
“There are hard deaths and easy deaths and cancer can be a very hard death. Maybe that’s just me.” “No heroic measures.”
What I think a lot of us believe is that we are often just prolonging death. So often people have not talked over what they want then we end up calling the 88 year old brother of some 90 year old woman at 2:00 in the morning and asking them what they want done. This always goes really well. It usually ends up with the brother saying “We never talked and I dont know what she wanted so just do everything.”
Just os you know, heroic measures are hard to define. We track in this in our network but it has been hard to find agreed upon metrics. That said we have not renewed contracts for several physicians who we thought were engaging in too many heroic procedures. Of note these folks seem to be split between those who were doing it for money and those who were true believers. God gave them their doctor skills so that they could try to save lives no one else would even attempt. They are correct. The rest of us tell the family there is no way to help and offer comfort care.
Steve