Against cancer: in search of a cure that has not just arrived
Today, cancer remains the most feared disease ahead of heart attacks, AIDS or Alzheimer’s. During the last decade, advances in cancer biology have led to a better understanding of this complex set of diseases.
However, these advances do not just reach hospitals, they do not translate into more effective drugs, nor do they help us to develop new and better treatments. Why does it always seem like we’re about to find the cancer cure and never get it?
A cure that never comes
From time to time a study appears to have made a giant leap in the cure of a certain type of cancer. But time passes and the successes we get in basic research have many difficulties to become treatments.
It is true that this, to a greater or lesser extent, occurs in all diseases, but failure rates in cancer research are well above average. In 2011, Lisa Hutchinson and Rebecca Kirk discovered that only 5% of all drugs that had proven their effectiveness in preclinical phases came on the market. In the case of cardiovascular or neurological diseases the rate is 20%.
As a result, Hutchinson and Kirk argued that basic research strategies were not working. We were failing to identify real opportunities in which to focus our resources. And that means that for each new cancer treatment we need four times more staff, four times more resources and four times more time than to develop a cardiovascular treatment.
The crisis of science comes to medicine
They were not misled. Also in 2011, Bayer Healthcare announced that its scientists could only replicate 25% of the latest findings on cancer biology. And the following year, another pharmacist, Amgen, announced that they could only reproduce 11%.
Pharmacists were pointing to a problem that only they were in a position to identify. After all, they are almost the only ones who try to repeat the experiments to try to develop therapeutic approaches.
The alarms went off. Was it possible that a good part of all the advances of the last decades were wrong? Was that the real reason why we only got that 5% clinical success? How had no one noticed before?
As you can see, they were questions that filled the waterline of the cancer research community. And to answer them was created the Reproducibility Project: Cancer Biology (RP: CB), a project oriented to review the most important discoveries of the last years.
A few weeks ago, we talked about this problem and that the first results of RP: CB were not good: only two of the first five studies reviewed had been replicable.
Are we shaking hands?
You can not say that. The data clearly show that we are moving forward. Yes, half of men and one third of women will have cancer throughout their lives and remains the fifth leading cause of death globally, but even so, cancer mortality declines at a rate of 1.3% per year .
The genetic, diagnostic and therapeutic advances that have come to clinics and hospitals have been an impressive step forward. The awaited cure has not arrived, but we have made great strides.
To perceive this change, it is sufficient to see what the Swedish novelist Henning Mankell wrote a couple of years ago about the disease:
“I am a son of the 1940s and I believe that all of my generation automatically associate cancer with death. Although I know, like the others, that the studies that have been done on cancer have advanced incredibly in recent 50 years and that cancer is not synonymous with an inevitable end, no doubt the old belief remains somewhere inside me ”
That old belief is, in fact, another of the great fields of research that we did not address in our review last year: behavioral medicine, psychological support and public policies against stigma and in favor of standardization.
And is that although we are sometimes unaware of it and tend to focus only on the medical side, the mere fact of having cancer carries a very hard emotional, social and occupational stigma. A stigma that the lives of patients change completely and their quality of life suffers. Above all, how people react to their environment.
So, When will we have the cancer cure?
All this does not mean that we are doing it wrong, it means we have to do it better. The fight against cancer is a long, complex and little photogenic process. The focus of the press and the continuous news about how close we are to getting their cure, even if they arise precisely from the desire we have for it to be, only manage to generate false expectations and make noise in a field of research quite upset.
Above all, because if we look at cancer research rigorously, we have to recognize that we are not close to curing cancer. But we are close to getting it to become a chronic and incurable disease, but not mortal. Or at least we are willing to try.