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The war on cancer: a review
1Department of Pharmacology, Dartmouth Medical School, Hanover, New Hampshire 03755, USA.
Annals of the New York Academy of Sciences
|June 9, 1998
Summary
The "war on cancer" has seen successes in childhood cancers but struggles with adult epithelial cancers. Advances in molecular oncology have not significantly reduced mortality, highlighting the need for better prevention and early detection strategies.
Area of Science:
- Oncology
- Cancer Research
- Public Health
Background:
- The United States declared a
- war on cancer
- 25 years ago, initiating extensive research and treatment efforts.
- Despite significant progress in certain pediatric cancers and specific adult malignancies, overall cancer mortality rates remain a critical public health concern.
Purpose of the Study:
- To review the progress and challenges of the
- war on cancer
- over the past 25 years.
- To identify key factors contributing to the limited impact of molecular oncology advances on adult cancer mortality.
Main Methods:
- This is a personal commentary and review of historical cancer research and public health initiatives.
- Analysis of cancer treatment successes and failures, focusing on the disparity between pediatric and adult epithelial cancers.
Main Results:
- Notable successes include the improved cure rates for acute lymphocytic leukemia, other childhood cancers, Hodgkin's disease, and testicular cancer.
- Substantial advances in molecular oncology have not yet translated into significant reductions in mortality for common adult epithelial cancers.
- Lethality is primarily driven by local invasion and distant metastasis, not solely by cell proliferation.
Conclusions:
- The focus on curing advanced disease and the neglect of prevention and early intervention, including preneoplastic lesions, may have hindered progress.
- A shift in strategy towards prevention, early detection, and targeting metastasis is crucial for achieving greater success in the fight against cancer.