Yale University School of Medicine neurologist Steven Novella, the editor of the Scientific Review of Alternative Medicine, provides this insightful NeuroLogica post that addresses the issue of why medical research has not discovered a cure for cancer despite the enormous resources dedicated to cancer research. In so doing, he clears up several common misconceptions about cancer and the incentives involved in finding a cure. He concludes as follows:
The overall reality is that the standard of scientific medicine is not a monolithic entity, controlled by any one institution, agency, or industry. It is a complex and dynamic set of many forces and interests. It is ultimately driven by science, which is a transparent and public process, and prevents any big brother type of control (this is partly why it is so important that healthcare be based upon science).
Cancer is a very difficult type of disease to treat, and the public has a very distorted view of the nature of cancer and of medical scientific progress in general. This has lead to unrealistic expectations of progress in curing cancer, which then in turn leads to thoughts that cancer research is somehow not working.
I find the same to be true in medicine in general ñ the public thinks of scientific progress in terms of dramatic ìbreakthroughs.î Media hype feeds this misconception. The reality is that medical scientific progress is largely a series of very small steps, with a cumulative effect of slow steady improvement in treatments. We have not cured Alzheimerís disease, ALS, Multiple Sclerosis Parkinsonís disease, and many other diseases as well. But treatments are slowly improving. Slow steady progress does not make good headlines, however, so the myth of miracle medical breakthroughs will likely continue to be promoted by the media.
Read the entire post. Hat tip to Sandy Szwarc.
*Groan*
Don’t even get me started on the search for “magic bullets.” Cancer is actually about 150 different diseases, many of which differ dramatically in mechanisms, pathways, and pathology. Aside from the media and the public, scientists and physicians also bear some responsibility for creating the expectation of such magic bullets, which has contributed to the disastrous focus in U.S. health care in curative as opposed to preventative medicine. Gostin et al. cite recent funding estimates which indicates a ratio of 95% of health care dollars allocated to acute care with about 5% going to public health and prevention.
This is deleterious given that a compelling argument could be made that public health and preventative medicine are likely to have a far greater effect on aggregate mortality than will so-called rescue medicine.
I’m not suggesting we should stop looking for cures, but I do think we need to strongly consider altering the proportion of funds we allocate to curative vs. preventative medicine and public health.