Taking on the Establishment

The standard mindset in treating cancer is to kill as many of the offending cells as possible with whatever artillery you can devise. Traditionally, the weaponry has comprised surgery, radiation, and chemotherapy, or, for the irreverent, “cuts, burns, and poisons.”

The military metaphor is intentional, as it conveys the all-out-assault, no compromise, take-no-prisoners attitude that has marked treatment for the last several decades. And besides, the first broadly effective anticancer drug (nitrogen mustard) was courtesy of gas warfare in WWI.

And now along comes Robert A. Gatenby from Florida’s Moffitt Cancer Center. His counsel? Forget conventional wisdom, don’t try to eliminate the tumor, treat it just enough to keep it from growing any bigger.

Gatenby makes the case in Nature ([May 28, 2009], 508–509). The basic argument is a comparison to controlling the invasion of exotic species in ecosystems. Examples include moths in a farmland or snails in a cityscape. Such pests are rarely eliminated, but they can be controlled in a way that doesn’t interfere with essential functioning.

Applying this lesson to cancer means the disease would not be cured, but neither would you die from it once treatment failed, as it inevitably does with most cancers.

The response of the cancer establishment is predictably skeptical, even hostile. I’m unconvinced myself, because even if drug resistance is skirted, the constant presence of a malignancy increases the equally deadly probability of metastasis to other sites.

But doubt should always be tempered by the wise observation of Arthur C. Clarke: “New ideas pass through three periods:

  1. It can’t be done.
  2. It probably can be done, but it’s not worth doing.
  3. I knew it was a good idea all along!

Posted In: History | Policy | Technology

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