Slash and Burn and Poison????

In my travels across the country over the past 20 years or so, one of the most common questions I got was "where's the progress?"  Or "are we really making any progress?".  After all, people often said to me "it's 50 years later and were still slashing and burning and poisoning", meaning that we are still using surgery, radiation and chemotherapy as the basic modalities of our therapeutic armamentarium.

Since I am not a physician, and therefore do not treat patients directly, I rarely talked to people about absolute specifics of various therapeutics and treatments. However when confronted with the "slashing, burning and poisoning" comment here is the answer that I often used.

Take a look at the two photographs that I have included in this post.  In the photos you will see two cars.  One of them is the 1908 model T Ford - you know the one that Henry Ford said that "you can have in any colour you want - as long as it's black" :). The other is a somewhat more modern version of a Ford GT sports car.  (Disclaimer: I do not own a Ford, and do not have any interest in Ford, but am merely using these pictures for the purposes of illustration.)

Look at the two pictures and ask yourself, "where's the progress?".  No one would have the slightest hesitation in noting the incredible progress that has been made since the very first automobiles were introduced compared to the state of the art today.

And yet, both of these cars still use a version of an internal combustion engine, they both still roll on four rubber tires, and they both still have a mechanical steering device called a steering wheel by which you navigate them.

Where's the progress indeed?

The point is, of course, that just because both cars have engines built upon the same fundamentals, or rubber tires or round steering wheels, we should not be fooled, even for one millisecond, into thinking that there has been no progress. 

So it is with cancer therapeutics.  Just because we are still using surgery, radiation therapy and chemotherapy does not in any way mean that we're still doing things the same way we did 20 or 30 years ago – or for that matter even 5 or 10 years ago!  The advances that research has given us in surgical and radiation techniques are nothing short of remarkable, as we develop and employ more and more precision including laser-guided and computer-guided enhancements.

Research means that chemotherapy of today does not, and certainly chemotherapy of the future will not, resemble the chemotherapy that one had to endure in years past, as we develop more and more selective and more and more targeted therapeutics that attack the cancer cells and leave normal cells alone.

In subsequent posts, I will give you some examples of how we are getting more and more selective and therefore more and more effective in our treatments.  Research has led the way for us to use surgery radiation and chemotherapy in brand-new ways with much better effects and far fewer side effects.

The days of "slashing and burning and poisoning" are done…