Download Cancer Therapy

By Setareh Motezamen, Annete Sonnenburg, Greg Garner, Wyatt
Shosted, Jarred Taylor, Donny Harding, Sean Neilson
ARE WE WINNING THE WAR ON
CANCER
Cancer Facts
Cause of Death
No. of Deaths
% of All Deaths
1: Heart Diseases
631,636
26.0
2: Cancer
559,888
23.1
3:Cerebrovascular Disease
137,119
5.7
4: Chronic Lower
Respiratory Diseases
124,538
5.1
As of Late, cancer has become one of the leading causes of death in the United
States. It is second only to Heart diseases. According to studies done in 2006,
cancer was responsible for 559,888 deaths in the U.S. alone. It was 23.1 percent of
all deaths in the U.S., and it is above Influenza, Pneumonia, accidents, and
Cerebrovascular disease. It is obvious that we are not wining the war on cancer.
Methodological Issues
Detection bias #1
 Discovers a malignant tumor
early
And
Starts therapy immediately /even if
Therapy is unsuccessful.
This will appear that the patient will
live longer.
Than a second patient
With an (identical tumor) diagnosed
At a later stage
Will not appear to live as long as
patient #1
Detection bias #2
 Usually found with smaller
tumors
Especially in the Breast and Prostate
Otherwise would not harm the
patient
if left untreated
But
Can lead to unnecessary surgery and
sometimes mutilating therapies
Diagnose Response
 Partial Response
 Complete Response –No
 Median Survival –The
length
Common Therapy for
Cancer
 Surgery – Any surgery is dangerous;
combined with unqualified surgeons,
mistakes, complications.
 Chemotherapy – Nonspecific;
killing sensitive, normal cells especially
in the intestine and bone marrow.
 Radiation – Nonspecific; killing
sensitive, normal cells especially in the
intestine and bone marrow.
 All The Above – With no guarantee
cure, Usually life changing, associated
with a decrease in the quality of life.
War on Cancer
Are we winning?
 Pharmaceutical companies –Are
in it to make money even stating a
genuine concern for cancer cures, the
bottom line is where the real concern,
finds its truth.
 Doctors/Specialists –Necessary
for the industry but mostly driven by
the Pharmaceutical and Insurance
companies
 Therapy –With early detection some
therapy is acceptable, however
Insurance companies and government
need to place policies, making this
available and affordable to everyone.
Including early treatment facilities,
diagnostic testing, palliative care, non
evasive treatment.
Publication Bias
 Pharmaceutical
Industry
Nearly one-third of cancer studies had financial
conflicts of interest
Positive studies
(especially those funded
by pharmaceutical
companies)
Tend to be published
while
Negative studies do not
Figure 1. Percentage of published studies that reported
positive results. Open bars, no pharmaceutical industry
involvement; hatched bars, pharmaceutical industry
involvement; solid bars, pharmaceutical industry
authorship.
Cancer Therapy
Criteria for Utility of Cancer Therapy
(Fojo and Grady 2009, J. Nat’l Cancer Inst.)
1. Meaningful prolongation of life or cure
(mortality)
2. Improvement of quality of life (symptoms)
3. Value of treatment (compared to cost)
Treatments
 Surgical removal of
the tumor and cure
(preferred)
 Requires complete
removal
 Early detection
 Chemotherapy
(Chemical/Medication)
& Radiation Therapy
 Mild to devastating or
even fatal side effects
 Some metastatic
cancers cured; very
small percentage
 Few are turned into
chronic diseases that
require daily
treatment
Factors
 Early detection and diagnosis
 Benefits of screenings
 Examples (Breast Cancer and Prostate Cancer)
 Cost-benefit analysis results must be
reasonable
 Some treatments used exclusively to counter
symptoms from the disease
 Cost prohibitive for potential outcome?
Smart Drugs
Bevacizumab
Cancer
Evidence for Prolongation of
Life; time*
Bowel/Rectum
Yes, four months with other
drugs
Lung
No
Breast
No
Kidney
No
Brain
No
why has the war on Cancer failed
 Since President Nixon declared the war on cancer in
1975, more people are diagnosed with cancer every
year and more people are dying than ever before.
The percentage of people dying has remained
constant since the war on cancer began. Most
treatments (except surgery) are nonspecific cell
killers and not smart. The complex biological
processes that form this disease make finding a cure
a difficult challenge.
What should we do now

1. Prevention (cancer prevented)
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a: Stop smoking (lung; other)
b: Minimize hormone replacement therapy (breast)
c: Vaccines
1) Hepatitis B (liver)
2) Papilloma virus (cervical, anal, penis)
d: Eliminate Helicobacter with antibiotics (stomach)
e: Prevent contracting AIDS (sarcoma)
f: Chemoprophylaxis
3) finasteride (prostate)
4) tamoxifen (high risk breast)
g: Decrease alcohol (liver, esophagus)
h: Decrease obesity (many types)
2. Screening for
a. Cervical cancer
b. Colorectal cancer
c. Breast cancer
3. More knowledge of cancers' causes and better animal models
4. Better drugs-once appropriate targets identified
References
 http://www.ehow.com/about_5656786_cance
r-hard-treat-cure_.html#ixzz2YCL95Vk7
 http://www.ehow.com/about_5656786_cance
r-hard-treat-cure_.html#ixzz2YCObcgAh
 Rethinking the War on Cancer, Bailar, John,
Issues in Science and Technology, National
Academy of Science.
http://www.issues.org/19.4/updated/bailar.ht
ml Accessed 7.31.08