The Not So Modern Stigma Of Cancer Research: A Scientists View Point

The Stigma Of Cancer Research Discussed By Dr Flávia OliveiraOne of several things that impressed me when I started working in cancer research was the fact that there were still some people who would raise an eyebrow when I answered the question “what do you do?”

Though most people are supportive and even enthusiastic about cancer research, there remains a small minority who obstinately upholds the idea – generally through doubtful websites or social media posts – that cancer research is just one big lie.

The “Cancer Conspiracy”

Probably every single person who has ever heard of cancer has heard of a “cancer conspiracy” at one time or another. Cancer has been known to humankind at least since 1600 B.C., the date of the oldest written cancer records1, and has probably affected humans since their origin. This is unsurprising, as cancer affects non-human animals too – you could say that where there are cells (or at least, where there is a multicellular organism), there is an implied possibility for there to be cancer. In other words, as a disease of the genome, cancer is a potential side-effect of biological existence itself.

Cancer Research Is Relatively Young

Cancer research is much younger than cancer itself. We have certainly come a long way since the time of Hippocrates, who proposed cancer was caused by an imbalance of bodily fluids1. But modern cancer research didn’t begin until after DNA was discovered, which propelled understanding of how genes work – and of what happens when they don’t work correctly.

It was only in the 1970s that scientists traced cancer’s origins to the malfunction of two different kinds of genes. One of these are oncogenes, which, when uncontrolled,  promote excessive cell growth and division. The second group is that of tumour suppressor genes, which normally control and regulate cell division. If oncogenes are overly active and tumour suppressor genes are not active enough, the result is an uncontrolled cell division that eventually results in cancer. There are several processes which cause these oncogenes and tumour suppressor genes to become defective – including damage caused by various substances (carcinogens, like cigarette smoke), or changing the way the cell divides (some viruses do this). But regardless of the trigger, it is now a widely accepted fact that cancer starts with a fault at the DNA level2.

Cancer Is Becoming More Common

Cancer research generates more knowledge with each passing year3, which in turns drives more research – and this is good, as cancer is becoming increasingly common. There are likely to be several reasons for this, but one explanation is relatively simple: there are more people in the world than ever before and, generally speaking, humans are living longer – more cells over more time simply equals more combined cancer risk. Cancer detection tools are also becoming better, which means the apparent increase in the incidence of some cancers, like thyroid cancer, reflects in fact not a greater number of cases but better diagnostic methods.  The mounting volume of information on cancer biology, combined with the escalating incidence of the disease, easily explains why cancer is such a major topic of current research – we are both getting better at it and continually in greater need of this knowledge.

Cancer Research Has Produced New TherapiesCancer Research Is hard work

The scientific community’s collective efforts to delve into how cancer forms and develops has been rewarded with new therapeutic approaches, which has given us a standing ground on the war on cancer – a diagnosis that for most cancer types no longer automatically equates to a death sentence. It’s slow work, and we’re certainly in for yet more work before we come closer to treatments that perform as well as we wish them to. But there have definitely been advances, as you may hear if you ask those who, after being prescribed medicines such as trastuzumab (to treat a subset of breast cancer), imatinib (to treat some forms of leukaemia and gastrointestinal stromal tumours) or abiraterone (to treat advanced prostate cancer), have lived to see their daughter graduating, or their son getting married, or to meet their grandchildren, when a couple of decades ago they would have had no such hope.

Is The “War On Cancer” A Fraud?

While cancer researchers obtain more information on cancer and help design better treatments, there are those who continue to call this ‘war on cancer’ a “fraud”. This is largely based on supposed quotes from notable scientists that turn out not to be real, and on claims that medical regulators have been suppressing “alternative cancer treatments that could cure millions”, based on “well-documented sources”, the evidence of which is never produced. It seems extraordinary that just a little bit of common sense cannot overcome these incendiary voices that proclaim that cancer can be cured by whatever alternative treatment they propose – and try to profit from.

Why Would The Government Hide The Truth About Cancer?

Can anyone truly believe that governments and researchers are allied in hiding the supposed truth about cancer? Cancer has huge societal costs, both on the economic burden of state-funded cancer treatment and on lost productivity hours. Would any government be interested in hiding and suppressing a solution to such a financial challenge? What politician would not welcome a chance to cut billions out of a healthcare budget by directing every cancer patient to a ‘natural’, low-cost alternative therapy?

Why Cancer Drugs Are Costly And Overpriced

It’s true that cancer drugs are costly. It is even true that some drugs are overpriced – though for those cases there are institutions, such as NICE in the UK, whose jobs are to investigate and prevent exorbitant pricing from taking place. But mostly, cancer drug prices are, if not pleasant, inevitable. What many may not understand is that producing a cancer drug is not as simple as mixing a few chemicals into the lab and testing them in mice. It involves great scientific understanding, and also a huge amount of trial-and-error effort, requiring thousands upon thousands of hours of work by vast numbers of professionals requiring comprehensive training, complex machinery and expensive raw materials. A cancer drug takes, on average, 8 years to move from preclinical data to regulatory approval, and less than 20% of compounds going into clinical trials make it to the market4. Successful drugs need to bear the costs of the 80% failed attempts – and sadly, without this balance, there would be no research.

Are Pharmaceutical Companies That Manufacture Cancer Drugs Are Pharmaceutical Companies That Manufacture Cancer Drugs Pressuring Governments?Pressuring Governments?

Can we really be led to believe that the pharmaceutical companies that manufacture cancer drugs are pressuring governments to stifle those much-advertised alternatives, in order to keep themselves in business?

Here are some hard and fast numbers: the estimated cost of cancer (not including longer-term costs to families and caregivers) in 2010 was $1.16 trillion, in the USA alone5. By contrast, the combined revenue of the world’s top 25 pharmaceutical companies was around $500 billion (and only a fraction of this number comes from the sale of cancer drugs)6. It doesn’t take a degree in economics to figure out that no pharmaceutical company, or even consortium of companies, could possibly bribe governments all over the world into silence over anything remotely likely to save billions of dollars of the state budget.

Natural Remedies For Cancer

Then what to make of so many reports of people who claim to have cured their cancer using only “natural remedies”? I daresay there will always be cases that confuse physicians, and to understand why we need only think about how each disease is unique because it is on a unique human being. But for the generality of the population, it is not so. A recent study showing this compared patients with curable cancer who chose to take only alternative medicines with similar patients who underwent conventional treatment. At the end of the study period, patients who used only alternative medicine – despite being generally younger and fitter – had an overall risk of death 2.5 times higher than patients on conventional treatment7.

Are Cancer Researchers Brainwashed Frauds?

Finally, what about the researchers? Is it at all plausible that a highly skilled workforce dedicates the better part of their time and energy into finding “cures for cancer” just to throw them away the next moment? Can people who spend their lives studying the intricacies of tumours truly not understand that cancer is a looming threat to all of us – including their own friends, families and themselves? What human being, no matter how selfish, doesn’t have at least a sense of self-preservation, would not really work to prevent and cure cancer? Is it really possible to think even for a moment that any scientist is putting his or her life to the service of a false goal?

As such, I am completely unable to understand how can the cancer conspiracy theory has lasted so long.

But this is what I’ve learned from my (admittedly short) time in cancer research: it’s hard work. It can be incredibly frustrating. Experiments take the better part of your day and sometimes pursue your thoughts into the night. And no one, I believe, would do it without the true conviction that it is all worth something.

Reference Sources

  1. Sudhakar A. History of Cancer, Ancient and Modern Treatment Methods. J Cancer Sci Ther. 2009;1(2):1-4. doi:10.4172/1948-5956.100000e2.
  2. Macconaill LE, Garraway LA. Clinical implications of the cancer genome. J Clin Oncol. 2010;28(35):5219-5228. doi:10.1200/JCO.2009.27.4944.
  3. Weinstein IB, Case K. The history of Cancer Research: introducing an AACR Centennial series. Cancer Res. 2008;68(17):6861-6862. doi:10.1158/0008-5472.CAN-08-2827.
  4. Siddiqui M, Rajkumar SV. The high cost of cancer drugs and what we can do about it. Mayo Clin Proc. 2012;87(10):935-943. doi:10.1016/j.mayocp.2012.07.007.
  5. Stewart BW, Wild CP. World Cancer Report 2014. World Heal Organ. 2014:1-2. doi:9283204298.
  6. GlobalData. Top 25 pharma companies by global sales. PMLiVE. 2014. Accessed January 11, 2018.
  7. Johnson SB, Park HS, Gross CP, Yu JB. Use of Alternative Medicine for Cancer and Its Impact on Survival. J Natl Cancer Inst. 2018;110(1). doi:10.1093/jnci/djx145.

Further Reading

Worldwide Cancer Research

Cancer Care Parcel: What we do

Flávia is a biomedical scientist currently working at the Institute of Cancer Research in London, where she performs tumour molecular profiling by Next-Generation Sequencing in the context of clinical trials. She received her BMSc from the Lisbon School of Health Technology and has strong interests in science communication and policy.

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