The ideology of curing cancer

“Can we cure, prevent or manage all disease by the end of the century?” Asked, Mark Zuckerberg and his wife in front of a packed lecture theatre at the University of California, San Francisco (UCSF). Apparently we can, with the investment of $3bn over one decade with the ingenuity of the Chan-Zuckerberg Initiative. The enterprise promises to help scientists in developing tools such as artificial intelligence, focusing in ending some of the world’s biggest killers including heart disease, cancer and infectious diseases.

“Throughout the history of science, most of the major scientific breakthroughs have been preceded by some new tool and technology that allows you to see in new ways,” Zuckerberg elaborated. “The DNA sequencing and editing helps us to fight cancer and genetic disorder.” And it is the artificial intelligence that could be used to help machine learning to analyze cancer genome and ultimately cure cancer. In reality, how distant is the prospect of curing cancer? Does it really take the social networking wheeze kid to end the century-long conundrum of curing cancer in ten years? Is the Zuckerberg proposal simply a “preposterous ideology” or “ingenuity in action”?

“Growth for the sake of growth is the ideology of the cancer cell”: Said Edward Abbey, the prominent American environmentalist, when incriminating corporate greed and its impact on the nature. Similarly, the ideology of the uncontrolled overgrowth of cancer cells is also universally accepted, as the disease is considered as the “bad apple” amongst the norm that had gone “rogue”, with the “insatiable parasitic drain” on the host until the depletion of life. Although the advancement of science had unearthed the intricacy of the cellular growth control and the potential breakdown that may trigger cancer, the exact “purpose” of cancer in evolution sense is largely unknown and unquestioned.

In fact, cancer is an aged old condition that existed throughout human history. The ancient Egyptian medical scroll, Edwin Smith Papyrus, had the documentation of breast cancer dated 1600BC. More than one thousand years later in 400 BC, Hippocrates described the abnormal appearance of cut surface of solid malignant tumour as Karkinos (the Greek word referring to crab), and the prominent Greek physician, Galen also outlined the resemblance of breast cancer to a crab, in view of “the lateral prolongations of the tumour and the adjacent distended veins”. Celsus subsequently translated karkinos into canker in Latin, the word “Cancer” was only recorded in medical literature in the 17th century.

Despite the presence of cancer throughout mankind, the ideology of eradicating cancer remained primitive for many centuries. Celsus was first noted to recommend surgery as the mainstream treatment for cancer, while other physicians such as Galen, disputed such intervention and proposed purgatives instead, and the practice largely stood for more than 1000 years to treat cancer.

The quest for cancer cure remained unremarkable for many centuries, despite the associations noted between certain cancers and the offending agents. The British Surgeon, Percivall Pott famously noted higher prevalence of scrotal cancers amongst the chimney sweeps; and the identifications of tobacco snuff as the potential aetiology of nose cancers by English physician, John Hill in 18th Century Britain, highlighted the ability of scientists to incriminate the environmental carcinogens, but remained helpless in treating the cancers.

The true scale of unfeasibility of curing cancer only become apparent after the advent of microscope, which unearthed the “true toxicity” of cancer cells. The very nature of cancerous cells possessing the unique ability to spread from the original primary organs resulted in distant metastasis; makes it near impossible to eradicate without harming the host. Such view was formulated by the British Surgeon, Campbell De Morgan in the late 1800’s, but only widely accepted well into the 19th Century.

Despite cancers being ranked second as the overall cause of death, after heart disorders in modern days, the condition is generally regarded as a difficult illness to treat, as it bears worse prognosis than all other diseases. The deadly perceptions of the ailment have undoubtedly cause widespread fear, taboo and stigma, which also undeniably become barriers to the effort to find solution.

The National Cancer Act of 1971 initiated by US President, Richard Nixon is generally viewed as beginning of “War on Cancer”. The Act galvanized efforts to find a cure for cancer, aiming to diminish cancer related deaths, by enhancing scientific research to promote the understanding of cancer biology and the development of more effective treatment. The tactic of declaration of “war” in the military metaphor was intentional, as focused on the need for the disease to be “fought” to end the “civil insurrection. This in turn portrayed a “state or urgency” and “the utilization of radical destruction” to end cancer threat.

Forty-five years after the National Cancer Act, the United States had spent more than $200bn on cancer research, and this translated to the decline in cancer related death by 5% between years 1950 to 2005. This is a reflection of dismal prospect of victory in the “war on cancer” even for contemporary medicine.

The principle of curing cancer is ironically quite straightforward. The “military metaphor” is often appropriate as it aims to create a “silver bullet” causing maximal destruction to the cancer cells, with the hope of minimal collateral damage to the host. The rule generally applies in oncology interventions such as chemotherapy, radiotherapy and immunotherapy. However, the real snag of making cancer therapy a success is the impossibility in specific differentiation cancer cells and sparing the norm. And this again and again becomes the main obstacle to the quest for cancer cure.

The Oxford English dictionary defined “Cancer” as “A disease caused by uncontrolled division of abnormal cells in part of the body” or “Phenomenon perceived to be evil or destructive that is hard to contain or eradicate”. On the other hand, the word “Cure” is defined as “The elimination of a disease, condition or injury with medical treatment”. Quantum leaps in the advancement of medicine in the recent decades have made the “suppression” and the “treatment” of cancer a reality. However, “the quest for cure” with the aim of complete “eradication or elimination” of this “uncontrolled evil phenomenon”, in an evolutionary sense will continue to be an ideology that is near impossible.

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