Upon closer inspection, the decline in cancer rates that the National Cancer Institute widely proclaim refer to death rates age-adjusted to the US 1970 population. When dissecting these wins, they turn into rather pyrrhic victories. Of course, other communities likewise express their progress using appropriate metrics; take an investment fund whose annual return is 8%. This hides the fact that the 8% is relative to the average return of the industry; in reality, the fund lost 10%, which was, however, less than the average fund in that industry.
While crude rates (how many deaths per 100,000 people) for all deaths combined (car accidents, lightning strokes, murder etc) excluding cancer fell by 24% between 1970 and 2010, the crude cancer death rate increased by 14%. In 2013, an expected 580,000 people in the US will die of cancer, and an estimated 7.6 million worldwide. Victory in the War on Cancer appears to be as illusive as the victory in the War on Drugs! By and large, diagnostic tools have improved - think pap smear, mammogram, and colonoscopy - allowing doctors to catch tumors earlier, when they have not yet metastasized or genetically diversified.
Leaf, a sympathetic (he suffered from s cancer as a teenager), thoughtful yet critical observer analyzes the cultural factors that led to this state. Some of them are a lack of risk-taking, an ever growing bureaucracy, few standards in the field, the lack of an effective national tissue registry and the complexity of the disease. But the primary culprit Leaf focuses on is a highly fractioned and non-collaborative clinical-academic cancer culture that maximizes winning of R01 NIH grants and the publication of papers in high-impact journals. Grants and papers make for great experiments on model systems or model organisms (which does not include humans), advance basic science, but does little to help patients. The massive investment in cancer science (an estimated $30B/year worldwide) produces studies but not cures!
It is interesting that the original 1971 recommendations of the committee charged by President Nixon with proposing how the War on Cancer aught to be carried out had been to take the cancer effort out of the NIH, creating a NASA-like National Cancer Authority, whose mandate would be to approach the problem like the successful moon shot, looking at the overall systems-aspects of cancer and cancer mortality. The committee was quite explicit in this matter, testifying that they would not recommend continuation of the present organizational arrangements within the existing NIH. However, heavy lobbying by the clinical and scientific communities for the autonomy of the basic research enterprise scuttled this plan. Instead the NCI received a massive increase in research funding and the status quo remained.
One wonders what would have happened if the NIH/NSF would have been charged by President Kennedy in 1961 to bring a man to the moon by the end of the decade and return him safely to the planet? Probably a lot of basic science papers on planetary formation, the geology of the early moon and the existence of unique solutions of the Navier-Stokes equations that mimic the aerodynamics of re-entry into the atmosphere!
Leaf argues for a much more focused engineering effort, one that
emphasizes all aspects of the cancer problem and not just the biology
of cancer, that enforces common standards, protocols and tissue
repositories, in an expeditious and efficient manner. One that takes
risks, just like NASA did in its early years. Yet that is unlikely to
occur within the current ossified structures that serve the cancer and
the university research communities so well.
It was only later, at university, that I became acquainted with
Buddhism and their emphasis on the universal nature of mind. Indeed,
when I spent a week with His Holiness the Dalai Lama earlier this
year, I noted how often he talked about the need to reduce the
suffering of ``all living beings'' , and not just ``all people'' . My
readings in philosophy brought me to panpsychism, the view that mind
(psyche) is found everywhere (pan). As Skrbina shows in this book,
panpsychism is one of the oldest of all philosophical doctrines extant
and was put forth by the ancient Greeks, in particular Thales and
Plato. Baruch Spinoza and Gottfried Wilhelm von Leibniz who laid down
the intellectual foundations for the Age of Enlightenment argued for
it, as did Arthur Schopenhauer, William James, the father of American
psychology, and the Jesuit and paleontologist Teilhard de Chardin.
Declining in popularity with the rise of positivism in the 20th
century, panpsychism is enjoying a renaissance in philosophical
circles. As a natural scientist, I find a suitably modified version of
panpsychism to be the single most elegant and parsimonious explanation
of the universe I find myself in. But that is a different story.
Skrbina's volume gives a great introduction to this doctrine and its
reception in the west, from ancient times until today.