The war on cancer — a healthy metaphor?

Gregory Warner Dec 23, 2011

Bob Moon: Let’s depart from our holiday observations for just a moment to take note of another important date. Today happens to be the 40th anniversary of the National Cancer Act. That’s the bill that brought government funding for cancer research, and a brand new metaphor: the so-called “war on cancer.”

That phrase wasn’t actually in the legislation, but it was used by President Nixon in speeches at the time — and more recently, President Obama called anew for an aggressive war against cancer. As our health reporter Gregory Warner points out, though, some scientists don’t like all this belligerent talk.

Gregory Warner: Scientists have two problems with the “war on cancer” metaphor. One is the word “war.” The other is the word “cancer.”

Derek Lowe: There is no disease called cancer. There’s actually thousands and thousands and thousands of diseases that we see as uncontrolled cell growth.

Derek Lowe is a medicinal chemist. He’s worked on cancer drugs. He says calling for war on cancer is like calling for war on fever. Or back pain. Cancer is the symptom, not the cause.

Lowe: If you just look at cancer and say ‘ah — uncontrolled cell growth!’ There’s thousands of ways to get that. And there’s probably going to have to be thousands of ways to fix it.

As for the war part of the metaphor, oncologist Alfred Neugut at Columbia University says that word sets up an expectation.

Alfred Neugut: A war is by its nature a time-limited event, in which there’s a defined end point. Or there should be.

But in the case of the war on cancer:

Neugut: If we’re still fighting for 40 years, then that implies failure.

Does it?

Neugut: Of course it does. If I go to a bar mitzvah, you know, some old relative will say, ‘so when are you going to cure cancer already?’

In four decades, finding the “cure” for cancer went from a political platform to a punchline. But maybe the bigger problem with declaring war on a disease is that it becomes a problem left for the generals. (The doctors, in this case.)

In 1971, when the war on cancer was declared, the entire budget for the National Cancer Institute was for medical treatment, which you’d expect, but since then the greatest strides against cancer haven’t been because of new treatments, but because of better prevention: getting people to stop smoking, get regular mammograms. It would take two more decades for the government to put aside money for that.

Neugut: In 1990, the Congress forced, forced, the NCI director to start giving money to prevention research.

Ann Zauber is a biostatistician at Memorial Sloan-Kettering in New York. She says we are winning the war and she likes the metaphor.

Ann Zauber: Because wasn’t it earlier in time, that people didn’t even talk about that they have cancer, it was considered to be, you know it’s a death sentence, there’s no way of fixing this? So in calling it a war on cancer it brought into focus that it’s a war we’re going to fight it.

Fight the disease, and the stigma.

In Philadelphia, I’m Gregory Warner for Marketplace.

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