Readers who don't like me might think that the title of this post refers to what I am about to write. I know, the title perfectly encapsulates the verbose style that is my stock and trade. In reality, though, it's referring to a couple of articles floating around the blogosphere of which I've become aware and about which I've been meaning discuss because of their similarities. One is a pretty worthless piece of conspiracy-mongering; the other, although it makes some appropriate criticisms of how we go about cancer research, comes to a wildly incorrect conclusion about what we should be doing differently.
The first article was brought to my attention by Kevin, MD. Normally Kevin is one of my favorite "just the facts" sort of medical bloggers, but this is one of those occasions when I have to say that I highly disagree with his comment of "interesting take" on the article to which he linked, entitled Why There Will Never Be a Cure for Cancer by L. Vincent Poupard. It's not an "interesting take." It's a brain-dead take. In essence, Poupard argues that a "cure for cancer" would devastate the U.S. economy, an utterly ridiculous proposition if you look beyond the simplistic claims. Here's what Poupard starts out with:
The billions of dollars that are raised pay the thousands of doctors that conduct the research. It also pays for the salaries of people that raise more money for cancer research. It also pays the salaries of hundreds of people that advertise for these organizations.
It all sounds impressive--until it's pointed out that the total budget for the National Cancer Institute this year will only be around $5 billion--in a budget of around $2.9 trillion--less than 0.2% of the entire federal budget. It's been estimated that, if you add the investment of charitable foundations and big pharma, the total spent on cancer research amounts to approximately $10 billion a year, give or take a billion dollars or so. In contrast, the gross national product in 2006 was over $13 trillion. To argue that eliminating this would somehow devastate the economy is a bit hard to justify. Not that that stops Poupard from trying, though:
It was once estimated that one out of every thousand people in the United States work in some field that is linked to cancer research. If a cure for cancer were to be found, it would have a strong, negative effect on the economy in the United States.
If a cure for cancer were to ever be found, the medical community would see shrinkage of staff unlike any that it has ever seen. Unemployment would skyrocket as thousands medical, advertising, and charity professionals lost their jobs. Homelessness in areas where research was centered would also increase.
Support for this failed industry would cause for a raise in taxes to help support the influx of newly unemployed. This raise in taxes would then, in turn like other raises in taxes, bring more people under the poverty level in the United States.
There most likely will never be a cure for cancer. A cure for cancer could be one of the worst mistakes for the United States economy.
Whoa! No wonder big pharma, its dark minions, NCI-funded lackeys like myself, and other physicians don't want a cure for cancer! Think of the economic carnage! Poupard's argument, is, of course, a load of crap. For one thing, if a single cure for cancer could ever be discovered (a highly unlikely prospect, given the heterogeneity of the many different diseases lumped under the term "cancer"), whoever discovers it is likely to rapidly surpass Bill Gates in terms of wealth. That's a lot of incentive. Second, cancer doctors are human too. We see patients suffer and die from cancer all the time, and most of us have or have had family members suffer and die from the disease. Just by statistics alone, one-third of us can be expected to be diagnosed with cancer sometime in our lifetimes. To imply that we would suppress a "cure" just to protect our hegemony and income requires a leap of faith beyond what I'm willing to make.
But let's assume that we cancer doctors are indeed all money-grubbing, cold-hearted greed-heads who don't care about our patients and would indeed suppress a cure in order to protect our income. Or not. It's really irrelevant to the sheer idiocy that is Poupard's article. The reason is that Poupard neglects one very simple consideration: Cancer costs the economy big time. For every researcher or caregiver working in the cancer field, there are many more who can't work due to cancer and whose treatments re costing big bucks. Besides the billions of dollars spent on surgery, chemotherapy, and radiation every year to treat cancer, there are other costs. For example, a recent study published in JNCI estimates that just the cost of the time that cancer patients spend pursuing treatment costs the economy $2.3 billion a year.
Now, imagine if there were indeed a cure for cancer found tomorrow. Let's say that it's a drug and that it eliminated even advanced stage cancers. Almost overnight, all the billions of dollars spent on research would be redistributed elsewhere and all the person-hours lost to cancer would be available to the economy. Health insurance costs would fall, leading to decreased rates, and Medicare and Medicaid expenditures would fall, helping with our long-term fiscal liabilities due to these programs. I'm not claiming that curing cancer wouldn't cause major disruptions in our health care system. I note that interventional cardiologists are getting a bit nervous over a relatively modest drop in coronary intervention rates. I also note that the rise of interventional cardiology has played havoc with cardiac surgery as a specialty, with cardiac surgeons losing a lot of business to the cardiologists.. Even so, I can't think of a scenario where the benefits of curing cancer would not far outweigh the temporary dislocation of those of us who make our living treating cancer and researching better treatments.
Indeed, even if a cure for all cancers were found, there would still be a need for oncologists to administer this cure. Moreover, there would definitely still be a need for surgeons like me, at least in breast cancer. The reason is simple: Most of the surgeries that I do still consist of biopsies to diagnose breast cancer. The need for these biopsies would not go away, "cure" or no "cure." So, yes, the number of physicians and ancillary staff would decrease, but perhaps not as dramatically as Poupard assumes. In addition, health care workers, even though specialized, are not "unredeployable." If a real cure for all cancers were found, residency programs and medical schools would quickly adjust and steer trainees to other specialties. In fact, oncology might become a more desirable specialty because oncologists, who previously couldn't cure metastatic solid tumors, now would be able to, leading to a lot less dealing with incurable patients and a lot more dealing with curable patients. Established physicians could also be redeployed into other specialties. For example, I could always go back to doing general surgery. I might have to do a little training or apprentice with another surgeon for a while to refresh my memory and skills relating to operations that I don't do that often anymore, but I could certainly do that. Similarly, although it would not be easy, I could change my research focus. My skills in molecular biology and in running a lab could be put to use studying many other questions.
The bottom line is that the conspiracy-mongering idiocy of the type shown by Poupard and so many alties comes from a deep-rooted distrust of the system and frustration that we haven't found a cure yet, rather than any rational analysis. It turns out that some in medicine share this frustration. They do not, however, direct that frustration into criticisms of the current system of funding cancer research. Some of their criticisms are valid, some not, but unfortunately they come to an incorrect conclusion about how to fix the perceived problem.
That, my readers, will be the topic for part 2. It will be especially fun because it allows me to set straight the bloviations of a blogger with whom we've had dealing before, who really, really doesn't like me.
Yes, the incidence of cancer is so high that virtually everybody is virtually guaranteed to lose a loved one from cancer or die from it themselves. And it's often not a particularly present way to go. The notion that researchers and physicians, most of whom are perfectly capable of doing other things besides cancer research and therapy, would choose to pass up a cure that they are virtually certain to need for themselves, their friends, and family is monumentally stupid.
Moreover, as somebody who interviews students entering medical school and graduate school, I can tell you that very many of those who come in with an interest in working in the field of oncology or cancer research do so because they have already lost a loved one to cancer, and have chosen to make curing cancer or helping people with cancer their life's mission. If you just want to make money, there are plenty of other fields to work in besides cancer. Oncology, in particular, is not a particularly pleasant field to work in. Very few people enjoy delivering bad news day in and day out, or seeing their patients die. Cures are far more satisfying. People enter the field not because working with people suffering and dying from cancer is inherently enjoyable, but because they see an opportunity to make a contribution where it is desperately needed.
Did he think that maybe us doctors would like to find a cure for cancer, just in case we or our loved ones got cancer?
Such scumbaggery-shills are almost impossible to argue with. One such individual accosted me one day when he saw me reading Robbins' Pathology, and told me where I could write to for a video made by a cancer-conspiracy nut (Sam Chuchuwa, or something like that). I gave him a piece of my mind, for what it was worth, but I suspect the Hitler Zombie had already eaten of him.
"In addition, health care workers, even though specialized, are not "unredeployable.""
Yeah, that was my first thought upon reading the lead-in paragraphs, if not in exactly those words. Somehow, I can't see Skid Row lined with former oncologists living in cardboard boxes and begging for handouts. "Will diagnose tumors for food." I imagine that they would somehow find some other useful purpose for their medical training, or at least learn to drive a truck or something. :)
Poupard is engaging in an argument well known to Austrian-School economists as "the broken window fallacy," after a "parable" told by Frédéric Bastiat in his 1850 essay, Ce qu'on voit et ce qu'on ne voit pas.
http://en.wikipedia.org/wiki/Parable_of_the_broken_window
Arguing that curing cancer would be a net loss to the economy or to society is like arguing, in the above example, that people should go around breaking windows.
But someone above mentioned a "cancer consipracy." I may be a little naive and slow on the uptake, but are there seriously other people who really think getting rid of cancer is a bad thing? Do they think more cancer is a good thing? I'm confused.
Somewhat ironically, capitalism is normally criticized for the fact that investment decisions made on the basis of net present value can devalue long-term economic benefits in favor of short term gains. Yet here, researchers and clinicians are essentially being accused of excessive foresight--letting potential long-term economic losses override short-term benefits, because even if all of this nonsense about a cure for cancer hurting the cancer research and treatment professions were true, the first person to come up with a cure for cancer will win a Nobel Prize, and the first company to come up with a cure will make a huge financial killing.
Following Poupard's argument, there must be no cures for, or prevention of, well, pretty much any major disease. Smallpox, polio, diarrhoeal diseases, tuberculosis, ... we must all be subject to them now, and their research and treatment must be major industries in the U.S. After all, big pharma was making zillions from Helicobacter pylori until Warren and Marshall selfishly broke ranks and let the cat out of the bag just so's they could get a Nobel.
This argument reminds me of the Yes Minister episode (actually Yes Prime Minister in this case) The Smoke Screen. You really do need to watch it to understand, but the following quote from Yes, Prime Minister gives a flavor:
Jim Hacker: "Humphrey, we are talking about 100,000 deaths a year."
Sir Humphrey: "Yes, but cigarette taxes pay for a third of the cost of the National Health Service. We are saving many more lives than we otherwise could because of those smokers who voluntary lay down their lives for their friends. Smokers are national benefactors."
Following Poupard's argument, there must be no cures for, or prevention of, well, pretty much any major disease. Smallpox, polio, diarrhoeal diseases, tuberculosis, ... we must all be suffering from them now.
This argument reminds me of the Yes Minister episode (actually Yes Prime Minister in this case) The Smoke Screen. You really do need to watch it to understand, but the following quote from Yes, Prime Minister gives a flavor:
Jim Hacker: "Humphrey, we are talking about 100,000 deaths a year."
Sir Humphrey: "Yes, but cigarette taxes pay for a third of the cost of the National Health Service. We are saving many more lives than we otherwise could because of those smokers who voluntary lay down their lives for their friends. Smokers are national benefactors."
Nice to see a surgeon who understands opportunity cost.
The link above to Poupard's bio says that he's a fiction writer (not surprising) who has an interest in conspiracy theories (not surprising).
He should stick to fiction, not conspiracy mongering or economic analysis.
Brain dead fiction;
a new genre perhaps... I think I smell something rotting
I'm an oncology researcher. I haven't been let in on the great secret cure yet, but when I am I am patenting it, going straight to a drug company to get it manufactured in quantity, and making reservations to Sweden to collect my Nobel. Screw the rest of you losers, you should have thought of it first...
Which is why the Sinister Conspiracy to keep the cure from cancer from becoming public doesn't and never will exist. No matter how much it might help the "cancer research industry" to keep it secret, the temptation to "discover" the cure, be a hero, and live off the proceeds would be too much for any individual researcher to exist. Furthermore, even if the secret is closely held among only a small number of trustworthy sorts, the biological reality is still out there for anyone to find independently...so why haven't they?
The real reason that the cure for cancer doesn't exist is because cancer isn't a single disease. Talking about "the cure for cancer" is like talking about "the cure for infectious disease" not "the cure for polio" or even "the cure for atherosclerosis." And some cancers are cured or close to it. Testicular cancer, Hodgkin's disease, and most thyroid cancers have pretty decent survival rates, where survival means "get over it and die eventually of something else".
And if I'm wrong about that, if there is a potential single cure and someone finds it, so what? I'll happily move on to research aging or immunology or something else. Or just hang out and enjoy my health if all those and every other disease is taken care of.
Somehow, I can't see Skid Row lined with former oncologists living in cardboard boxes and begging for handouts. "Will diagnose tumors for food."
For some reason I love this image. But it seems unlikely. There's always the internal medicine, pediatric, or surgical specialization to fall back on. Even assuming that non-malignant hematologic diseases (most medical oncologists are hematologist-oncologists) went the way of cancer.
It's also tiresome how they refer to "cancer" as some kind of monolithic disease. Cancer is thousands of diseases. You've got about 200 tissue types in your body and each one finds all sorts of interesting ways to go batty.
It's also tiresome how they refer to "cancer" as some kind of monolithic disease. Cancer is thousands of diseases. You've got about 200 tissue types in your body and each one finds all sorts of interesting ways to go batty.
Thank you for the attention to my article. The article was not meant in any way to attack the medical community as a whole. The point was to point out that the corruption of many of the major drug companies, the tobacco companies, and of many politicians would lead to the censoring of anyone who claimed to have a cure for cancer.
Keep in mind that there is still, and always be, major corruption from major companies. Does this reflect on the workers? No. It does affect them, though. An example would be that the corruption at Enron was not the fault of the general workers, but it did affect them (Fact).
When it comes to the potential that the US Government would have to bail out the medical community in a case of a cure for cancer is founded on fact. In the early 1980s when Chrysler was having severe financial difficulties, the Federal Government stepped in to bail them out (Fact).
At the time, it was decided that the only cause for the Government to do this in the future would be if there were a significant change in the medical or educational communities. A cure for cancer would cause for a significant change in the medical community (Fact).
I am under the strong belief that almost all of the people in the medical community that are working day and night to find a cure for cancer should be commended for their efforts. I do not believe that there is a medical-world-wide conspiracy against a cure for cancer. I do believe that those at the top are strongly affecting the chances of a cure being found.
There are many cases from history where one can point to a blockage of information that was controlled by a small group of people. In the case of Project MKUltra, members of the CIA and military conducted inhumane experiments on people (Fact). Many reporters have attempted to sue their former employers in the news industry for changing reports so that they were more, "Big business friendly (Fact)."
There have also been many times in which heads of pharmaceutical companies kept certain information from being printed in documentation about certain drugs. These issues have caused for the deaths of many people (Fact). Many in the medical community fight everyday for stronger legislation against these companies (Fact).
Do I have to remind all of you that the tobacco companies have admitted to realizing that their product causes cancer (Fact)? Do I have to point out that the heads of the tobacco companies new this years ago and tried to prevent the information from getting out (Fact)?
I could go on for hours pointing out corruption in major corporations and in the US Government, but I will not digress and further. I still stand firm in my beliefs that there are many at the top of the ladder that would fall if a cure for cancer were ever to be found.
The personal attacks that I have received for this article from some in the medical community are what have me truly surprised. Aren't doctors supposed to be higher then that? Aren't doctors supposed to near, or at, the pinnacle of education? The third grade attacks on me do not show very much for your character.
As for those who have wondered if I have been unaffected by cancer, I can say that I have been effected deeply by cancer. Many members of my family have been treated, and/or died of cancer. The loss of these individuals from my life will always affect me.
I am surprised that I am coming under so much fire from the medical community for this article. I was surprised that so many of you could not see that this was a social commentary about how our information is controlled by so few people.
I respect your point of view, but I am discouraged by the fact that I had to explain mine. I am happy for the debate. If anything, this might have lit a fire under someone's rear to prove me wrong.
Conspiracy theorists thrive on stating a variety of unconnected "facts" and concluding that they prove nefarious doings at the top (Fact).
Readers who are invited to "connect the dots" are unable to do so in any intelligible fashion (Fact).
Their failure to accomplish this task is interpreted by the conspiracy-mongers as a lack of intelligence, naivete or outright participation in the plot (Tiresome Silliness).
Ongoing efforts by major medical organization and cancer societies to curb smoking and thus limit heart disease and cancer have or will devastate medical income and the economy as a whole (Hah).
Which of my facts are unconnected in my statement? Isn't the job of the medical communtiy to, "connect the dots," for a medical solution?
I have not made any attempt to attack your intelligence. I am actually complimenting it my not making personal attacks.
There was no response to my statement to prove me wrong by finding a cure.
L. Vincent Poupard
Lovely. Apparently to prove Mr. Poupard's thesis that there will never be a cure for cancer because it would supposedly be a disaster for the medical economy wrong, all we in the medical profession have to find a cure for cancer.
How convenient for Mr. Poupard.
As for all your "(fact)s," Mr. Poupard, really, they're basically all non sequiturs. Your conclusion does not follow from them. They really are a bunch of unconnected or poorly connected statements that do not form a coherent argument and demonstrate glaring lapses in logic.
Finally, I did not call you names. Rather I attacked your argument as ignorant and fallacious (which it is) and as ignorant conspiracy-mongering (which it also is). I realize that the distinction may escape you, but it is not an ad hominem attack to point out when an argument is brain dead as long as a rational explanation as to why it is brain dead is provided. It would have been an ad hominem attack if I had said that the argument was worthless only because the person making it is an idiot without providing any reasoning and evidence, but that's not what I said or did.
I understand taht you are not making personal attacks on me, only attacking my ideas and ideals. By attacking one's ideals and ideas, you are pushing for a debate.
I understand your point of view. While I understand that you do not agree with my point of view, I am not criticizing you. Many of your posters criticized me for my statements, and that ws what I was referring to.
I appoligize if it appeared taht I was making an ill reference to you. I actually enjoyed reading your response.
L. Vincent Poupard
I may just have to go on to write a best seller on this then.
L. Vincent Poupard
Seems unlikely, as it makes the unlikely assumption that a huge fraction of the people involved in cancer treatment and research are too incompetent to do anything else of value. Keep in mind that all of the people who live longer because they don't die from cancer will have other health problems--heart disease, Alzheimer's Disease, etc., which will require treatment. But even if it were true, it is a bit like claiming that DVDs could never be invented because they would put all of the people who make and cell VCRs out of business.
This is a really foolish argument. Nobody is saying that there has never been any conspiracy to keep anything secret. Rather, the point is that knowledge of cancer biology is so widely distributed, and the rewards to the first person or company to come up with a cure are so enormous, that it would simply be impossible to stop it. This certainly doesn't apply to knowledge of MKUltra, which at most was of minor commercial value to the first news organizations to break the story.
Suppose that I was working at a pharmaceutical company and came up with a cure for cancer. Even if my company currently had a chemotherapeutic drug on the market, they would recognize the immense short-term profit potential for such a cure, and rush it to market.
OK, but suppose they were really, really stupid--so stupid that they didn't realize that the net present value of a cure for cancer far, far exceeds the value of anything else they might have on the market, what would I do?
Quite simple--I'd quit, and take my cure to somebody else, a company with no anticancer product on the market, and no vested interest in the status quo. Sure, my original company might sue me for leaving with an idea that I originally developed on company time (if they could prove it, and if they could find a jury that would actually rule in favor of a company that was trying to deny them and their families a cure for cancer) but so what? It would be too late to put the genie back in the bottle, and even if my new company had to give them a share of the profits, I'd still be fabulously rich, and on the short list for the Nobel Prize.
More important, I'd have a chance to save my own life, and the lives of my loved ones. With average prevalence of cancer about 30%, it is virtually certain that absolutely everybody--including cancer researchers and CEOs of major pharmaceutical companies--will eventually be desperately in need of a cancer cure, if not to save their own lives, then to save the life of a loved one. Your conspiracy theory supposes that people are going to be willing to pass up fame, fortune, and the chance to save the lives of their loved ones--for what? To protect the government from having to "bail out" the health care industry? Fat chance!
Do you really have any understanding of what Project MKUltra was? It was an effort by a handful of CIA and military people to experiment on mind control. In doing so, they ended up introducing the US population to LSD.
It resulted in the deaths of over 17 people, and caused permanent brain damage on an estimate 235 people.
On top of that, these member of the CIA were storing chemical weapons, and experimenting on a small group as to what these weapons actually did.
The reason why there was such little media coverage was that the US Government was still trying to recomver from Watergate, and the US was at war in Nam. The Federal Government restricted the information from leaking to the press, and threatened strong fines on any news company that publicized it.
You can read up on the entire affair in the National Archives due to the Freedom of Information Act.
In a conversation that has to due with a matter that includes a few people filtering information, all of you should gain a perspective on this case.
I would not suggest trying to download all of the information that is available as it is well over 27 gigs of information. A simple search on a site such as wikipedia, or something simialar for information on the case.
There was little media attention at the time because the government did not allow it. This is well documented in the case, and is signed off on by Congress.
I personally have spent a long time researching all of the documentation from Project MKUltra, Project Midnight Climax, the investigation into the CIAs involvement in multiple assassinations. If the general populace realized what actually was performed by their own government from 1954-1972, they would be sick.
L. Vincent Poupard
And all of this has to do with your argument that there will never be a cure for cancer because of the economic havoc such a cure would cause exactly...how?
Answer: At best it's seriously tangential and a non sequitur to conclude what you did based on all of that. In reality, it simply doesn't prove anything supportive of your point.
Whether you know it or not, you've just dived very deeply into the deep end of the conspiracy theory pond, deeper than even I had thought you were capable based upon reading your cancer article. Next you'll be saying that black helicopters appear to snatch up scientists who are getting too close to the "cure."
Yes, I'm familiar with MKUltra. The secret wasn't as well kept as you seem to imagine. If you didn't hear about it until it broke in the press, then I probably knew about it before you did.
But that isn't the point. The point is that as embarrassing as the story was politically, its economic value was modest. Nobody stood to get rich from revealing the secret of MK Ultra. Nobody stood to win the Nobel Prize. Nobody could use the secret of MK Ultra to save their mother, child, or wife from a miserable death. I can assure you that if the secret to curing cancer was as well protected as the "secret" of MK Ultra, then somebody would already have it patented and would have gotten very, very wealthy off it.
The reason why there was such little media coverage was that the US Government was still trying to recomver from Watergate, and the US was at war in Nam. The Federal Government restricted the information from leaking to the press, and threatened strong fines on any news company that publicized it.
The reason it wasn't well publicized, is that, quite honestly, most Americans don't want to know about it. Any more than they want to know about American business interests with the Nazis, any more than they want to know about the Tuskegee experiments, any more than they want to think about the Japanese internment camps of WWII or any other atrocities carried out by our nation. The same cannot be said about a real cure for cancer.
I think it's sad. It is even reprehensible, not to talk about these issues, for by trying to ignore them, we run the very real risk of similar atrocities being carried out in the future. Indeed, I do not doubt that our nation is doing things now, that make the crime of our current administration, that we do know about, seem quite benign.
I spent a fair amount of time researching various "cures" for cancer, including Essiac. I even believed it was quite possible that your reasoning, citing economic factors to hide such cures was true. The problem with that is well stated by trrll. Nearly everyone has powerful motivation to find cures for every cancer in existence. No one remains untouched by it. My own interest was due to the loss of loved ones and finding out that a fifteen year old girl I knew, and cared about, was told she would be very unlikely to live to her twenty fifth birthday.
My interest in Essiac in particular came from an aquaintance who found out the lumps in her breast were cancerous. After taking Essiac, they "dissapeared." What I didn't know at the time, was that she had also undergone targeted radiation. Within eighteen months, she had more tumors. She chose to undergo chemo when they reaccured, having been admonished by te same doctor who had done the radiation that she had a pretty good chance of a longterm remission if she gave up on the Essiac.
It, along with many other "natural" therapies, sounded great. Some even appeared very promising. But when the curtain was pulled, the most promising turned out to be complimentary, every time. The only ones that "worked" did so in conjunction with conventional therapies. Unfortunately, too many did so at the expense of those who chose to believe they could work by themselves.
I still buy into some of it. I eat foods, drink juices and teas, that may have some benifit in reducing the risk of cancer for me. Mostly, it makes me feel better, I imagine with much, if not all of it, that's all it does for my cancer risk. Though I do believe that much of it does help my risk factor for heart disease, something far more likely to get me than cancer anyhow. But I just cannot believe that if there existed a cureall for all cancer, that someone would not be making a mint off it. Likely a pharmacuetical company at that, they do have a lot of power and influence. In fact, knowing what I do now about cancers, I understand that it is virtualy impossible that any one thing could cure every cancer.
Still, thanks for the blast from the past about MK-Ultra. It could well be said that I am a (clean since my five yr old was concieved) and that LSD is my junk. I bloody well made a career out of using it, for many years. For obvious reasons, I researched the MK-Ultra experiments rather exaustively. As far as bad things our country has done, MK-Ultra was rather mild compared to some (though still a dark spot). Most of the people involved knew they were taking something that no one knew very much about and did so voluntarily.
Sorry, It could well be said that I am a (clean since my five yr old was concieved) should have read, It could well be said I am a junky...