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A cure for a disease such as malaria, polio, or cancer is a treatment that eliminates it. A cure can work on an individual level or a group level. If a treatment is effective for a group such that no disease is left in the population, the condition is considered eradicated or cured.
The Problem with a Cure
While it seems logical to focus on curing diseases like cancer, the role of prevention should be examined. Consider this—if breast, stomach, or colorectal cancer could be prevented in part of the population, much suffering and many lives could be saved. And preventative measures could be employed in conjunction with research on a cure.
One problem with this scenario is that cancer is a complicated puzzle. It includes a large group of diseases, each with many, often unknown, causes. Even with advances in cancer diagnosis and treatment, there are many questions about what triggers a cell to become cancerous and why some cancer patients fare better than others.
Harvard Public Health asserts that “on a population level, the only way to substantially reduce incidence and mortality for any disease is through prevention.” Rather than framing cancer as a curable disease, it should also be portrayed as a preventable one. Primary prevention does reduce cancer deaths; it involves fighting the causes and promoting factors that protect against it. Examples include taxes on products containing carcinogens, like cigarettes and alcohol; vaccines against HPV, a known cause of cervical cancer; and education on healthy eating and regular exercise to combat obesity.
The HPV vaccine is an example of cancer prevention that works. A 2019 meta-analysis that included over 60 million females in 14 countries showed strong evidence that HPV vaccination programs are effective. Among other outcomes, the study found that after vaccination began, the prevalence of precancerous lesions that can lead to cervical cancer decreased by 51% among girls aged 15 to 19 years and by 31% among women aged 20 to 24 years.
Could a similar model be applied to obesity? According to a 2019 The Lancet Public Health report, in the United States, excess body weight contributed to 13 types of cancer, including 60% of endometrial cancers, 36% of gallbladder cancers, and 33% of kidney cancers. Successful prevention depends on a multitude of factors, ranging from governmental support to funding. Reducing obesity, for example, would require structural changes in our society. Over 2 million people in America alone live in food deserts, areas with low access to fresh, healthy foods. Modern Western diets rely much more on processed foods than they did a generation ago, resulting in a dominance of calorie-dense but nutritionally depleted foods.
Unfortunately, developing preventive therapies comes with many challenges. In many cases, research on prevention involves monitoring people over time. As a result, it can take years to determine if a new preventive therapy decreases cancer risk, not to mention the number of deaths from cancer. Also, individuals at high risk for cancer often have comorbid conditions, for instance, diabetes, that can make experimental treatment risky. In addition, although we are beginning to understand events in cells that initiate cancer, developing methods to specifically block or interfere with these events is complicated and time-consuming. And finally, the private sector traditionally has had less interest in spending resources on prevention and risk reduction and more on cure. Curing a patient with advanced disease is more dramatic (and press-worthy) than preventing disease in a healthy person, and sales of treatments result in higher profits than prevention measures.
Cancer prevention research is essential for studying how cancer develops, determining ways to reduce cancer risk, educating the public on prevention, testing preventive interventions. By 2025, 2.1 million people in the United States will be diagnosed with cancer every year, and the estimated number of annual cancer-related deaths will reach 250,000. Something must be done. Could prevention be the new cure?
Edited by Sara Musetti
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