02-04-2012, 03:05 AM
Just a comment that is not meant to be picky or snarky. Breast cancer is a collection of diseases that have different molecular signatures, different cellular origins, and sometimes very different prognoses. There are some forms that are likely cured by the first snip. There are others that seem to leave their victims OK, but after radiation and/or chemotherapy. And finally there are some cases that don't get cured and lead to a very unhappy outcome.
In other words, there are already cures for some forms, there are effective treatments for others, and there is at present no one single concept of "the" cure, since any such cure involves a multiplicity of cures for a multiplicity of diseases. That leaves us at present with the currently optimal approach, which is to look for early cases which can mostly be cured with minimal surgery. There is a huge amount of research testing variations on this and that and doing statistics to see which works better. Beyond the clinical testing aspect, there is a remarkable effort going on in basic science labs intended to identify the root causes of these diseases down at the molecular level. It's really remarkable that no gene sequence was known when I started grad school, and now we have the basic human genome and are accumulating huge amounts of information about every little variation in human DNA, and how some of these variations are pathological.
Perhaps Komen is correct in putting about two-thirds of their spendable money into active surveillance and the other third into research, since finding new cases at a curable stage prevents a lot of pain and suffering and saves lives.
What's hopeful is that science is bit by bit identifying the molecular pathways that become deranged and how they become deranged. Out of this will come a more precise diagnostic process which will point to the best treatment for any one version. That's the brighter side of things.
Now for the picky part: There is a lot of work remaining to be done, and most of the research funding in this country comes out of federal sources such as NIH. But much more could be done if funding were higher. The move by this congress to actually cut NIH funding is to lack perspective. I understand that every interest group has the same complaint about losing funding during a recession, but somehow the priorities get mixed up sometimes.
In other words, there are already cures for some forms, there are effective treatments for others, and there is at present no one single concept of "the" cure, since any such cure involves a multiplicity of cures for a multiplicity of diseases. That leaves us at present with the currently optimal approach, which is to look for early cases which can mostly be cured with minimal surgery. There is a huge amount of research testing variations on this and that and doing statistics to see which works better. Beyond the clinical testing aspect, there is a remarkable effort going on in basic science labs intended to identify the root causes of these diseases down at the molecular level. It's really remarkable that no gene sequence was known when I started grad school, and now we have the basic human genome and are accumulating huge amounts of information about every little variation in human DNA, and how some of these variations are pathological.
Perhaps Komen is correct in putting about two-thirds of their spendable money into active surveillance and the other third into research, since finding new cases at a curable stage prevents a lot of pain and suffering and saves lives.
What's hopeful is that science is bit by bit identifying the molecular pathways that become deranged and how they become deranged. Out of this will come a more precise diagnostic process which will point to the best treatment for any one version. That's the brighter side of things.
Now for the picky part: There is a lot of work remaining to be done, and most of the research funding in this country comes out of federal sources such as NIH. But much more could be done if funding were higher. The move by this congress to actually cut NIH funding is to lack perspective. I understand that every interest group has the same complaint about losing funding during a recession, but somehow the priorities get mixed up sometimes.
