私醫聯招 英文歷屆試題｜第 546 題

In 1969, the Citizens Committee for the Conquest of Cancer, inspired by the success that year of the Apollo 11 space mission and propelled by the indomitable philanthropist Mary Lasker, conceived of a “moon shot” for cancer. That December, the group ran a full-page ad in The Washington Post and The New York Times: “Mr. Nixon: You can cure cancer.” At the time, a cure was perceived to be imminent.

President Richard Nixon's grandiloquent response in his 1971 State of the Union address: “The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease. Let us make a total national commitment to achieve this goal.”

But the War on Cancer, as the moon shot was called, didn't reach its goal. Partly, that was because “cure” was an erroneous target. Cancer is not one disease, but more than 200. “We talk about a ‘cure’ for cancer, but no one would ever use the term ‘cure’ for infectious disease—they would talk about a cure for AIDS or TB or malaria,” says the Harvard Chan School's Giovannucci. “You have to think about these diseases one by one.” More fundamentally, the War on Cancer failed because it spent far too little on cancer prevention and cancer prevention research.

There are many reasons why prevention research is unenticing to medical researchers. Most societies are reactive, rather than proactive, toward the problems they face. This explains why the final phases of the research on reactive treatment are usually simpler than the research on proactive prevention. Curing a patient with advanced disease is often more dramatic than preventing disease in a healthy person. And perhaps most conspicuously, treatments earn far higher profits than do new diagnostics or prevention measures.

“The way I message this to lawmakers is that our well-being is a gift; we can't take good health for granted, and prevention is a powerful way to protect that gift. When prevention works, you can enjoy the miracle of a perfectly normal, healthy day,” says Koh. “When I interact with lawmakers, I often ask about whether they have experienced the pain of losing a loved one when it could have been prevented. That usually humanizes the conversation and gives it relevance and immediacy.”