Why is science doing so poorly in the fight against cancer?

We all know that doing the same thing over and over again and expecting the outcome to change is a mark of insanity. It's time for some fresh ideas on cancer research.

As thousands of women line up to run Cancer Research UK’s Race for Life this summer, few will be aware of how poorly science is doing in the fight against cancer. It’s not something anyone likes to talk about. But now, after years of silence, two dissenters have come along at once.

Few of us are untouched by cancer. If it is not a personal experience, we know someone whose life has been, or is being, affected by this most hideous of life’s processes. Everyone wants to do something about this scourge of modern living. That was why, in 1971, President Nixon declared war on cancer. He had all the confidence of a man whose national space agency had just left human footprints on the moon. Making an impact on cancer has proved much harder, however. We are now better at combating childhood leukaemia than we were, but few other cancers have succumbed to science.

In 1950, cancer killed 193 per 100,000 people. In 2004, the numbers were hardly changed: 186. Many billions of dollars and 54 years of research had saved seven lives out of every 100,000. It’s hardly a success story, especially when compared with the 63 per cent drop in death rates from cardiovascular disease over the same period. We have made a huge difference by using preventative information – getting people to stop smoking and exercise more, for instance. Curing cancer that has already taken hold, though, remains a matter of battering it with chemotherapy and radiotherapy.

Those kinds of figures are why, in 2007, the deputy director of the US National Cancer Institute asked Paul Davies to get involved. Davies is a physicist; speaking of his forays into cancer research at a New Scientist event in London this month, he acknowledged the problems of invading other people’s research territory. Nonetheless, he suggests, a fresh set of brains asking dumb questions is not always a bad thing.

So far, the result of his work with other physicists is to suggest that cancer may be an extremely ancient cellular program that creates a secondary, competing organism within the body. Davies sees the program as a genie in the bottle: when something – stress, or some kind of injury to the cell – breaks the bottle, the genie is released. Spending billions on examining cancer cells is like examining the shards of the bottle while ignoring the genie, Davies reckons.

Just as left-field is Maurice Saatchi’s incursion into the cancer arena. The former ad executive is even less (formally) qualified than Davies to offer critiques of the cancer establishment, but he is far more belligerent. Watching his wife die of ovarian cancer, Saatchi was struck by what he calls the “medieval” nature of the treatment options currently available. In April, he told the New Statesman of his decision to launch a private member’s bill in the House of Lords in order to give doctors more scope to try innovative unlicensed treatments.

The medical research establishment will no doubt scoff at Saatchi’s call; yet it is not always a bad thing to approach a scientific field with the heart as well as the head. The IVF pioneer Robert Edwards was spurred into action by his friendship with a couple who were unable to have children. Whether or not Davies or Saatchi are ultimately successful in their attempts to regain some ground in our fight against cancer is not really the point. The point is to acknowledge that fresh ideas are required.

We all know that doing the same thing over and over again and expecting the outcome to change is a mark of insanity. Let’s end this cancer madness now.

Researchers working at the Cancer Research UK Cambridge Research Institute. Photograph: Getty Images

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

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Junior doctors’ strikes: the greatest union failure in a generation

The first wave of junior doctor contract impositions began this week. Here’s how the BMA union failed junior doctors.

In Robert Tressell’s novel, The Ragged-Trousered Philanthropists, the author ridicules the notion of work as a virtuous end per se:

“And when you are all dragging out a miserable existence, gasping for breath or dying for want of air, if one of your number suggests smashing a hole in the side of one of the gasometers, you will all fall upon him in the name of law and order.”

Tressell’s characters are subdued and eroded by the daily disgraces of working life; casualised labour, poor working conditions, debt and poverty.

Although the Junior Doctors’ dispute is a far cry from the Edwardian working-poor, the eruption of fervour from Junior Doctors during the dispute channelled similar overtones of dire working standards, systemic abuse, and a spiralling accrual of discontent at the notion of “noble” work as a reward in itself. 

While the days of union activity precipitating governmental collapse are long over, the BMA (British Medical Association) mandate for industrial action occurred in a favourable context that the trade union movement has not witnessed in decades. 

Not only did members vote overwhelmingly for industrial action with the confidence of a wider public, but as a representative of an ostensibly middle-class profession with an irreplaceable skillset, the BMA had the necessary cultural capital to make its case regularly in media print and TV – a privilege routinely denied to almost all other striking workers.

Even the Labour party, which displays parliamentary reluctance in supporting outright strike action, had key members of the leadership join protests in a spectacle inconceivable just a few years earlier under the leadership of “Red Ed”.

Despite these advantageous circumstances, the first wave of contract impositions began this week. The great failures of the BMA are entirely self-inflicted: its deference to conservative narratives, an overestimation of its own method, and woeful ignorance of the difference between a trade dispute and moralising conundrums.

These right-wing discourses have assumed various metamorphoses, but at their core rest charges of immorality and betrayal – to themselves, to the profession, and ultimately to the country. These narratives have been successfully deployed since as far back as the First World War to delegitimise strikes as immoral and “un-British” – something that has remarkably haunted mainstream left-wing and union politics for over 100 years.

Unfortunately, the BMA has inherited this doubt and suspicion. Tellingly, a direct missive from the state machinery that the BMA was “trying to topple the government” helped reinforce the same historic fears of betrayal and unpatriotic behaviour that somehow crossed a sentient threshold.

Often this led to abstract and cynical theorising such as whether doctors would return to work in the face of fantastical terrorist attacks, distracting the BMA from the trade dispute at hand.

In time, with much complicity from the BMA, direct action is slowly substituted for direct inaction with no real purpose and focus ever-shifting from the contract. The health service is superficially lamented as under-resourced and underfunded, yes, but certainly no serious plan or comment on how political factors and ideologies have contributed to its present condition.

There is little to be said by the BMA for how responsibility for welfare provision lay with government rather than individual doctors; virtually nothing on the role of austerity policies; and total silence on how neoliberal policies act as a system of corporate welfare, eliciting government action when in the direct interests of corporatism.

In place of safeguards demanded by the grassroots, there are instead vague quick-fixes. Indeed, there can be no protections for whistleblowers without recourse to definable and tested legal safeguards. There are limited incentives for compliance by employers because of atomised union representation and there can be no exposure of a failing system when workers are treated as passive objects requiring ever-greater regulation.

In many ways, the BMA exists as the archetypal “union for a union’s sake”, whose material and functional interest is largely self-intuitive. The preservation of the union as an entity is an end in itself.

Addressing conflict in a manner consistent with corporate and business frameworks, there remains at all times overarching emphasis on stability (“the BMA is the only union for doctors”), controlled compromise (“this is the best deal we can get”) and appeasement to “greater” interests (“think of the patients”). These are reiterated even when diametrically opposed to its own members or irrelevant to the trade dispute.

With great chutzpah, the BMA often moves from one impasse to the next, framing defeats as somehow in the interests of the membership. Channels of communication between hierarchy and members remain opaque, allowing decisions such as revocation of the democratic mandate for industrial action to be made with frightening informality.

Pointedly, although the BMA often appears to be doing nothing, the hierarchy is in fact continually defining the scope of choice available to members – silence equals facilitation and de facto acceptance of imposition. You don’t get a sense of cumulative unionism ready to inspire its members towards a swift and decisive victory.

The BMA has woefully wasted the potential for direct action. It has encouraged a passive and pessimistic malaise among its remaining membership and presided over the most spectacular failure of union representation in a generation.

Ahmed Wakas Khan is a junior doctor, freelance journalist and editorials lead at The Platform. He tweets @SireAhmed.