A Novel Suggestion for Combating Cancer: Don't Try to Cure It

By Eliza Strickland | May 28, 2009 3:56 pm

chemotherapyWhat if we stopped trying to cure cancer, and learned how to live with it? That’s the provocative question asked by  mathematical oncologist Robert Gatenby in an essay published in Nature (subscription required). Gatenby argues that by trying to eradicate tumors with heavy doses of chemotherapy, doctors sometimes end up selecting for drug-resistant cancer cells that can spread rapidly once treatment is halted. Instead, he suggests giving patients moderate doses that aim to stabilize the tumor and prevent its growth.

If doctors were guided by this principle, it would change treatment fundamentally, Gatenby says. “Your whole goal is to keep the tumor stable…. With a mouse ovarian cancer model, if you treat it with a very high dose, the tumor goes away. It looks like you’ve cured it. But a couple weeks later it comes back and starts killing animals. This is a standard outcome. What we did is use smaller doses of drugs and applied them when necessary. We were able to keep tumors stable and mice alive indefinitely” [Wired], he says.

In his essay, Gatenby writes that the focus on a cure for cancer is a part of a mindset that began when the German Nobel laureate Paul Ehrlich introduced the concept of ‘magic bullets’ more than 100 years ago: compounds that could be engineered to selectively target and kill tumour cells or disease-causing organisms without affecting the normal cells in the body. The success of antibiotics 50 years later seemed to be a strong validation of Ehrlich’s idea. Indeed, so influential and enduring was medicine’s triumph over bacteria that the ‘war on cancer’ continues to be driven by the implicit assumption that magic bullets will one day be found for the disease [Nature, subscription required].

Instead of campaigning for cancer eradication, Gatenby submits a plan for containment that he likens to an ecologist’s attempt to control an invasive species. “In treating a field for a pest, for example, you might treat three-quarters of it with a pesticide, and leave the other quarter untreated. Pesticide-sensitive pests remain there, and they spread out into the field after treatment, preventing pesticide resistance from becoming dominant” [Wired], he says. If the ecologist took the opposite tack and spread pesticide over the entire field, only chemical-resistant bugs would remain, making future pesticide applications less and less effective.

Gatenby acknowledges that the idea is controversial, and says that his proposal has sometimes been met with “a mixture of horror and contempt.  The crux of the response was that patients and physicians would never accept the idea of not treating for cure.  The psychology will inevitably be a significant problem for the acceptance of a therapy that explicitly does not aim for a cure” [Scientific American], he says.

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Image: iStockphoto

CATEGORIZED UNDER: Health & Medicine
MORE ABOUT: cancer
  • jdporter

    It is controversial, but in my opinion that is because it goes in exactly the wrong direction. We should be devoting more resources to understanding the *causes* and *prevention* of cancer. Even so, there’s no reason not to fight cancer on all fronts.

  • jon

    jd….you read the article: higher doses of chemo makes the cancer more likely to come back. You like that kind of “fight?” I don’t.

  • justin

    I have seen our treatment models kill many people including my own mother. Cancer is but a natural process that happens when an environment is out of order. Establish homeostasis, and the cancer will reverse itself. Theres too much money in the “war” on cancer, thats why you wont have progress. Do you know how much money pharm would lose if cancer was gone???

  • Grant H

    Something about this is setting off alarm bells in my head.
    A cancer patient who remains a patient indefinitely and will require medication for their entire natural life sounds a little like a gold mine.
    I’m cynical and I’m probably way off. I felt I should share that this newly announced line of thinking (for the treatment, but not cure, of cancer) has me a little suspicious.

  • Ashley G

    Grant H: As opposed to the current model, where a cancer patient often requires medication, invasive surgery, and body-weakening chemotherapy for the rest of their (rather shortened) lives? I’d rather live longer on medications that don’t cure me fully, but keep the problem from getting worse, than only have a year or two of hospitalization and near-hopelessness. Would there be a profit in these medications? Sure, but that’s the case in any chronic illness.

    I guess that, to put a finer point on it, current cancer treatments make a patient a patient for the the rest of their shortened lives; this method might make a patient able to live a normal, unhospitalized, non-”patient”-like life for a whole lot longer.

  • Jo

    @justin: No. Your explanation of cancer is dead wrong.

    @Grant: Agreed, it sounds like a great recipe for Big Pharma to make a lot of money. But forget who would benefit the most from this for a moment. It doesn’t matter. The true test is whether or not it works. Do a study, start some trials, and if we then increase survival rates and quality of life? Bring it on.

  • Sue

    Our “cure” rates for most primary cancers are going up and mortality rates are going down, so it looks like we are onto something good here. Unfortunately, the incidence of secondary cancers are going up and many of these are harder to treat. Will moderate long-term doses of chemotherapy reduce or increase the likelihood of secondary cancers?

    In addition, not all cancers can be controlled and when they metastasize, they go to the brain, lungs, or liver. Will this long-term treatment prevent/reduce metastases? I doubt it.

  • Dolores Pomilio

    Remember AIDS in the late ’80s? Everyone was looking for a cure and still and yet, none has been found. Today, thousands of people are still living relatively normal lives with the disease, thanks to containment medicine. I too believe that containment is probably the most viable option for other cancers. “Learn to live with it”. As for the Pharmaceutical Companies making a killing, they’re doing that with many other chronic diseases that have no cure e.g. heart disease, diabetes, etc., and no one thinks anything about those costs. Quality of life is more important than periods of intense suffering and worry when cancer is attempted to be cured. I hope this “revolutionary” idea takes hold.

  • FB36

    I think this is really good idea to try. When current treatments do not work well and cause
    too much suffering for the patient it is time to try a new approach.
    I think low dose or less effective long term treatment may cost less in money and suffering.

    I think another problem with cancer treatment is this:
    Many plants may have useful compounds that could cure/stabilize cancer cheaply and w/o
    side effects. The problem is Big Pharma would not spend money to research on them because
    even if they find any cure they cannot get a patent for any naturally occurring substance.
    So they keep experimenting w/ dangerous artificial chemicals to find a cure, instead.

  • JJ

    I haven’t read the Nature article, so maybe this comment is redundant, but has anyone said the words natural selection? This is the same principle as the evolution of antibiotic resistance under heavy use of antibiotics and by reducing the use of antibiotics, we keep them effective, because the selective factor for the evolution of more resistance (in this case more resistant to chemo drugs) is not there (or is less). This being said, I imagine that for this to work there would have to be more innovation in early detection of cancers to target them with low dose chemo before they metastasize.

  • http://crowlspace.com/ Adam

    I think JJ has hit the nail on the head – get it early and keep it small. If drugs just select the more aggressively reproducing varieties because of the extreme selective filter the drugs impose, then keeping the cancer cells ‘placid’ and able to outcompete the aggressive variety might actually be a stable arrangement. At least meta-stable.

  • Lucyface

    I agree that for those with cancer it would likely make for a higher life expectancy and quality of life if you do discover it early and keep it small and stable. Why take those last two years of your life and spend them in a hospital bed feeling awful? On the other hand, I do think more focus should shift to the cause and prevention in the first place, which would be the ideal in terms of quality of life.

  • TinaG

    It makes sense actually. I’ve known and read about too many people getting treatement for cancer that were overdosed and effectively killed from the treatment rather than the cancer.

  • http://www.kenstech.com Ken

    Sounds kinda like the Nash Equilibrium, only applied to drug /disease resistance. Instead of trying to go for the “win,” doctors should go for an intermediate solution that may not be definitive, but is nevertheless more attainable.

    Ken

  • Brian

    When a family member was diagnosed with prostate cancer I did some investigation. The outcome was very interesting.

    Many prostate cancers are slow growing and the older you develop them, the less aggressive they normally are. In fact the number of elderly men who have prostate cancer is remarkably high (something like 1 in 3 or 1 in 2). Now add in the fact that, until recently, prostate cancer treatments could be very negative on the patient’s quality of life.

    It all added up to this common strategy: monitor, but don’t treat unless the disease accelerates. Sure, the person has cancer. However they are almost certainly going to die of something else, long before the prostate cancer gets them.

    I understand that recent advances have made prostate cancer treatment much less damaging. Lengthening lifespans could change the picture, as does diagnosis at a younger age. One size does not fit all, your mileage may vary, etc.

    However in such cases, maybe coexistence is a good strategy.

  • Doug

    Is this something that exists today? Can one specify or request this type of treatment?

    I agree with Dolores, Aids is not curable. But we haven’t given up on those with the disease.

  • http://www.wolfshaman.com Elias Walks-With-A-Limp C.W

    Cancer was believed to be the curse of the Three Powers in the Age of Discovery by the Ancestors for brutalies until as time crept and flew by and as peoples and lifestyles changed with diet ,Europianism, and residences on reservations the Cure for Revenge became the First Nations Curse too ?
    As some Big Medicine Mide believe the harnessing of a hideously fearsome weapons byproduct or essence there of to blast nuclear radiation into the fleshcloak contaminated with Cancer seems as barbaric as being bitten by a Rock Rattler to counteract the bite of weaker venom …..
    Nobody deserves this Hellfire on Earth alas though it is essential that the afflicted be within the hearth of home surrounded by the love of family and supportive friends i agree for the last remaining days can very well become so in the white clinical lone soul environment of the hospital for there is much to be spoken of the many combined factors of Herbal spiritual healing and combined remedies utilised to work with and around the dinosaur of radioactive life force sapping !
    There are roads that wrapped together into a bundle of proven power can be taken in doses regularly mixed with combinations of treatments that under family or trusted ones supervision can not only battle the forces of Cancer but can also assist in giving the wounded the power to make it to their chemo appointments and then get back to where their hearts are within hearth and home temple and sanctuary which just in itself grabs the unlimited power of the brain and gives more life force to our phsycological crusade against the infidel called Cancer !
    To think of the tumor as an enemy that has your body under seige gives one the strategic self governance over self and with a scroll of measures and secrets to win this seige combined with chemo can has and will win the war against this invader of invaders .
    Learn to lie to yourself about your mood the fundamental beginning of the seige and victory is to remain under the veneer of HUMOUR dry tasteful slapstick whether or not you are nauseated sickened angered and depressed to remind oneself of something recently that really made you laugh is a key ingredient to winning the war and is absolutely essential not to mention the impossibility of all pleasures you regaled in pre Cancer must be repeated even in as small doses as possible ,Whether through m oney favors or if the lone want one must attempt to do pleasurable activities to help endorphins and dopamine beleived by some to have Cancer battling properties hence laughter and this is just a few of the tactics i am sharing but have not enough time to finish yet am sure those in suffering have read this or their loved ones who are already sure of what i preached but also enquire if MIRACLE MINERAL SOLUTION 28% SODIUM CHLORITE in a misture of distilled water which is cut with citric acid and water solution to ingest daily at your discretion with SILVER TINCTURE ,GOLD TINCTURE , PLATINUM TINCTURE , COPPER Etc all seperate cut with i imagine the same recipe at 28% DISTILLED WATER Only Mineral Solutions can be taken as drops pure on tongue and or in your favorite drink except highly acidic ones which kill the potency of the heal !

    There is so much more but begin with these all at the same time with the chemo and witness your self for unless the mixtures are deadly for you in some allergic one or combinatory recipe that can harm you seriously or something else after expert investigation make your own judgement for i speak only from what i know and claim and i do it because i care about all of my SISTERS AND BROTHERS and have if i could one wish end human suffering everywhere as any Big Medicine Maker worth his or her weight in salt would so get to your health foos store and LIVE LAUGH AND LOVE Again i do pray for HOPE is the next step then HEAL

  • pramod tiwari

    if our hare cane grow then why should our tissue
    if we try to find the content of hair might it helpful in this diesase

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