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Mr. Kiyosaki might be interested to consider the idea that only rich people make wars. Only rich people can afford to do so. And, wars come in many forms. Likewise, only the rich – relatively so – can afford drugs. Alcohol has always been accessible and relatively inexpensive. Even John Doe could, and still can, make his own beer and wine. Not so with addictive drugs in the likes of opioids, cocaine and heroin. The cost of such drugs is large, while the cost of the wars upon their distribution and use have been even greater. Both the War on Drugs as well as the War on Cancer have been in effect in the USA since 1971 when President Nixon put his stamp on these two ideas. Neither of them have been successful. They are both generally considered as failures, regardless of the amount of energy and money put into them. At the same time, it might be said that wars and fighting appear to be almost synonymous with human existence. Americans are known for fighting and guns, in particular, more so in the present day. Witness the numbers of shootings in the USA, even massacres, at the hands of assault weapons in recent times. Americans have the predilection for fighting not just national enemies, but as a general stance in dealing with often subtle issues. Rather than negotiate, or study, or contemplate issues, we tend to go off into battle with alien forces. Drugs and cancer might well be considered alien. Alien in the sense of unknown, little known, or poorly understood. Both cancer and drugs in the general sense, are far from being truly understood. Drugs and the War on Disease and the
War on Sanity
Let’s take on drugs first. It seems that the medical system has “A pill for every ill.” If all those pills really did what they were supposed to do and without side effects, the human race would have much less discomfort and life would be a whole lot easier on us. Rational, thinking people realize life is not that simple. But, we have been taught and believe otherwise. Mr. Kiyosaki would support the idea that all is not as it appears or is advertised. What is intended for our good is not always so. Obviously, medications quite often do not live up to the specifications, promotions and advertisements behind them. Like government fixes, medics and their system are supposed to help. They often REALLY want to help. But, methods and practice rarely stack up with intentions. Help is clearly not always helpful. There are two sides to every coin, we repeat. Sometimes, it seems like more than two. In the case of medical practice, it seems that the coin is more like a multi-hedron. Like a many-sided die which tends to be easily pushed onto a different side after it is first thrown. Interestingly, the word medicine has at least a dual meaning. One refers to the profession which deals with treatment of disease. The second involves potions and pills most generally taken by mouth in those treatments. “Take your medicine whether it’s good for you or not.” Medicine and medication are practically synonymous in recent generations. Pills are the preferred and sometimes, it seems, the only acceptable method in treating modern ailments. No wonder we are a pill popping society! As a young physician, the writer’s choices (being in training and watched over by the all-powerful guild) were often between prescribing penicillin or ampicillin. Or, nothing at all. The latter was generally a better choice. But often, neither appreciated nor understood by patients and physicians. “In the Church of Modern Medicine, the doctor who treats without drugs is regarded as a heretic because he or she appears to have rejected the sacrament of medication. Non-drug healers are regarded as belonging to a different religious system and are thought of as quacks, nuts or faddists.” (Robert Mendelsohn, Confessions of a Medical Heretic) Early in his medical career, this doctor-writer sensed that he had worked his way into a very narrow, limited, and non-creative if not often destructive profession. Most of our treatments – and especially our MEDICINES – were and are antagonistic to body functions. Antagonists which work against the body and its usual actions. When a person takes a medication, s/he generally has two if not three problems with which to deal. His/her original complaint plus the effects and side effects of the medication. If one problem isn’t enough when you are the patient, you will likely have at least two when you depart your doctor’s office. Here is another quick list for your consideration. This one is of common types of drugs. anti-allergics
anti-cholinergics anti-diarrheals anti-tussives anti-depressants anti-cholinesterases anti-adrenergics anti-biotics anti-spasmodics ant-helminthics anti-arrhythmics anti-convulsants anti-arthritics anti-hypertensives anti-asthmatics anti-inflammatories anti-cholesteremics anti-diabetics anti-infectives anti-pyretics anti-septics This list really could go on and on. On the other hand, a list of “pro” type medications, ones intended to support and enhance body functions, would be on the order of less than one tenth the length of “anti” medicines. Such medications are also newer, generally less known, and infrequently prescribed. Drugs and the chemicals from which they are made very often do not accomplish the task they are meant to address. This is most simply because all bodies do not react the same to medications. And with every action, there is a reaction. The suppression of one symptom is likely to create another – sooner or later. Medications are developed under laboratory conditions. Human beings live under human conditions. No wonder the real life experience of taking drugs often does not follow the patterns set in drug trials and testing. Furthermore, physicians and their patients are often looking for quick fixes and ready remedies. “The faster the better, so I can get back to regular life.” This aspect of modern life often adds to problems, as symbolized in the television commercial which shows Vanquish taking care of a headache in a hurry. Is that how real life works? Certain age groups are well known to experience more troubles with medications. Particularly the older population because they consume so many. Polypharmacy can create a host of problems. SPECIAL
POEM FOR SENIOR CITIZENS
Anonymous A row of bottles on my shelf Caused me to analyze myself. One yellow pill I have to pop Goes to my heart so it won't stop. A little white one that I take Goes to my hands so they won't shake. The blue ones that I use a lot Tell me I'm happy when I'm not. The purple pill goes to my brain And tells me that I have no pain. The capsules tell me not to wheeze Or cough or choke or even sneeze. The red ones, smallest of them all Go to my blood so I won't fall. The orange ones, very big and bright Prevent my leg cramps in the night. Such an array of brilliant pills Helping to cure all kinds of ills. But what I'd really like to know........... Is what tells each one where to go! Yeah, where DO they go? If medical science is so advanced, why do medications circulate through the whole bloodstream and affect the whole system when most of the time the patient is complaining about an ache here, an upset there, or a discomfort somewhere else? Not all over. The numbers of medications which some older people take can be staggering and downright scary – not to mention expensive. Especially when those patients see more than one physician. An old high school of the writer shared the list of meds was taking recently: Pramipexole
Metoprolol Ramipril Gabapentin Plavix Furosemide Tramadol Pantaprozol Atorvastatin Chlorthalidone Basaglar Ozempic Sometimes, the best remedy for a patient is to take him or her off all medication and start all over. A daunting process in itself, discontinuing medication is often the last thing which a Regular Physician will TRY. Where medications are considered, physicians are uniformly more comfortable with addition rather than subtraction. Besides, they started the process. Reversing course may not look so good to patient and family members. Discontinuing medication can really agitate the patient and his/her family as they wonder about the consequences of drug withdrawal. “Were those drugs ever useful or necessary? How much did we spend on them?” The physician has qualms and concerns because s/he has no way of predicting what will happen when the medication is discontinued. Even more so when several are stopped or tapered at the same time. That said, a regimen of tapering medications is a sure way to keep the patient visiting the clinic regularly. Medics definitely don’t like to take people off their pills. They feel safer with “the usual regimen,” whether helpful to the patient or not. Prescribing is relatively simple. While stopping a medication has a host of uncomfortable implications. Polypharmacy (sounds like a new drugstore chain, doesn’t it?) refers to patients who take multiple medications. This is a whole arena of modern medicine which has become an area of common concern. It persists and continues to grow more and more lucrative for the pharmaceutical industry. The major problem with polypharmacy is simple. Physicians and pharmacists are often uncertain about the effects and risks of a single medication in one patient’s body. When more chemicals are added to the human body which is already under stress, the interactions of the drugs are often totally unknown. All the while, the body is called upon to metabolize a host of waste products beyond the usual. But, the desire for remedies in pill form persist. “Pills are popular” with patients and practitioners. “One of the first duties of the physician is to educate the masses not to take medicine,” Sir William Osler, Father of American Medicine The height of pill-pushing seems to have arrived with Nexium, the Purple Pill, a preparation for heartburn made by Astra Zeneca. Pharmaceutical companies have used marketing gimmicks to get the public’s attention – as well as the physician’s – for decades. The Purple Pill deserves a prize. It does have a ring to it, but the ploy is clearly the height of hype. Pharmaceutical companies have been literally sugar-coating their medications for a long time. Along the way, they have spent huge monies in coming up with exotic names. Have you ever noticed how many drugs have Xs and Ys and Zs in their names? How does a catchy name for a pill make it more useful or effective? The Purple Pill obviously and blatantly puts cosmetics above substance. “Try our Purple Pills. They will not only help your stomach but also go well in your medicine chest or pill box and even serve as table ornaments. Take Purple Pills with you anywhere. They will brighten up most any decor.” The writer is reminded of an incident some years ago with an old friend: Dan Henning was a college professor nearing retirement who had overcome his alcohol addiction in a relatively novel way. He was warm, funny, sincere and generous, but also tall, gangly, awkward, and needy. Henning was quite affectionately and accurately known as Big Foot. Dan came to every class the writer taught. That might have been flattered, but it was well known that he went to many, many self-help classes. Dr. Dan attended 12-step programs, supported all kinds of therapists, and took every workshop that came down the pike. On visiting his home one time, all kinds of health oriented books piled here and there. He had many bottles of vitamins visible in the kitchen and bathroom. Dan subscribed to the idea that, “If one is good, two is better.” This became clear as he had TWO tape players running non-stop with TWO different subliminal tapes buzzing away. Curiously, Dan was hard of hearing and wore aides in both ears. Dr. Dan often appeared at class sessions with something to share. One evening he came to a session and proudly displayed a tiny bottle that contained “healing oil which was expressed from the bones of a dead nun.” That prompted the remark, “Wow! Dan, you’ve tried so many of these things, been to so many workshops and classes and therapists. You ought to write a book about your experiences.” Henning chuckled and responded, “Yeah, Bob, I think you’re right. I might do that. I would call it Gullible’s Travels.” Dan and you and I are more alike than we might admit. When thinking of drugs and pharmaceuticals, there are so many issues of which pill-taking patients should be aware. Here is another partial list: • Iatrogenic (physician-caused) disease is more common than even researchers want to know. The use of prescription drugs is enormously overdone and the system doesn’t keep up with the plethora of pills in patient hands. Much to the detriment of the patient population. Ten to 20 percent of hospital admissions are known to be due to adverse drug reactions (ADRs) and other ill effects of medication. Alas! That information does not filter well into medical training or practice. And, is rarely known to patients. • Warnings are commonly made about pregnant women taking medications. Those warnings may be useful for that population. But, they seem to make the rest of us second class citizens with regard to drug safety. If drugs can be harmful to the pregnant and the fetus, they also may be harmful for the rest of us. Shouldn’t we all be protected against the dangers of prescription drugs? • On the other hand for some patients (remember everyone is different), medication does not build up in the system. Instead, it is metabolized so quickly and efficiently by the body that it is likely to have little or no effect. Or, the body may simply get used to the drug’s presence. Sometimes, requiring increased dosage. Some people can become habituated to their meds like drinkers do with alcohol. Regular intake may have no apparent effect at all on the body. The patient may just get accustomed to the situation thinking, “I must be getting some benefit out of this prescription.” So, it is possible that medication you have been taking and paying well for may have absolutely no effect on your body. Your feeling or behaving better may be caused by a dozen different things which have nothing to do with medication. • Trial and Error. It is typical for the Regular Physician to say, “Let’s give this new medicine a TRY for a couple weeks. If it doesn’t work, we will TRY something else.” Haven’t you heard that a few times? Your physician is just practicing, but maybe you should expect more savvy in his methods and practice. • While the Food and Drug Administration mandates primarily for safety when passing on new drugs, efficacy is less important. Even then, how many drugs show up years later to be implicated in one serious problem or another? Some human beings take the same medication for years and it may take years for ill effects to appear. How many drug makers value the consumers’ health and welfare to test their medications with humans, day-to-day, in real life situations for Years rather than Weeks prior to pumping their new med into the market? • The Food and Drug Administration doesn’t make pharmaceutical companies prove that their new medicine is effective – that they really do what they are prescribed for. Proof of safety is hard enough. Proof of REAL efficacy is not required to get medication on the pharmacist’s counter and in your doctor’s office. The law requires “substantial evidence of effectiveness” to okay a new drug. At the same time, it says “relative efficacy” is sufficient and the FDA may not disapprove a drug on the grounds that a more effective option is available. The question of “relative efficacy” is an important one which has not been well answered for over 40 years. How can you or anyone really know that the new prescription just filled is effective or even safe? • Hippocrates, Father of Medicine from ancient times, told us, “Let food be your medicine and medicine be your food.“ Why do we persist in looking for answers in expensive colored pills if answers may be found in our foods? (Actually, medics are trying harder to find other routes besides pills to make things easier for patients. Like patches and long-term injections, etc.) Nutrition was little discussed when this writer went to medical school. It was announced at some point that we had been given twenty (20) hours of nutrition during our thousands of hours of classroom basic science courses. But, that was stretching facts. In two areas, we got bits and pieces of nutrition. Pathology: we were given some information on diseases which appear in extremes of malnutrition, such as scurvy, beriberi, pellagra, etc. Surgery: Dr. Stanley Dudrick was a leader in parenteral nutrition at our medical school at the time. He was a surgeon and was working on ways for surgical patients to be “fed” through the intravenous route during prolonged periods in which they could not take food by mouth. It was laudable work, but little applicable to most medical practice then or now. For practical purposes, nutrition presently has had next to no place in medicine. This writer is reminded of when my mother was dying of breast cancer. She wouldn’t dare take an aspirin or a vitamin without consulting her physician. Elder brother Norman wanted her to take some of his Herbalife products, but Mom wouldn’t hear of it. “The doctor would have to say it’s okay.” One day, medical orthodoxy suggests that vitamins and nutritional preparations are innocuous or useless. “Don’t waste your money.” On the next, they say that they might be dangerous and interfere with prescribed medications. • It is IMPORTANT to note that practically every medication – or one like it – in the books is naturally produced in the human body. If it doesn’t, the body surely has the innate capability to do so. The human form is constantly reproducing, constructing and re-constructing itself. Like other living creatures, the human organism miraculously takes a few simple building blocks and transforms – transmutes others to keep its structure intact and its functioning uniform over decades of use. If man can make a drug in the laboratory, the human body most certainly makes something like it already. • If a human body can make a small amount of a substance, why not a “normal” amount. At the first hint of hypothyroidism, physicians place the patient on a synthetic thyroid hormone (often for years or a lifetime). The synthetic preparation is a takeoff on the original. If the body is already making some of the hormone (which is quite likely even after surgery or irradiation), why don’t physicians help, teach, stimulate the body to produce more adequately, functionally, and normally? • Magic bullets. A whole book could be written about these medications. Actually, many have already been so written on anti-biotics and steroids. But, few if any from a critical point of view. First, physicians use these drugs with an attitude something akin to “We’ll knock ‘em dead and clear ‘em out.” It is never that simple. Both kinds of chemicals are destructive and antagonistic drugs, anti-biotic and anti-inflammatory being their main usage. If antibiotics kill bacteria, they certainly can have negative effects upon other cells which they contact as they circulate through the whole body. Side effects are numerous with anti-biotics, but usually not severe. That doesn’t mean they should be given so indiscriminately as they are today. Anti-biotics are commonly prescribed preventively in all sorts of situations as well as for supposed viral conditions where even the “experts” say they do no good. From the get-go, steroids (cortisones by many names) are particularly destructive to important body cells which are necessary for body defense and immune function. This is well known. Still, they are commonly prescribed to counteract the body’s “inflammatory response,” which after almost two centuries of scientific study is still not well understood. Since we don’t really understand inflammation after all these years, it seems strange that physicians are so ready and eager to use steroids which essentially interfere with quite normal and common body reactions. Second, “If some is good, more is better.” Not only are these medications prescribed freely, their dosages are often excessive and time of use can be extended sometimes indefinitely. Clearly with steroids, the longer they are taken the more serious the potential side effects such as depression of immune response, disturbance of bone metabolism, and interference with glandular function. In many situations, “The cure becomes worse than the illness.” Third, “If all else fails, don’t forget the antibiotics and steroids.” It is common medical thought that no one should die without the benefits of these two magic bullets. Cortisone and antibiotics are often given in this “shotgun” manner. In fact, much of medicine is played out like target practice with a shotgun. Shotgun medicine is just another name for guesswork. Is there real magic in these medications? Many will claim that to be the case, and say such has been proven. But, the real magic lies within the patient. “Our remedies oft in ourselves do lie.” (William Shakespeare, All's Well That Ends Well) The future will eventually see thoughtful medics rethinking the extravagant use of drugs in medical practice and in life. Such thoughts will not be new, but resurrected from thinkers like Oliver Wendell Holmes, Sr. (1809-1894). “Throw out opium, which the Creator himself seems to prescribe, for we often see the scarlet poppy growing in the cornfields, as if it were foreseen that wherever there is hunger to be fed there must also be a pain to be soothed; throw out a few specifics which our art did not discover, and it is hardly needed to apply; throw out wine, which is a food, and the vapors which produce the miracle of anesthesia, and I firmly believe that if the whole materia medica [medical drugs], as now used, could be sunk to the bottom of the sea, it would be all the better for mankind, — and all the worse for the fishes.” (Medical Essays)  The War on Drugs
We clearly live in the midst of a Rich Man’s pill culture. Billions of drugs are prescribed every year costing over $700 billion in the USA alone – which figures to about $2500 per person, infant to centenarian. That figure does not include the over-the-counter market which has grown substantially in recent years. And certainly not the drugs in various illegal forms which circulate rather freely in America. The Powers That Be might want to contemplate and study thoroughly the place of prescription and over-the-counter drugs – not just forbidden ones – in America. There is a pill – potion or product – for every ill. How does that way of living affect young people who are bombarded with pill mentality from early on? What kind of a message do we send to young people? “You need to take Ritalin, but you’re too young to drink alcohol.” “I am going to the pharmacy to refill your psychotropic medication. I don’t want to smell cigarette smoke when I get back home.” “That weed you’ve been smoking is illegal and going to get you in trouble. It will lead to heroin. Or, maybe back to Ritalin.” It is well known that mental ills most often tend to break through in the teen and young adult years of life. With that stated, the National Institutes of Mental Health has suggested that 20 percent – one in 5 – of Americans suffer from mental disorders. Forty-eight (48) percent of Americans will have psychiatric or substance-abuse disorder over a lifetime. (National Comorbidity Survey, 1990) It should be acknowledged that around the edges of orthodox medical science there have been investigations into the effects of drugs prescribed ever so freely for mental ills – ranging from depression to schizophrenia, attention deficit/hyperactivity disorder (ADHD) to bipolar disease. Robert Whitaker, writing in Anatomy of an Epidemic, remarks that, “the more we use drugs, the more the burden of mental illness seems to rise in our societies.” We seem to have a case of societal schizophrenia, as we tell young people to “Say No to Drugs,” while finding more and more ills for which to prescribe drugs. And among the hugely increasing incidence of chronic illness in America, mental illness has become central. Mental illness is now the leading cause of disability in children. One in 16 young adults is now considered seriously mentally ill while prescribed drugs appear to be key to their problems. And, many of them are being told that like diabetics they may have to take meds for mental ills the rest of their lives. Drugs of all kinds, but quite clearly prescription drugs, are fueling the epidemic of disabling mental illness. Whitaker’s research concludes that psychotropic medications isolate many patients, interfere with their ability to empathize, and produce flat affect. "They tend to lose their souls; never to get them back." All the while, psychiatrists don’t understand the long term effects of many psychotropic meds. Furthermore, many meds for mental ills are themselves addictive, not to mention causative of significant ill effects. The writer brings to mind a memorable moment with his former wife, two decades ago. Kathy struggled with depression for most of our marriage, and surely still does. The moment in mind came during a phone call to Kathy and her mother living in New Orleans. She was still doctoring and taking then about $300 of medication a month. To a question about her health and well-being. Kathy responded, “I feel pretty good, Bob. But, I can’t balance my check book.” Psychotropic medications have helped to create psychiatric prosperity and abundance in the pharmaceutical industry. Anti-psychotic medications are the top revenue-producing class among all prescription drugs in the USA, as noted previously. Even while the short-term benefit of many of them has not been shown to be markedly greater than placebo, they have created “medical bondage” among many patients through the range of ages. It appears that, “With psychiatric medications, you solve one problem for a period of time, but the next thing you know you end up with two problems. The treatment turns a period of crisis into a chronic mental illness.” (Amy Upham, quoted by Robert Whitaker in Anatomy of an Epidemic) Over the generations, society has spawned a drug culture. This has been developing for centuries as noted by William Osler, who said, “The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.” The medical system and in particular the developing branch of psychiatry has certainly added to the penchant for taking drugs. Even while we spout, “Just Say No to Drugs.” Through mid 20th century psychiatry took the stance that “mental illness must be medicalized.” That was a major point in the development of psychopharmacology and the creation of the psychotropic drug industry. Biological thinking pointed psychiatry toward “science-driven medicine.” The design and promise stand far, far from being fulfilled. And it seems clear that psychiatry itself has become a major part of the growing mental illness and drug problem. Availability of quick drug treatment appears to have led to increased diagnosis of mental disorders. Even though, “The psychiatrist is condemned to know next to nothing of what he is putting a stop to.” (R.D. Laing) That while original thinkers in the field have concluded that the whole notion of psychiatric illness is “scientifically worthless and socially harmful.” (Thomas Szasz) Szasz and similar thoughtful medics believe that psychiatric patients are not ill, but merely deviant or distressed with their lives and responding in personal and unique manners. But, the system likes names and labels. While psychiatry like much of modern medicine has never been shown to be safe and effective over the long term. Psychiatry is far from based on science – even further than orthodox medical practice. “Medicine is not based on science – it’s based on faith.” (Robert Mendelsohn)  It must said that the War on Drugs continues to be selective – in deciding which drugs to attack, shifting and changing those over the years. And from the perspective of most interested parties, the War has failed in its stated objectives to curb drug use and to end the illegal drug trade. The use of narcotic drugs has been prevalent in American society since the mid 1880s, when morphine and laudanum were marketed to consumers as cure-alls. As the 1900s dawned, presidential administrations began to adopt restrictive approaches toward what are now called recreational drugs. In the 1960s, medicinal and recreational drug use in the United States became a major issue and Congress passed the Controlled Substances Act in 1970. Nixon’s War on Drugs was engaged in 1971 as it was deemed that drug addiction was a “national emergency” and that drug abuse was “public enemy number one.” By 1973, it had become a criminal issue as the Drug Enforcement Administration was created. With fears of a cocaine epidemic, Ronald Reagan was prompted to reinforce and expand many of Nixon’s anti-drug policies, arguing that drug use was a “repudiation of everything America is.” The 1986 Anti-Drug Abuse Act was his administration’s most notable piece of anti-drug legislation. Bill Clinton’s administration passed the Crime Bill in 1994. It was a $30 billion piece of legislation that funded 125,000 new state prison cells, mandated life sentences via three-strikes laws, and added 60 new crimes worthy of the death penalty. Between 1980 and 1997, the number of people locked up for non-violent, drug-related crimes rose from 50,000 to 400,000. Those offenders now make up almost half of the federal prison population. Incarceration is supposed to reduce drug use. But, there is little evidence to suggest that locking people up reduces drug consumption in the long-term. Studies have found no statistically significant correlation between drug imprisonment rates and the rate of drug use across most states. That while surveys suggest that over 80 percent of Americans think the War on Drugs has failed and that over 60 percent of voters support eliminating criminal charges for drug possession. All the while, it seems quite clearly that rich America’s drug addictions persist. The War on Drugs has much in common with Prohibition – the War on Alcohol – which lasted only 13 years from 1920 to 1933. In dollars of that day, it cost the federal government a total of $11 billion in lost tax revenue, while costing over $300 million to enforce. The costs of the present era’s War on Drugs is estimated to be more than a trillion dollars. That includes around $40 billion the federal government spent in 2022 alone, according to the Government Accountability Office. Illegal drugs and drug abuse are still very much with us regardless of the dollars expended. But the personal costs of the War from jail time can be horrendous: physical and mental health effects as well as the stigma of prison time, family and social disruptions, and stresses upon the whole society. They can be a hell of a way for Americans to learn life’s lessons.  The War on Cancer
Similar to the War on Drugs, little substantive progress has been made in the War on Cancer. That even though researchers suggest that “important scientific discoveries have been made along the way.” Those discoveries appear relatively minor because cancer is as prevalent – maybe more so – than it was 50 years ago. The two Wars come together in a way when we think about powerful Drugs being promoted and used as the mainline “weapons” to treat Cancer. Over fifty years on, the War on Cancer is far from being won. The hoped for Magic Bullets as targeted therapies for the large majority of cancers have proven neither curative nor even enduringly effective. The War on Cancer did raise public awareness but also the Fear of the “devastating disease" – presenting it as a dangerous enemy that posed a serious threat to society. Diverse forces and resources — research institutions, hospitals, medical centers, the pharmaceutical industry, governments, and philanthropic organizations — were assembled in hopes to counterattack and win the War. Cancer is currently considered to manifest as hundreds of types and sub-types, collectively affecting most organs and tissues. The complexity is immense according to present scientific view, as mysteriously transformed cells drive the expansive growth of different cancers. Genes are thought to re-program regulatory functions, which corrupt normal cells to become proliferating cancer cells. In this day, it is admitted that few cancers can be cured unless detected early and surgically excised. Although some progress towards understanding the nature and basis of cancer has been made, an important question was asked at the World Oncology Forum, in Lugano, Switzerland, in late 2012: “Are we winning the War on Cancer?” The conclusion was, in general, “NO.” Despite the introduction of hundreds of new anticancer drugs, including advanced therapies (so-called Magic Bullets), cancer is undeterred and uncured for the vast proportion of victims. Overkill has been common in the War for fifty years as toxic and aggressive chemotherapy in solid cancers have failed to achieve longer survival or better quality of life. Often chemo has done the opposite. Otis Brawley, former Chief Medical Officer for the American Cancer Society has written that, “Cancer patients and their doctors routinely accept horrific risks as they inject drugs intended to cure cancer or slow down its process…. Sometimes we treat one hundred people to benefit ten. All one hundred will be subjected to harm, and ninety people will pay the price for the lucky ten.” (How We Do Harm)  Brawley went on to say that for many years, cancer treatment strategy has amounted to the summation that “anyone who died of cancer died because he didn’t get enough chemo.” Beyond that simple fact, the further reality sets in that supposedly promising new cancer treatments are very expensive. Then, the War on Cancer is expanding on the world map. Incidence of lifestyle-associated cancers are rising in developing countries as populations adopt diets and lifestyles associated with risks of cancer in high-income – rich – countries. Now after fifty years, some physicians are rethinking the strategy of fighting the War on Cancer. One prominent theory is to develop a plan “in which individual battlefields, armies, and armaments are integrated into an overarching, holistic so-called battlespace that guides strategic war plans …” The War on Cancer and the search for Magic Bullets to kill cancers are not over. They just need to be integrated into a larger “battlespace.” (Ian Haines, Lancet 2014) Besides the personal emotional and bodily costs to patients and families, cancer care is one of the most expensive aspects of medicine in the USA, with a substantial financial burden on individuals and the medical system. At the same time, the cost of cancer care is projected to continue increasing due to factors like population demographics and advancements in treatment options. According to recent estimates, the cost of cancer care in the United States is around $183 billion annually, with projections indicating it could reach over $245 billion by 2030 due to an aging population and increasing cancer rates.
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Introduction - Table of Contents
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