In a prior blog, I listed arguments, that I have encountered over the years, against the the importance of precancer research. This is the fourth of several blogs where I respond to the arguments.
Argument. The mission of the National Cancer Institute, the primary funding agency for cancer research in the U.S., is to develop cures for cancer, not precancer. If precancers were as important as you say they are, there would be a National Precancer Institute. But there isn't.
ResponseThis argument turns the tables on people, such as myself, who insist that precancer is a lesion that is distinct and separable from cancer. If precancers really are a different lesion from cancer, then why should precancers receive research funds earmarked for cancer? Well, the answer is obvious. The job of the National Cancer Institute is to eliminate cancer through research. Pursuing precancer research is the best strategy to eliminate cancer.
Argument. Precancers regress spontaneously. Why should we try to develop treatments for a disease that usually resolves without treatment?
Response. Yes, many precancers regress spontaneously, and if we were to treat all of the precancers, we would be treating many lesions that would have regressed without treatment. At this time, we cannot distinguish the precancers that will regress from the precancers that will progress to invasive cancer. Until we can distinguish regressing precancers from progressing precancers, we need to treat them all.
At this point, we know almost nothing about the causes of precancer regression. We could potentially cause all precancers to regress, if we knew how to control the conditions that favor regression. If we could arrest the transition of precancer to cancer, we could halt the occurrence of invasive cancers. If we could simply delay the transition of precancers to cancer, even if it were for just a few years, we could greatly reduce the burden of cancer in the population.
Next blog entry in precancer series
Jules Berman
key words: preneoplasia, premalignant, preneoplastic, incipient neoplasia, pre-cancer, dysplasia, metaplasia, intraepithelial neoplasia, premalignancy, premalignancies, precancers, precancerous, carcinogenesis, pathology, cancer research, cancer funding, cancer research funding, funding for cancer research
