So, Joe Biden is going to cure cancer. That was among President Obama’s big ideas in his final State of the Union pageant.
Let’s start with the obvious: Joe Biden is not going to cure cancer. Joe Biden couldn’t find chlamydia backstage at a Mötley Crüe concert. (It’s easy to picture Joe Biden backstage at a Mötley Crüe concert, isn’t it?) He couldn’t find NaCl in an aqueous solution if he fell into the Pacific Ocean. Joe Biden is about as likely to discover a cure for cancer as J. J. Watt is to sing the lead in The Marriage of Figaro and dance in La Sonnambula with the Bolshoi in between back-to-back Super Bowl wins. Ain’t gonna happen.
You’d have a better chance tracking down Paul Begala’s self-respect.
In fact, it is isn’t very likely that anybody is going to cure cancer — ever. There are some reasons for that, none of which seems to have occurred to Barack Obama.
To begin with, there’s the inconvenient fact that there is no such thing as cancer. “Cancer” refers to a category of diseases, one that contains hundreds of different maladies. Some of those have a great deal in common with one another, many do not. Spindle-cell breast cancer really isn’t very much at all like Hodgkin’s lymphoma; the former presents a very difficult course of treatment with a poor outlook, while the latter is so effectively treated (90 percent survival rate) that it is sometimes described as “curable,” though physicians tend to shy away from the use of that word.
Some cancers are even transmissible, though no known human cancers are. The comparison with the mission to the moon is inapt insofar as that was, despite all of the effort and ingenuity involved, a relatively straightforward engineering problem. This is more like planning a mission to a moon that has a completely random orbit.
Cancer is one of nature’s great survivors, an eternal (so far) reminder that you can give your heart to Jesus but your ass belongs to evolution. As breast-cancer surgeon David Gorski puts it, “Cancer progression can be viewed as being due to a case of evolution in which the tumor cells that survive selection to continue to grow are the ones that become best at doing all the things that tumor cells need to do to evade the body’s defenses and overcome its growth-control signals.” Cancer is unlikely to be “cured” for the same reason that crime will never be eradicated: adaptation.
After the federal government in the Nixon era ’declared war on cancer,’ everyone was committed to its conquest — and cancer didn’t care, because cancer doesn’t follow politics.
At the same time, it would not be at all surprising if, in a generation or two, dying from cancer were as rare and exotic as being crippled by polio is today. There is a great deal of promising research in any number of fields, from genetics to nanobiology, that should instill in us a cautious and sober optimism that we can make more cancers treatable and manageable, that in a few decades having cancer could be more like having diabetes. But that is a very different thing from finding a cure.
This is an example of political thinking. The political mind imagines that if political will is bent toward some particular end, and that if the right people with the right philosophy are empowered to command sufficient resources, then all of reality is malleable. That isn’t how the world actually works; if it were, there would never be a recession or other economic shocks, intractable national-security problems related to distant primitive desert savages, or, for that matter, traffic jams. But these things exist, because the world that exists in the political imagination is not the real world.
President Obama might have made a different sort of declaration: “We are going to spend some additional money to fund a number of different cancer-research projects, and we hope that at least some of those projects will yield results that enable us to develop, at some point in the future, marginally more effective treatments for some kinds of cancer.” But that isn’t what President Obama said.
It isn’t what President Richard Nixon said, either. In 1971, the federal government — stupid phrase — “declared war on cancer.” President Nixon, with some fanfare, signed into law the National Cancer Act, which increased support to the National Cancer Institute. “As a result of signing this bill,” President Nixon said, “the Congress is totally committed to provide the funds that are necessary, whatever is necessary, for the conquest of cancer. The president is totally committed. . . . You will have, of course, the total commitment of government, and that is what the signing of this bill now does.” Everyone was committed — and cancer didn’t care, because cancer doesn’t follow politics.
“We’re going to cure cancer” isn’t a scientific-research agenda – it’s a political promise. Government funding of basic scientific research at its pre-commercial stages is one of the most fruitful (or, if you prefer, least destructive) things that government does. Sometimes that research is in the service of an explicit federal priority (usually military), and sometimes it is more general.
Ensuring that the money is well spent without putting research decisions in the hands of lawyers is sometimes a tricky business, one that the researchers themselves often enough complicate by following their own political agendas. Our management practices here probably should tend toward the regular and the general, rather than directing resources into moonshot projects that sound more plausible on television than in the laboratory.
Joe Biden isn’t going to cure cancer. Let’s make sure that he and the imperial hubris he brings with him don’t get in the way of our making progress in treating it, and in advancing our understanding of other diseases.