Opinion

Could We Have Cured Cancer by Now?

Could We Have Cured Cancer by Now?

Image via Shutterstock

Earlier this month, scientific heavyweights came together for the first of a year-long series of talks designed to engage the general public in a conversation about cancer.

Commentary - in-story logoThese talks, organized by the San Diego Center for Ethics in Science and Technology, stem from issues raised in Siddhartha Mukherjee’s Pulitzer Prize-winning book, “The Emperor of All Maladies.”

More than a history, the book is a biography of cancer, asking us to consider the disease from medical, historical, cultural, sociological, personal and even linguistic perspectives.

This first event, on the cusp of National Cancer Awareness Day Oct. 8, featured controversial science journalist Clifton Leaf. His groundbreaking article from 10 years ago and newly published follow-up offer critiques of practices that promote independent science and disincentivize the sharing of data.

Leaf argued that this has slowed progress and shifted the focus of research away from patients and toward breakthroughs that will get the next grant and build a scientist’s career.

He didn’t point the finger at the scientists or indicate that their intentions are impure. Instead, he said the structure of how we fund research has subtly influenced the culture of science in ways that fall far short of maximizing the speed and efficiency of progress.

How do we begin to think about changing the entire system? It is a monumental task that will likely cost billions, inevitably have winners and losers, and may not actually work. And the stakes — with hundreds of thousands of people dying from cancer each year — couldn’t be higher.

If we agree with Leaf, and believe that what we need is greater sharing of data and ideas during research (not afterward in publication), then the task is to re-imagine a funding system that asks for and rewards collaboration. This sounds simple, but what would that really look like?

There are models of this we might consider.

Corporations do research and employ multidisciplinary teams of scientists and engineers who work together and share ideas in pursuit of breakthroughs. But the profit motive of these companies narrows the focus of research, and often promotes short-term gains over long-term risks with potentially big payoffs. Also, while there are often scientific collaborations within a company, they do not often extend to others.

The military is well known for its powerful and successful projects. The absence of the profit motive certainly makes them an important place for long-term, speculative research (much of which never “pays off”). These projects have led to world-changing innovations — modern computing, for example. But when we deal with “civilian” careers, including promotions based on individual achievement and salary incentives, it is hard to imagine translating the military model, restructuring the entire economic system.

California currently offers a small-scale alternative model that looks promising. In 2004, the California Institute for Regenerative Medicine was founded through Proposition 71 to institute a state agency that would fund stem-cell research. The institute offers many creative grants, such as “collaborative funding agreements” that are only funded when a California stem-cell lab demonstrates it will collaborate with another group outside of the state.

It has also funded research facilities including San Diego’s Sanford Consortium, which requires teams to move in and out of one another’s labs on a regular basis, facilitating more regular communication among them. But the institute is funded by general obligation funds totaling $3 billion, which will expire in 2017. For the institute to stay active, the state Legislature or the voters will have to find a way refund it.

Still, even this approach would require at least a majority of scientists — who thrive in a culture that worships individual accomplishment —to  rally around the idea of contributing to the cure(s) for cancer instead of potentially being the one to do it.

So we have to ask ourselves: Can we expect our scientists to be more selfless than the rest of us? Are we ready for such a profound change?

What if it might cure cancer?

This op-ed is part of a collaboration with the Emperor of All Maladies Project, exploring cancer as it exists both publicly and privately. This is the third Common Read project organized by a science and education alliance including Grossmont College, Point Loma Nazarene University, San Diego State University, University of California San Diego, the Reuben H. Fleet Science Center, Sharp Health Care and the Center for Ethics in Science and Technology. Learn more here.

Tate Hurvitz is associate professor of English at Grossmont College, and writes on behalf of the San Diego Center for Ethics in Science and Technology.  He lives in Chula Vista. Hurvitz’s commentary has been edited for clarity. See anything in there we should fact check? Tell us what to check out here. Want to respond? Submit a commentary.

Voice of San Diego is a nonprofit that depends on you, our readers. Please donate to keep the service strong. Click here to find out more about our supporters and how we operate independently.


  • 0
    Followers

Show comments
Before you comment, read these simple guidelines on what is not allowed.

8 comments
David Stroup
David Stroup

Clearly the author shows little understanding of "Military" projects and their history. The military specifies what it wants and civilian contractors do the work -- for profit. While the military manages the project and doesn't earn a financial profit, their careers can be enhanced or destroyed based on their handling of a project -- their personal profits from the task.

The speculative, long-term research on many ideas is left over from WWII; we were caught completely off-guard as to the possibilities of new technology and nearly lost the war in 1942. No one wants to be the general or admiral in charge if another Pearl Harbor occurs. Pearl Harbor was a change in technology -- fighters & aircraft carriers vs. battleships; 9/11 was a change in tactics with no new technology.

The military contractors have a single customer -- the government. They do whatever the customer wants, just like any business, to make the most money. The government makes rules that seem like a good idea for military contractors, but in reality, create unforeseen problems. For instance, the contractors get paid based on number of engineering hours used on a project. All of the contractor costs are factored into that payment instead of itemized, so it is actually a multiple of an engineer's hourly salary (the gov't might pay $150/hr while the engineer personally gets $50/hr). Those costs include the physical facilities, utilities, support personnel (admin assistants, shipping, cleaning, etc), employee benefits, etc. While this seems like a good idea because many of those costs are relatively fixed, it results in few admin assistants and ridiculously long periods between computer upgrades. Why? Because both result in MORE engineering hours spent and lower costs -- doing their own tech writing, editing, & copying and waiting for their slow computers to complete the task that would take 1/4 of the time on their personal laptop (that can't be used due to security regulations). More hours = more pay to the company with fewer personnel and no computer expense = even more profit. Companies are rarely rewarded when they come in under cost or beat a schedule deadline. They are also rarely punished for missing a deadline and are usually given added budget to complete the project (more hours = more profit!), so there is no incentive to change their behavior.

The capitalist system of finding the best way through competition will always result in some inefficiencies and we will probably never be free of them. We can only hope to recognize them from time to time and try to eliminate them -- while the new inefficiencies bubble to the top. Scrapping the system to create a new system won't change human foibles -- we'd just get a new set of inefficiencies to go with the new system.

As for getting anyone to do a job for the "Joy" of it, that has never worked on as large a scale as needed to cure cancer. Socialism and communism are still dead...

David Stroup
David Stroup subscriber

Clearly the author shows little understanding of "Military" projects and their history. The military specifies what it wants and civilian contractors do the work -- for profit. While the military manages the project and doesn't earn a financial profit, their careers can be enhanced or destroyed based on their handling of a project -- their personal profits from the task.

The speculative, long-term research on many ideas is left over from WWII; we were caught completely off-guard as to the possibilities of new technology and nearly lost the war in 1942. No one wants to be the general or admiral in charge if another Pearl Harbor occurs. Pearl Harbor was a change in technology -- fighters & aircraft carriers vs. battleships; 9/11 was a change in tactics with no new technology.

The military contractors have a single customer -- the government. They do whatever the customer wants, just like any business, to make the most money. The government makes rules that seem like a good idea for military contractors, but in reality, create unforeseen problems. For instance, the contractors get paid based on number of engineering hours used on a project. All of the contractor costs are factored into that payment instead of itemized, so it is actually a multiple of an engineer's hourly salary (the gov't might pay $150/hr while the engineer personally gets $50/hr). Those costs include the physical facilities, utilities, support personnel (admin assistants, shipping, cleaning, etc), employee benefits, etc. While this seems like a good idea because many of those costs are relatively fixed, it results in few admin assistants and ridiculously long periods between computer upgrades. Why? Because both result in MORE engineering hours spent and lower costs -- doing their own tech writing, editing, & copying and waiting for their slow computers to complete the task that would take 1/4 of the time on their personal laptop (that can't be used due to security regulations). More hours = more pay to the company with fewer personnel and no computer expense = even more profit. Companies are rarely rewarded when they come in under cost or beat a schedule deadline. They are also rarely punished for missing a deadline and are usually given added budget to complete the project (more hours = more profit!), so there is no incentive to change their behavior.

The capitalist system of finding the best way through competition will always result in some inefficiencies and we will probably never be free of them. We can only hope to recognize them from time to time and try to eliminate them -- while the new inefficiencies bubble to the top. Scrapping the system to create a new system won't change human foibles -- we'd just get a new set of inefficiencies to go with the new system.

As for getting anyone to do a job for the "Joy" of it, that has never worked on as large a scale as needed to cure cancer. Socialism and communism are still dead...

Jamie Edmonds
Jamie Edmonds

Curing cancer would crash the economy--it'll never go without a fight from the monetary/market system.

Consider: the market system, with its very old assumptions regarding possibility, also ignores (or even fights) the powerful breakthroughs in science and technology which express capacities to solve problems and create elevated prosperity. In fact, such progressive actions and harmonious recognitions regarding the habitat and human well-being reveals that “Free-Market” Capitalism literally cannot facilitate these solutions, since its very mechanics disallow or work against such possibilities by default.

Generally speaking, the resolution of problems and hence increasing of efficiency is, in many ways, anathema to the market's operation. Solving problems in general means no more ability to gain income from the “servicing” of those problems. New efficiencies almost always mean a reduction of labor and energy needs and while that may seem positive with respect to true earthly efficiency, it also often means a loss of jobs and reduction of monetary circulation upon its application.

A simple example of this is the amount of funding and employment that has been generated from the serving of cancer. If cures for cancer where to actually emerge, the downsizing of these massive medical institutions would naturally result. This means that the solving of problems can result in the loss of livelihood for many who worked to service those problems. This creates a perverse reinforcement to keep things the same – avoiding change in general.

It is here where the Capitalist model begins to take the role of a social pathogen, not only with respect to what it ignores, disallows or fights against by design, but also with respect to what it reinforces and perpetuates. If we go back to Locke's statement about how the nature of money, given its tacit consent by the community, was to essentially serve as a community in and of itself, it is easy to see how this once mere “medium of exchange” has evolved into its present sociological form, where the entire basis of the market serves, in fact, not with the intent to create and assist with human survival, health and prosperity, but to now merely facilitate the act of profit and profit alone. Adam Smith never would have fathomed that in the present day, the most lucrative, rewarded fields would be not the production of life supporting/improving goods, but rather the act of moving money around – hence the “work” of financial institutions such as banks, “Wall St.” and investment firms – firms that literally create nothing, but hold immense wealth and influence.

Don't expect anyone to "discover" a cure for cancer within the current monetary system any time soon. We have to starve and kill the beast first, then we can actually start taking care of each other.

Jamie Edmonds
Jamie Edmonds subscriber

Curing cancer would crash the economy--it'll never go without a fight from the monetary/market system.

Consider: the market system, with its very old assumptions regarding possibility, also ignores (or even fights) the powerful breakthroughs in science and technology which express capacities to solve problems and create elevated prosperity. In fact, such progressive actions and harmonious recognitions regarding the habitat and human well-being reveals that “Free-Market” Capitalism literally cannot facilitate these solutions, since its very mechanics disallow or work against such possibilities by default.

Generally speaking, the resolution of problems and hence increasing of efficiency is, in many ways, anathema to the market's operation. Solving problems in general means no more ability to gain income from the “servicing” of those problems. New efficiencies almost always mean a reduction of labor and energy needs and while that may seem positive with respect to true earthly efficiency, it also often means a loss of jobs and reduction of monetary circulation upon its application.

A simple example of this is the amount of funding and employment that has been generated from the serving of cancer. If cures for cancer where to actually emerge, the downsizing of these massive medical institutions would naturally result. This means that the solving of problems can result in the loss of livelihood for many who worked to service those problems. This creates a perverse reinforcement to keep things the same – avoiding change in general.

It is here where the Capitalist model begins to take the role of a social pathogen, not only with respect to what it ignores, disallows or fights against by design, but also with respect to what it reinforces and perpetuates. If we go back to Locke's statement about how the nature of money, given its tacit consent by the community, was to essentially serve as a community in and of itself, it is easy to see how this once mere “medium of exchange” has evolved into its present sociological form, where the entire basis of the market serves, in fact, not with the intent to create and assist with human survival, health and prosperity, but to now merely facilitate the act of profit and profit alone. Adam Smith never would have fathomed that in the present day, the most lucrative, rewarded fields would be not the production of life supporting/improving goods, but rather the act of moving money around – hence the “work” of financial institutions such as banks, “Wall St.” and investment firms – firms that literally create nothing, but hold immense wealth and influence.

Don't expect anyone to "discover" a cure for cancer within the current monetary system any time soon. We have to starve and kill the beast first, then we can actually start taking care of each other.

Jim Jones
Jim Jones

Curing cancer won't crash the economy, cancer is cured every day for plenty of people.

The point of the article seems to be about collaboration, but this already exists and to me I see no advantages to be had.

Everything done is done on the shoulders of giants. The question then becomes can we speed up the discovery timeline through increasing collaboration. I don't think so because competition serves as a driver as well, and perhaps is a better driver. When two teams compete you get a faster finish than one big team with no incentive to reach the finish line first.

Scientists and researchers do collaborate in their groups, through publications, and occasionally through correspondence, on an as needed basis. Opening those lines to the point where your individual contribution is lost sounds good in theory but is likely to lessen advancement speed by being a disincentive to accomplishment.

Jim Jones
Jim Jones subscriber

Curing cancer won't crash the economy, cancer is cured every day for plenty of people.

The point of the article seems to be about collaboration, but this already exists and to me I see no advantages to be had.

Everything done is done on the shoulders of giants. The question then becomes can we speed up the discovery timeline through increasing collaboration. I don't think so because competition serves as a driver as well, and perhaps is a better driver. When two teams compete you get a faster finish than one big team with no incentive to reach the finish line first.

Scientists and researchers do collaborate in their groups, through publications, and occasionally through correspondence, on an as needed basis. Opening those lines to the point where your individual contribution is lost sounds good in theory but is likely to lessen advancement speed by being a disincentive to accomplishment.

Jamie Edmonds
Jamie Edmonds

Talk about "sounds good in theory", do you have any evidence/research to back up your alleged benefit of competition? There are reams of studies proving the contrary. Ever read Alfie Kohn's work?

http://www.alfiekohn.org/books/nc.htm

Scientists and researchers collaborating more closely and more seamlessly--for the joy of the discovery and without regard to "winning" or "Profit"--is akin to networking more, larger and faster processors together, but combined with the human brain's creative ability to synthesize concepts and build on the inspiration of others--the shoulders of the giants you mention.

Bottom line is, "What does the DATA say?" We have to be governed by the true facts to the best of our ability to rationally ascertain them, not on how we think it is, what the talking heads want us to believe, or on how we WISH it were. That is merely parroting ignorant dogma and it is killing the growth and evolution of the human species. Unfortunately, the cost of that could ultimately be the destruction of the planet's ability to sustain HUMANS. The earth couldn't give to shakes about humans, but we need to guard against getting caught up in, or even helping to create another great Permian Extinction.No Contesthttp://www.alfiekohn.org/books/nc.htmbooks by alfie kohn

Jamie Edmonds
Jamie Edmonds subscriber

Talk about "sounds good in theory", do you have any evidence/research to back up your alleged benefit of competition? There are reams of studies proving the contrary. Ever read Alfie Kohn's work?

http://www.alfiekohn.org/books/nc.htm

Scientists and researchers collaborating more closely and more seamlessly--for the joy of the discovery and without regard to "winning" or "Profit"--is akin to networking more, larger and faster processors together, but combined with the human brain's creative ability to synthesize concepts and build on the inspiration of others--the shoulders of the giants you mention.

Bottom line is, "What does the DATA say?" We have to be governed by the true facts to the best of our ability to rationally ascertain them, not on how we think it is, what the talking heads want us to believe, or on how we WISH it were. That is merely parroting ignorant dogma and it is killing the growth and evolution of the human species. Unfortunately, the cost of that could ultimately be the destruction of the planet's ability to sustain HUMANS. The earth couldn't give to shakes about humans, but we need to guard against getting caught up in, or even helping to create another great Permian Extinction.No Contesthttp://www.alfiekohn.org/books/nc.htmbooks by alfie kohn