All the drugs that could defeat cancer: hope and skepticism in biomedical research (and journalism)
My grandfather got lung cancer from a Corpus a good handful of years ago. I will never forget the harsh sound of his breathing the hours before his death. There are still nights that I dream sitting in that chair looking at him lying on the bed. Yes, I know that we should not use warlike language when we talk about cancer, but if I am honest with you, what I want, what comes out of me, is that: defeat it, defeat it, eradicate it all at once.
In other words, I like the good news about cancer. These days we have been able to read in the press that researchers from the Institute of Oncology at the Vall d'Hebron Hospital (VHIO) have developed a drug that could be key to fighting most cancers. They talked about it on television while having coffee in the cafeteria and someone at the back of the room has said "don't you ever get tired of saying that giving this kind of news?".
As I dipped the croissant into the café con leche, I realized that I understood that feeling perfectly. The key, deep down, is in the "could", when it is worth using. At least in scientific and health journalism, each “could” is a knife fight between hope and skepticism, not only to clarify the facts, but also to see what opportunities are worth betting on.
The real challenges of biomedical research
Vall d'Hebron's research is incredible. After 20 years, the team has achieved positive results in the effectiveness of Omomyc in mice with non-small cell lung cancer, the deadliest of its kind in humans. According to the results published in Science Translational Medicine, the drug appears capable of blocking the activity of MYC, a family of genes that has a lot to do with the development of cancer, with good efficacy and without serious side effects.
In other words, animal tests indicate that the drug may be able to slow growth and reduce tumor grade. This is the new (and the interesting): the drug. We already knew that shrink activity can be blocked thanks to genetic engineering techniques, but developing an easily administrable drug could be sensational.
The bad? You could. As the same researchers explain, the good results make them hope to start clinical trials with patients in 2020. That is, now they have the hardest part. In 2011, Lisa Hutchinson and Rebecca Kirk discovered that only 5% of all drugs that had been shown to be effective in preclinical phases were ever put on the market.
It is true that, in the case of cardiovascular or neurological diseases, the rate is 20%. But in the case of biology studies, the results of large studies of achievement invite us to be very very conservative. To put it in numbers, for each new cancer treatment we need four times more staff, four times more resources and four times more time than to develop a cardiovascular treatment.
A science without neon signs
And this not only forces us, as Hutchinson and Kirk concluded, to admit that basic research strategies were not working, but also lead us to reflect (perhaps even more critically) on communication and scientific-health journalism. We are (all) failing to identify real opportunities to focus our resources on.
My main concern, at least on days like today, is in that tension between hope and skepticism that is so difficult to manage. And not (only) because of the false hopes that arise in millions of people every time the newscast announces a new treatment that could change everything. As those of us who have lived with the disease in one way or another well know, one ends up becoming desensitized to those announcements with hype and cymbals that never quite come to the consultations. Like the man in my cafeteria.
That too, but for the social implications of living in a constant coming and going of possibly promising solutions. Without being able to identify which battles must be fought and which lines must be financed, society becomes a modern transcript of the Arendt fox, the one that was so cunning that he did not know how to distinguish a trap from a burrow. It makes no sense to think of science as a marketplace overrun with press cabinets and neon signs.
And here I am afraid that the main criticism can only be self-criticism: the essence of research is like this, putting many minds to study the nature of things, giving them all possible resources and crossing our fingers so that we are lucky. We can only learn to communicate that essence and no, it is not an easy task.