There have been several interesting media reports about cancer lately. First, there was the study that showed that women who participated in a psychological intervention at the time of their breast cancer diagnosis did significantly better (a statistical term) than those who did not. Then there was the study that showed that intraoperative radiation was as good as six weeks of radiation in selected patients.
Both of these well-designed studies provoked incredulity from the medical world: â€œintraoperative radiation therapy termed experimental!â€ screamed one headline. â€œOncologists skeptical regarding psychological interventionsâ€ blurted another. Yet, these are the same people who tout a two-month increase in survival from a new drug as earth shattering news.
Why are studies that decrease treatment less acknowledged than studies that increase it? Part of it has to do with our health care system, which rewards more treatment but not less. Another part may be the doctors who tend to be conservative and not eager to change or to accept new data.
Importantly, both of these new studies do more than suggest an alteration in therapy. They suggest a new thinking about cancer, which was echoed in the recent New York Times series about genetics and cancer.
There is growing data suggesting that for cancer to develop you need not only the mutated genes but an environment or neighborhood of cells surrounding these genes that are egging them on. It all depends on the peer group! What can change the neighborhood? Stressâ€”or lack thereof, exercise, radiation therapy, and hormones, for example.
The reason the medical profession doesnâ€™t like studies that show less therapy is as good if not better is because they still think that killing every cell is the goal. But what we are learning is that we can rehabilitate the cells if we change the neighborhood! Just like taking a kid out of a bad neighborhood with drive by shootings, drug pushers, and gangs can well salvage him or her. The same is true of cancer cells. This new thinking starts to explain why stress seems to increase cancer or its recurrence while psychological interventions or exercise can decrease it. We need to focus on more than mapping the genes if we are going to eradicate cancer.Â We need to understand the local environment around the cancer if we are going to find ways to control it.