CANCER.

I'm not an epidemiologist so I don't have a lot to say on the article, but Newsweek's feature on how we're losing the War on Cancer is a deeply reported, fairly important piece of journalism. A lot of it focuses on the problems with the "breakthrough" model of medicine, in which all funding and most of the efforts go, in government and academia, towards elegant new discoveries that make scientific careers, and in the private sector, towards blockbuster drugs that make for successful stock market performance. That's been working well for both groups, but not necessarily for patients:

Both presidential candidates have vowed to support cancer research, which makes this a propitious time to consider the missed opportunities of the first 37 years of the war on cancer. Surely the greatest is prevention. Nixon never used the word; he exhorted scientists only to find a cure. Partly as a result, the huge majority of funding for cancer has gone into the search for ways to eradicate malignant cells rather than to keep normal cells from becoming malignant in the first place. "The funding people are interested in the magic-bullet research because that's what brings the dollars in," says oncologist Anthony Back, of the Hutch. "It's not as sexy to look at whether broccoli sprouts prevent colon cancer. A reviewer looks at that and asks, 'How would you ever get that to work?' " And besides, broccoli can't be patented, so without the potential payoff of a billion-dollar drug there is less incentive to discover how cancer can be prevented.[...]Which leads to the third big missed opportunity, the use of natural compounds and nondrug interventions such as stress reduction to keep the microenvironment inhospitable to cancer. (Cancer cells have receptors that grab stress hormones out of the bloodstream and use them to increase angiogenesis.) "Funding has gone to easier areas to research, like whether a drug can prevent cancer recurrence," says Lorenzo Cohen, who runs the integrative care center at M. D. Anderson. That's simpler to study, he points out, than whether a complicated mix of diet, exercise and stress reduction techniques can keep the micro-environment hostile to cancer. And while we're on the subject of how to reduce mortality from cancer, consider these numbers: 7 percent of black women with breast cancer get no treatment, 35 percent do not receive radiation after mastectomy (the standard of care), and 26 percent of white women do not. As long as scientists are discovering how to thwart cancer, it might make sense to get the advances into the real world.

American culture has a bias towards the heroic. That goes for health care, where surgeons are far more valued than general practitioners, and health care policy, where protecting patients from the costs of catastrophic medical expenses receives far more attention than ensuring their access to preventive care and basic, low-cost, highly effective treatments.