The Current

Cancer research is an 'embarrassment,' must switch focus to early detection: oncologist

Leading oncologist Azra Raza says despite all the money spent and progress made, the way we treat cancer today is an “embarrassment.” Her new book, The First Cell: And the Human Costs of Pursuing Cancer to the Last, argues we need to change our approach to treating and diagnosing the disease.

Some treatments like hitting a dog with a baseball bat, to rid it of fleas: Azra Raza

Dr. Azra Raza has worked as an oncologist for decades, and wants to see a change in how we fight the disease and try to save lives. (Chad Hunt; Submitted by HBG Canada)

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A leading oncologist says it's an "embarrassment" that we have been using the same methods to treat cancer for decades, despite the billions spent in research.

Most cancer diagnoses are "still being treated with chemotherapy, radiation therapy and surgery — what I call the slash, poison, and burn approach," said Azra Raza.

She told The Current's Matt Galloway that she is prescribing the same drugs today as when she treated her first North American patient in 1977.

"Why are we not looking at the entire overall picture and trying to do something different instead of repeating the same old, same old? This is why it's an embarrassment."

Raza is a professor of medicine at Columbia University and the author of The First Cell: And The Human Cost of Pursuing Cancer to the Last.

Why aren't we using the latest technology to try and identify cancer at its inception?- Dr. Azra Raza

The book tells the stories of some of the thousands of patients she has treated during her career, as well as her own husband's diagnosis and death from the disease. After five decades as an oncologist, Raza argues that efforts to fight cancer should be refocused on early detection.

"The only thing that seems to work is identifying cancer early," she said.

"Why aren't we using the latest technology to try and identify cancer at its inception?"

She explained that currently, a lot of research is aimed at prolonging life, but can come with side effects.

Often those treatments make "things even more grisly," she said, and can feel like "taking a baseball bat and hitting a dog with it to get rid of its fleas" for the patient.

"I am asking for redirection of funds being wasted in doing useless clinical trials, or trials that are yielding a five-per-cent success rate," she said. 

For every successful drug, there are eight or nine drugs that have not been successful in clinical trials — but that doesn't mean the research has failed.- Dr. Len Lichtenfeld

That money could go towards developing tests to find "the presence of cancer in any secretion through a liquid biopsy: blood, sweat, saliva, tears, urine."

In November, technology company Toshiba said it had developed a device that could detect 13 types of cancer from a single drop of blood, with 99 per cent accuracy. The company said trials would start this year, with a view to having the device on the market in a few years' time.

A study published in 2018 suggested that early testing could have negative consequences, such as leading to false diagnoses, or unnecessary treatment. 

Raza's book, The First Cell: And The Human Cost of Pursuing Cancer to the Last, documents the stories of cancer patients she's helped over the years, including her own husband. (Basic Books)

Raza said that overdiagnoses are already happening in regular testing.

She is confident that in the near future, we will have the technology "to find the earlier footprints of cancers, and that along with that revolution will come better treatment options."

Research hasn't failed: doctor

Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, said it's "a little presumptuous to say that all we're doing is poisoning people, or burning people, or cutting people."

He told The Current that millions of premature deaths have been prevented by cancer research, but acknowledged that treatments for some cancers haven't made much progress

"For every successful drug, there are eight or nine drugs that have not been successful in clinical trials — but that doesn't mean the research has failed," he said.

"A tremendous amount of effort has gone to finding the first cell, to finding the first signals of cancer, and then deciding how best to treat it."

Raza said she agreed the research to date has made for valuable progress, but said more could be done. 

"Yes, a lot of money is being spent in finding the first cell, but not enough," she said.

Raza said she is still prescribing the same cancer medications as when she first arrived in North America in 1977. (The Associated Press)

She wants a re-energized fight against cancer to have the competition witnessed when the U.S. and Russia raced to put man on the Moon, and the cooperation "seen between scientists around the world doing the Human Genome Project."

"Nobody is trying to denigrate what has been done until now, but how can we do better?"

Written by Padraig Moran. Produced by Karin Marley.


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