“Why don’t researchers and drug companies come up with better treatments for cancer?”

Readers with five minutes to spare and an interest in what the answer is to this question should read this well-written article from The New York Times:

“New Drug Points Up Problems in Developing Cancer Cures”

The labor involved in finding, then developing, then approving a new chemotherapy drug or biological agent that is a real advancement is like betting in a game of poker. One is more likely to bet the whole pile when holding a great hand (promising new anti-cancer agent), but until one sees what the other player (cancer) has, the win (successful outcome) is not guaranteed.

Unlike poker, however, in oncology we don’t restrict ourselves to winner-take-all rules. There are several ways to “win”, or experience a better outcome than if no treatment was ever given, even if cure is not possible. These rules, if used in a poker game, would require the player with the better hand to split the pot with the loser. Examples of outcomes that are less than cure but still can provide meaningful palliation to patients include:

Prolonging the time until the tumor begins to increase in size, or cause symptoms

Stopping the tumor from growing or appearing in new areas of the body

Reducing the noxious symptoms caused by the cancer

Living longer after taking treatment than those who never took any treatment for their cancer

Getting more effective treatments approved is a frustrating wait for patients, loved ones and all involved in the care of people living with cancer, partly because the bigwigs in charge have continued to insist upon rigid “winner-takes-all” outcomes when considering the efficacy of a new agent. This article explains why.