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Hawaii’s World

By A.A. Smyser

Tuesday, May 9, 2000

Finding cures for
cancer is complex

PRESIDENT Franklin D. Roosevelt made a secret commitment in 1940 to build an atomic bomb. We exploded two in 1945.

President John F. Kennedy in 1961 vowed to send a man to the moon in that decade. We did --in 1969.

Perhaps buoyed by those successes, President Richard Nixon in 1971 declared a war on cancer. No such success here. Death rates 29 years later are down only 2 or 3 percent. Cancer remains our No. 2 killer.

How come? For an answer I went to Dr. Carl-Wilhelm Vogel, director of the University of Hawaii's Cancer Research Center.

There is an essential difference, he said. When we committed to build a bomb and go to the moon, we had scientists who already knew how to do it. Of cancer in 1971 we had the ignorance of cave men.

Something approaching that must have prompted the director of the National Cancer Institute in 1984 to predict a halving of the cancer death rate by 2000.

Now, however, Vogel says we have basic knowledge about how cancers grow. We understand that there are some 200 varieties of cancer, one for almost every cell type in our bodies. Each must be treated differently for real success.

He gave me a military example. The drug chemotherapies used to attack most cancers resemble B-52 bomber attacks. They kill vast numbers of other cells as well as the target cancer cells.

Now we have advanced to a few chemotherapies that are more like cruise missiles -- far more specific in their targeting.

On the horizon we have something comparable to undercover agents who go into a human body and destroy only the cancer cells, nothing else.

The first "undercover agent" is named STI-571. It goes after the dividing cells that cause chronic myelogenous leukemia. A trial on 31 patients cured all 31.

That particular leukemia is not common, so success there won't make a major dent in the overall cancer death rare.

It does point a path that could, however, take years to travel down because cancer is so complex. Surely, though, it will stimulate new research approaches to the Big Four of cancer killers -- breast, colon, prostate and lung -- as well as to other types.

CANCER cells have the special characteristic of being dividing cells that produce unnatural growths. Some normal cells also divide, however. They, too, are killed by the B-52 attacks that remain our best available weapons against most cancers.

Radiation similarly kills more than just cancer cells. Surgery is useful primarily when a cancer is detected early and can be removed totally before it spreads.

The Cancer of Research Center of UH is particularly valuable because our ethnic diversity makes Hawaii a natural laboratory. The biggest cancer killers here are stomach for Japanese, thyroid for Filipinos and colon for Caucasians. Why the differences -- lifestyles, diet, genes? Major studies are addressed to this question.

A major opportunity lies in the fact that 70 percent of all cancers are preventable. Thus education becomes a major factor to teach proper diet, exercise and deter smoking.

Vogel leads a team of more than 30 scientists. No way will he predict any early conquest of cancer, but he does see progress. The bad news is that if we live longer as cancer is curbed we then may fall prey to painful joint diseases and Alzheimer's.

A.A. Smyser is the contributing editor
and former editor of the the Star-Bulletin
His column runs Tuesday and Thursday.

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