War on cancer and the influence of the medical-industrial complex

AbstractThe ‘war on cancer’ arose from a toxic combination. A socialite with powerful friends and a misguided belief that cancer could be ‘conquered’ within 7 years recruited a flawed US President to lead an ‘all-out assault [against] one of mankind's deadliest and most elusive enemies’. Mary Lasker and her Citizens’ Committee for the Conquest of Cancer ran a skilful campaign during 1969–1971, comparing the number of cancer deaths with American troop losses in the unpopular Vietnam war. Richard Nixon preferred to compare US cancer mortality with American troop losses in World War II.‘Waging war’ against a disease that is so intrinsic to our cellular biology is even more quixotic than declaring a war on terror, drugs or religion. ‘War’ is more than just a metaphor. It distorts political thinking about cancer with the illusory clarity of victory and defeat. Therapeutic attacks on the ‘enemy’ are prioritised over strategies to prevent the disease occurring, and where there is ‘war’, there goes the medical-industrial complex. The therapeutic armamentarium has improved out of all recognition since the 1970s, but it now threatens to bankrupt the health system in the world's richest country, where millions still await access to health insurance under the Affordable Care Act. Elsewhere, entire countries have no access to radiotherapy. The inequalities are glaring.One may, perhaps, imagine a world where an outbreak of sanity has removed injustice and the roots of terrorism. I cannot imagine a human race without DNA, which occasionally makes mistakes that our cells cannot repair. The language of war, victory and defeat is misplaced and outdated. All cancer patients, everywhere, deserve prompt and equitable access to optimal treatment and pain relief. But we should drop the lazy, simplistic jargon and the distorted priorities of ‘war’, and focus on prevention to make long-term progress against cancer