A Rainbow Coalition for Cancer

Cancer blogger Tranette Ledford is worried that she has the "wrong color" of cancer. Every year over 180,000 women just in the United States are diagnosed with breast cancer, accounting for about 25% of all cancer diagnoses in women. But 90,000 women, just in the USA, like Ledford are diagnosed with "cancers that hit below the belt" such as anal, uterine, ovarian, vulvar, vaginal, cervical, or endometrial cancer, which don't get as much public attention.

Breast Cancer Receives Inordinate Attention

Ledford maintains that there is a pecking order in women's cancer diagnoses, and breast cancer comes out on top. There are pink ribbons and pink arm bands. There are breast cancer awareness days and breast cancer events all over the United States, and Ledford participates in them. 

But the focus on just breast cancer, however, leaves out tens of thousands of women who suffer other gynecological cancers. The warnings of complications of cancer treatment, such as the condition of permanent swelling known as lymphedema, occur in many kinds of women's cancers but are directed at women who have breast cancer. And while there a Susan G. Komen Race for the Cure for Breast Cancer in nearly every city every year, Ledford struggles to get out the word about Gynecologic Cancer Awareness Month, which occurs every September, and the National Race to End Women’s Cancer, which occurs every November.

But maybe an even better idea is to stop looking at cancer in terms of its organs of origin.

A New, Emerging Way of Looking at Cancer

For most of the twentieth century, doctors and lay people alike viewed cancer as a disease that caused cells in particular organs to go wrong. Even when cancer spreads to different parts of the body, it retains the properties of the tissues in which it orginates. Breast cancer that breaks out of a tumor and spreads to the lungs is still breast cancer. Melanoma that metastisizes to the brain is still skin cancer, and so on.

Cancer treatment, however, is not necessarily limited to one organ at a time. The very promising cancer drug Avastin has been used to treat certain kinds of brain, colorectal, lung, and ovarian cancers. Gleevec has been used to treat leukemia and certain kinds of tumors that can occur in both the stomach and the intestines. 

So if you want to raise awareness for Avastin, what color ribbon do you use? There's a gray ribbon for brain cancer, a teal ribbon for ovarian cancer, and an orange ribbon for kidney cancer.  The orange ribbon for kidney cancer duplicates the orange ribbon for leukemia, and the teal ribbon for ovarian cancer duplicates the teal ribbon for thyroid cancer, but there are only so many colors to go around.

Read More: Researchers Have Found a Way to Predict When Cancer Will Spread

Not a Bigger Piece of the Pie, a Bigger Pie

Dr. Susan Love, an expert on breast cancer, argues that the way to approach fund raising for cancer is not to play off a black ribbon campaign for melanoma against an emerald green ribbon campaign for liver cancer, and so on. The solution is not to have fundraisers competing for limited resources. The solution is finding greater resources.

Where To Start Finding More Resources For Fighting Cancer

Dr. Love is undoubtedly right, but where do you start to find more resources for cancer? Maybe the place to look is the cost of the medications for cancer.

My own mother had had breast cancer, stage IV breast cancer, lesions in skull and arms found in 1984, in fact, for 11 years when a new medication called Taxol was discovered in 1995. At that time, making this yew tree extract required cutting down literal groves of yew trees. (It's synthesized in a laboratory now.) Every single injection of the drug cost approximately $110,000 (about $240,000 in 2013-dollars), and she needed an injection every week. It helped a little, but her HMO put up quite a fuss about the cost. A wealthy friend intervened, but that help only lasted so long. Just six days after her oncologist told her "you are not worth the cost of more treatment," she gave up and died.

Cancer Therapies, Although Much Less Expensive Than They Used to Be, Still Very Costly

Similar stories exist today, even though medication costs are much, much lower. A year's treatment with Avastin costs $100,000. A year's treatment with Gleevec also costs $100,000. Treatment with protein-bound paclitaxel, which is the more modern version of a drug given to m my mother, costs $96,000 per year. 

Obviously there would be a lot more resources for fighting cancer if cancer treatments cost less--or if they worked in smaller doses. Perhaps that is the kind of research that a rainbow coalition of cancer concerns might seek to fund.

The Nature of Cancer Research Leads to Prescription of High Doses of Expensive Drugs

Cancer drugs aren't usually tested on people who have any other options. It would be considered unethical to deprive someone of a drug with known benefits, so new medications are typically tested on people in the later stages of the disease.

A research company is not going to spend hundreds of millions of dollars on a clinical trial if it believes the test drug would be found to "fail" because it was not administered in a large enough dose. Therefore, tests of new cancer drugs involve high doses of potent drugs in the hope they get statistically significant results. Higher doses of drugs, of course, cost more, and cause more side effects.

Read More: Seven Cancer Treatment Practices That May Be Discontinued

Lower doses of medications wouldn't necessarily cost less, at least not at first, because pharmaceutical companies still seek to recover the costs of running clinical trials on drugs that work as well as drugs that don't. But research to determine the smallest effective dose in patients at earlier stages of cancer would seem to be the way to save money on pharmaceuticals, at least in the long run, and to avoid side effects from treatment.

Of course, forming a rainbow coalition to find drugs that work for multiple kinds of cancer, in both women and men, requires a lot of organizers to check their egos at the door. It also threatens the high salaries of the CEO's of some fund raising organizations. But getting beyond a pattern of supporting research for cancer by organ of origin may be exactly what is needed to finally start winning the war on cancer.