By Kevin D. Williamson
Thursday, January 14, 2016
So, Joe Biden is going to cure cancer. That was among
President Obama’s big ideas in his final State of the Union pageant.
Let’s start with the obvious: Joe Biden is not going to
cure cancer. Joe Biden couldn’t find chlamydia backstage at a Mötley Crüe
concert. (It’s easy to picture Joe Biden backstage at a Mötley Crüe concert,
isn’t it?) He couldn’t find NaCl in an aqueous solution if he fell into the
Pacific Ocean. Joe Biden is about as likely to discover a cure for cancer as J.
J. Watt is to sing the lead in The
Marriage of Figaro and dance in La
Sonnambula with the Bolshoi in between back-to-back Super Bowl wins. Ain’t
gonna happen.
You’d have a better chance tracking down Paul Begala’s
self-respect.
In fact, it is isn’t very likely that anybody is going to
cure cancer — ever. There are some reasons for that, none of which seems to
have occurred to Barack Obama.
To begin with, there’s the inconvenient fact that there
is no such thing as cancer. “Cancer” refers to a category of diseases, one that
contains hundreds of different maladies. Some of those have a great deal in
common with one another, many do not. Spindle-cell breast cancer really isn’t
very much at all like Hodgkin’s lymphoma; the former presents a very difficult
course of treatment with a poor outlook, while the latter is so effectively
treated (90 percent survival rate) that it is sometimes described as “curable,”
though physicians tend to shy away from the use of that word.
Some cancers are even transmissible, though no known
human cancers are. The comparison with the mission to the moon is inapt insofar
as that was, despite all of the effort and ingenuity involved, a relatively
straightforward engineering problem. This is more like planning a mission to a
moon that has a completely random orbit.
Cancer is one of nature’s great survivors, an eternal (so
far) reminder that you can give your heart to Jesus but your ass belongs to
evolution. As breast-cancer surgeon David Gorski puts it, “Cancer progression
can be viewed as being due to a case of evolution in which the tumor cells that
survive selection to continue to grow are the ones that become best at doing
all the things that tumor cells need to do to evade the body’s defenses and
overcome its growth-control signals.” Cancer is unlikely to be “cured” for the
same reason that crime will never be eradicated: adaptation.
At the same time, it would not be at all surprising if,
in a generation or two, dying from cancer were as rare and exotic as being
crippled by polio is today. There is a great deal of promising research in any
number of fields, from genetics to nanobiology, that should instill in us a
cautious and sober optimism that we can make more cancers treatable and manageable,
that in a few decades having cancer could be more like having diabetes. But
that is a very different thing from finding a cure.
This is an example of political thinking. The political
mind imagines that if political will is bent toward some particular end, and
that if the right people with the right philosophy are empowered to command
sufficient resources, then all of reality is malleable. That isn’t how the
world actually works; if it were, there would never be a recession or other
economic shocks, intractable national-security problems related to distant
primitive desert savages, or, for that matter, traffic jams. But these things
exist, because the world that exists in the political imagination is not the
real world.
President Obama might have made a different sort of
declaration: “We are going to spend some additional money to fund a number of
different cancer-research projects, and we hope that at least some of those
projects will yield results that enable us to develop, at some point in the
future, marginally more effective treatments for some kinds of cancer.” But
that isn’t what President Obama said.
It isn’t what President Richard Nixon said, either. In
1971, the federal government — stupid phrase — “declared war on cancer.”
President Nixon, with some fanfare, signed into law the National Cancer Act,
which increased support to the National Cancer Institute. “As a result of signing
this bill,” President Nixon said, “the Congress is totally committed to provide
the funds that are necessary, whatever is necessary, for the conquest of
cancer. The president is totally committed. . . . You will have, of course, the
total commitment of government, and that is what the signing of this bill now
does.” Everyone was committed — and cancer didn’t care, because cancer doesn’t
follow politics.
“We’re going to cure cancer” isn’t a scientific-research
agenda – it’s a political promise. Government funding of basic scientific
research at its pre-commercial stages is one of the most fruitful (or, if you
prefer, least destructive) things that government does. Sometimes that research
is in the service of an explicit federal priority (usually military), and
sometimes it is more general.
Ensuring that the money is well spent without putting
research decisions in the hands of lawyers is sometimes a tricky business, one
that the researchers themselves often enough complicate by following their own
political agendas. Our management practices here probably should tend toward
the regular and the general, rather than directing resources into moonshot
projects that sound more plausible on television than in the laboratory.
Joe Biden isn’t going to cure cancer. Let’s make sure
that he and the imperial hubris he brings with him don’t get in the way of our
making progress in treating it, and in advancing our understanding of other
diseases.
No comments:
Post a Comment