When Elizabeth Edwards told the world last week that the cancer that had attacked her body two years ago had returned and then added, with some conviction, that she and her husband planned to go forward with his presidential campaign, the news was greeted with a mixture of admiration and doubt.
Should someone with cancer and two small children be making plans for an enterprise likely to demand significant investments of time and energy over the next two years? What was she thinking? Katie Couric asked on national television.
Edwards' answer reflected the most public manifestation of a significant if subtle turning point in the long war on cancer. A cancer diagnosis is no longer necessarily the death sentence it long was. Growing numbers of Americans are living longer as they fight the disease and, in the last two years, the number of cancer cases has actually declined.
While the death rate from cancer is high -- accounting for at least 20 percent of deaths in the United States -- about 40 percent of the million Americans who are diagnosed with cancer each year get early treatment and live for many years after the diagnosis. Many are fully cured.
Still, the war on cancer is far from won.
The gains made have been hard-fought in a long and expensive battle with a disease that continues to be more feared than any. While the mortality rates from heart disease, stroke and pneumonia have been cut by half since 1950, the advances in the war on cancer have been minimal, despite a largely successful anti-smoking campaign and billions spent on new drugs and aggressive treatment regimes.
The more we learn about cancer, the more complicated the fight becomes. Earlier this year, two respected studies produced sharply differing conclusions about how some forms of lung cancer should be treated.
Cancer's challenge is so difficult because it takes so many forms. It is not one disease but more than 100 diseases, all with common factors. While only a small fraction of cancers are believed to be inherited, all cancers develop because something in a cell's genes has gone wrong; determining just what is a difficult challenge for each variation.
Still, researchers are optimistic because so much has been learned about the genetic roots of cancer. And hardly a week passes without the introduction of new drugs and new treatment strategies. There are more than 10 million cancer survivors living among us now, more than three times the 3 million counted in 1971.
