The Supreme Court has issued a unanimous ruling that has stopped short the notion that our bodies in their natural glory can be licensed and auctioned off to the highest bidder. In response, proponents of the recent status quo in granted genomics patents complain that such a ruling will have a chilling effect on research and development funding, that companies, even governments, will no longer be able to justify making research commitments. The fire-hose of scientific findings, converted to our undeniable benefit, by their calculation, will end.
In response, we would say, "Good. Finally the insanity may stop". Those programs do not "pencil out" in the first place. In the Myriad case, two genes out of our 30,000 were found that signal a higher-than-normal incidence of breast cancer in one out of four women. They developed two tests for these, for which they set a list price of $1,500 each. Based on known demographics, one-fourth of women have one or another or a combination of the genes. Let's see, we are all MBAs or we know some, what is $3,000 times one-fourth times 3 billion five hundred million women (you know, half of the world population)? If you are on the receiving side of the ledger, that "budzillion" dollars looks very good. Now, combined with the fortunate few that can afford Angelina Jolie replacements after surgery (or have insurance that will pay for it because, you know, they have the gene), it looks even better. Think about it, too, these are only two out of 30,000 genes. The prospects are mind-boggling from a business perspective.
Not. It would be a serious evolutionary trick, would it not, for us to need to take such draconian steps to ensure our health? Of course, such a development would me largely viewed as an economic boon, the next of a long line of growth markets. Perhaps, but if this is the future laid out for us, most of us would exist in a huddling mass while the biological geniuses on the other side of the equation would live in exorbitant luxury, amassing as much gold and as many of the diamonds of the world as can be brought together. It would be like one of the desert scenes from the movie "Dune", where there were a few islands of wealth in a world of want, despair, and eventually, just blowing sand.
We don't need the blockbuster, Hail Mary cancer therapies that will give sufferers another couple of weeks of life. There is no biological or economic basis for this or other late stage chronic disease strategies, as there are far better options for both. We don't need the masterful plastic surgery skills to account for slightly different genetic risk profiles. Rather, we need to use a more complete knowledge of biology, particularly of metabolic, protein-oriented interactions, to relegate cancer, as well as other chronic conditions, to the history books. There are vast amounts of knowledge that have been arrived at to support this, yet many are not used.
Victory needs to be our avowed goal. War? That might not, in retrospect, be the best metaphor. The war on cancer will last as long as there is pink paint and pink textiles to be had. How about extermination? Possibly also too malleable. Perhaps simply "elimination".
There is a codicil, a summary, at the end of virtually all promising scientific studies with regard to cancer genesis and growth patterns of chronic diseases. Such summaries indicate that such knowledge as is found in such studies will help to develop "improved cancer therapies", to provide "more effective cancer therapy drugs", etc. Such declarations are like stamps of approval, confirmation of good work done. There is an assumed camaraderie in such statements, as in, "We'll really get 'em now, boys, we've got 'em on the run".
While they sound beneficial, objectives of this kind pale in comparison to the needed goal, forestalling cancer so that it does not happen in the first place. Pre-cancerous conditions need to be systematically detected; they need to be identified so that tumor growth is stopped before it gets a chance to start. The same must be said for preconditions of other chronic diseases. The "ghastly, horrific outcome", the "silent spring" of medicine and pharmacopiea, the end of chronic disease, needs to be our objective. I know this would be a bitter pill to the economy as we know it, as healthcare seems to be our only economic stopgap. Given increases in productivity elsewhere in the economy, people are increasingly turning to the world of medicine for employment. Where else are people going to get their jobs? Well, that is another matter, though it would clearly be a travesty if we weren't clever enough to adapt to a world without disease and the employment that it brings.
To create such a world, we need to embrace scientific findings with regard to cancer that indicate that such diseases surface from poor lifestyle choices. In the famous Oxford UK report to the US Congress in 1980 that helped to turn the tide on cigarette smoking, 30% of cancers were associated with smoking. Most of the other 70% were also associated with environmental causes, both behaviors and forms of contact with carcinogens, including 35% of cancer cases from poor nutrition choices. Approximately 5% to 10% of cancer genesis was associated with genetic inheritance alone.
What about that 65% of cancer causes, also lifestyle related, that we do not hear very much about, including nutritional factors? We do hear platitudes, admonitions that we should eat better or otherwise make improvements. The point is, vigilance and knowledge are called for, including constant monitoring of associated data, protein-oriented testing that discloses what is actually happening in the body, not just genetic possibilities, and providing people with more obvious, more attractive lifestyle options. For one thing, as Michael Moss points out, we could well stop trying to cram salt, sugar, and fat down everybody's gullets. There is nothing wrong with marketing, but couldn't we start to market the good stuff?
The idea of radical surgery in response to found genetic conditions alone is problematic. For one thing, surgery itself brings risks. Cytokine levels rise significantly with even minor surgery, a sign of inflammation that takes its toll, nudging up the prospects for chronic disorders. Furthermore, a higher genetically-based risk of cancer does not in any way foretell that cancers will form. In one with elevated risk, increased vigilance is warranted. Vigilance is warranted anyway, as we live in a dangerous world. If roughly 90% of our chronic disease risk comes from our lifestyles, that should bring hope, though the US Institute of Medicine recently published a report, "Shorter Lives, Poorer Health", that makes the case that Americans have structural limitations causing us to have shorter life expectancy and inferior health to people in other parts of the world. Can you imagine such a development?
In the subsequent thirty-three years sine the Oxford study was release to Congress, there has been an unexpected silence on the part of political and health advocacy groups regarding the "other" 65-70% of all cancer threats. Colin Campbell makes reference to a bias against nutrition as a viable source of risk, going back to the 1960s. Dietary aspects that have demonstrated increase risk are considered controversial even when the science is well-founded. "We must tip-toe. Big money is at stake." It is as though we need to buy time for nature to sort things out. Medical leaders in particular were not entirely comfortable with the answers we were getting in the 1970s and 1980s, so they ignored then. Unfortunately, such passivity turns out to be quite effective. With the overwhelming levels of advertising, direct and indirect, supporting problematic food practices and products, the public has been effectively beaten back on the issues. Diets have significantly worsened in the process, as have chronic health conditions.
Lest we stew ourselves in self-pity, there are solutions. After decades of struggle, the integrative medicine community has poked its head out of obscurity, emerging with verified data supporting their commitment to choice and their orientation toward wholeness in foods and breadth in the form of medical solutions. Their work represents a ray of light in this obscure world of misinformation and despair. For one thing, apart from epidemics and conditions where populations came in contact with foreign contaminants and pathogens, or pernicious bugs, people throughout history have been found to have been quite healthy. Of course, there have been famines and other serious disruptions of the food supply, resulting in want and suffering, even to starvation.
Ken Albala mentions the first staple diets that the "first civilizations" ate over millennia: barley, chickpeas and lentils as sources of protein. Very small amounts of meat, but cabbages, lettuces, and cucumbers. He says dairy was a late innovation, with little ability to digest milk past infancy. With this and improved means of storing food, populations were able to grow.
Thus were conditions regarding nutrition, up until not long ago. Now, we've gone all wild and crazy nutrition-wise. There are so many motivations and other factors in what we eat that health has long been crowded out. This takes us back to Michael Moss and his concerns about marketing promotion of foods that are obviously imbalanced, skewed toward self-serving marketing schemes, but not real nutritional requirements. Once again, I have to ask the questions, "Must markets be perverse? Isn't there a way to promote something that is good for us, that also tastes good, and that entertaining and readily available to eat?
More broadly-stated, was Adam Smith wrong when he called attention to "goods" and services in the first place? Should he have stated "stuff" and services. For that matter, services might be a bit too perky a term. Perhaps Professor Smith should have said "stuff we give you" and "things we do to you". I know, there has always been the "caveat emptor" clause, that the "buyer beware". But that has been a quality issue for the most part, short of the idea the "stuff" you get and the "things" done to you are flat out bad for you. The Institute of Medicine, as mentioned earlier, has made this very concession. The most advanced, richest country in the world is far from the healthiest, because all of this advancement and all of this prosperity has made us ... stupid.
Michael Moss mentions a neighborhood in Philadelphia where there is a flat-out war over what children buy in close proximity to the schools. The point is, the battle isn't going well. Part of the phenomenon is related to the "don't think about brown monkeys" problem. All the kids can think about is salt, sugar, and fat, all of which is plentifully and cheaply available. Part of the problem is the fact that conspiring companies have misused their mandate to pollute the palate and position both science and commerce against us. There are governmental and legal prescriptions for such kinds of problems to be sure, but the ultimate solutions are likely to be in those original realms, by providing legitimate science and effective commercial offerings when and where they can be embraced and enjoyed.
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