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Why are so many lives affected by cancer?

rope bridgeI’m a regular reader of The New York Times obituaries. I don’t read them because I’m a morbid person; rather, the obituaries offer me a window into history reflected through the lives of accomplished individuals.

One day in August, I was struck by the photos accompanying obituaries of three women, who all appeared to be relatively young. The 59-year old was co-founder of a nonprofit, Common Sense Media, committed to helping families navigate through entertainment, media and technology arenas. The 64-year old was an Olympic Equestrian medalist winning the U.S. title of rider of the year three times. And the 56-year old was a Harvard scholar and artist whose work explored myth, mystery and identity.

Each shared another characteristic besides a relatively early death: cancer.

These losses of life – far too early – brought back memories of the opening words of a story set more than 300 years ago: “On Friday noon, July twentieth, 1714, the finest bridge in all Peru broke and precipitated five travelers into the gulf below.” That was from Thornton Wilder’s 1927 novel, The Bridge of San Luis Rey. In this story, a friar, who observed the collapse of the rope bridge, wanted to know about the events that led up to each person being on the bridge at that time. Through extensive interviews, he was determined to understand the circumstances that led to their deaths.

A similar question haunts us in 2015: Why will one of every two of us, on average, “fall off the bridge” – that is, have our lives impacted by cancer? Over the past few decades, we’ve gained knowledge that allows for a safer life journey. We know that one half of cancers can be prevented by measures such as not smoking, protecting against excessive sun exposure, getting regular prostate check-ups, lowering obesity, reducing alcohol consumption and engaging in regular exercise.

We appear to be making progress. A recent report revealed that fewer people in the greater San Francisco Bay Area are getting cancer, and fewer are dying from it. More specifically, in the most recent 25-year period for which data are available, the occurrence of all new cancers combined declined by 13.2 percent.

Such news is encouraging. Yet, while advances in cancer treatment may allow more of us to cross our bridges safely and to help us heal if we fall, we must do better. We haven’t yet unlocked the mysteries of cancer. Indeed, the task is more daunting than we ever imagined; we now know that there are more than 200 diseases that we call cancer. We need to look for answers with large-scale genomics (looking at the structure and mapping of genes), bioinformatics (analyzing complex data, such as genetic codes) and computational biology (using data to study relationships in the biological system). We need to develop a better understanding of health disparities (across socially disadvantaged populations) and to drill down to an individual’s unique molecular and genetic characteristics.

For asking troubling questions which threatened authority, the friar in The Bridge of San Luis Rey was tried by the Inquisition and burned at stake. I would only hope that those of us who are probing deeply to prevent the scourge of cancer will be treated more kindly by society (and, especially, by funding agencies).

Donna Randall, PhD, is chief executive officer of the Cancer Prevention Institute of California, a partner of the Stanford Cancer Institute.

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