200 Years of Cancer Research

The New England Journal of Medicine is celebrating its 200th anniversary this year. Kind of amazing -- almost as old as the country itself, and its been providing cutting edge medical research for all that time.

As part of the celebration, the NEJM has been including lots of articles the history of medicine, including this one by Dr. Vincent T. DeVita, and Dr. Steven A. Rosenberg called "Two Hundred Years of Cancer Research."


It's a fairly quick summary of a lot of history. I like the opening line: "In the 200 years since the New England Journal of Medicine was founded, cancer has gone from a black box to a blueprint." Indeed, for many, many years we really had little understanding of what makes cancer cells begin, grow, and survive. We have so much more knowledge now, enough to understand a lot of the genetic makeup of cancer, and to attempt to use that knowledge to create treatments. Pretty amazing how far we've come.

I also like this line: "Until recently, cancer treatment was a three-legged stool sitting on a base of surgery, radiation therapy, and chemotherapy. In the past 25 years, immunotherapy has been added as an important component of cancer treatment." This begins a discussion of the importance of immunotherapy in recent cancer treatment approaches. Hello, Rituxan, my little friend....

Mostly, though, I found this fascinating to compare to Dr. Siddartha Mikharjee's incredible book The Emperor of All Maladies: A Biography of Cancer. Mikharjee doesn't claim to write a history of cancer, though there's quite a bit of history in it. But as with all historical subjects, it's interesting to see how two historians pick and choose the details that they think are important. DeVita and Rosenberg are writing a 7page article aimed at physicians; Mikharjee is writing a 300 page book aimed at the general public, and is much more interested in telling a  good story.

That said, I learned something from this article, and it was nice to see that two prominent cancer researchers see the development of monoclonal antibodies and the development of kinase inhibitors as two of the three most important events in cancer treatment to have occurred in the last 15 years.