Fighting Cancer by Controlling It, Rather Than Killing It

Jerome Groopman:

The breakthrough is notable in part for the unconventional manner in which the drug attacks its target. There are many kinds of cancer, but treatments have typically combatted them in one way only: by attempting to destroy the cancerous cells. Surgery aims to remove the entire growth from the body; chemotherapy drugs are toxic to the cancer cells; radiation generates toxic molecules that break up the cancer cells’ DNA and proteins, causing their demise. A more recent approach, immunotherapy, coöpts the body’s immune system into attacking and eradicating the tumor.

The Agios drug, instead of killing the leukemic cells—immature blood cells gone haywire—coaxes them into maturing into functioning blood cells. Cancerous cells traditionally have been viewed as a lost cause, fit only for destruction. The emerging research on A.M.L. suggests that at least some cancer cells might be redeemable: they still carry their original programming and can be pressed back onto a pathway to health.

This is a fascinating article. This approach seems so obvious that it feels simultaneously maddening and completely understandable that it took so long to develop. On the other hand, by the end of this piece, I wondered what people would make of it in—100 years. Or even worse, in 200 years. What about 500 years? So much talk and work about and on cancer works from an assumption that it is something that eventually will be overcome. But what if (and pardon me for getting super nihilistic for a moment) cancer is something that we aren’t meant to beat/eradicate/cure? What if we’re beating our heads (and wallets) against the wall, fighting an enemy on the molecular level, for nothing?