A generally-held beliefby both the medical profession
and the lay public is that therapeutic medicine greatly
affects health. Providing more hospital beds, doctors
and resources is viewed as the path to improve health.
Therapeutic medicine is of much benefit to sick
people. However, with the exception of several highly
contagious infections, it has not reduced the incidence
of disease. This generalization applies particularly to
cancer. Despite this fact most ofthe expense and effort
devoted to the management of cancer is directed
towards early diagnosis (screening) and improved
therapy. Evidence has steadily accrued that this
strategy is essentially a failure: little impact has been
made on the toll taken by the major cancers.
The failure of therapy, coupled with the realization
that the overwhelming majority of cancer is related
to environmental, particularly lifestyle, factors,
dictates that prevention should be our foremost aim.
It follows, therefore, that cancer research should
concentrate on those environmental factors which
may cause or prevent cancer. Instead, most research
looks at either the detailed mechanisms of cancer
formation or else investigates new types of therapy.
Medicine should admit its severe limitations in
therapy and redirect itself. Using the fruits of an
expanded research programme into such areas as diet
and exercise, medicine should strive to apply this
knowledge to cancer prevention
