Prevention: It’s boring

Morgan Housel writes:

In 2013 Harold Varmus, then director of the National Cancer Institute, gave a speech describing how difficult the war on cancer had become. Eradicating cancer – the National Cancer Act’s goal when it was signed in 1971 – seems perpetually distant. Varmus said:


There’s a paradox that we must now honestly confront. Despite the extraordinary progress we’ve made in understanding the underlying defects in cancer cells, we have not succeeded in controlling cancer as a human disease to the extent that I believe is possible.

But prevention is boring, especially compared to the science and prestige of cancer treatments. So even if we know how important it is, it’s hard for smart people to take it seriously.

Boom. That’s where I have always pitched in- as an oncologist, I understand the limitations of the craft. Surgery can remove as much of the tumour without causing functional deformities, radiation therapy as much as the critical OAR’s can tolerate and chemotherapy- as much as the marrow can support life. As with the author, I have learned more about my field from getting an outsider’s perspective than reading the books per se. Here’s an interesting snippet from the link:

This is an extremely powerful narrative.

Prevention is better than cure but it is not glamourous. It is because our healthcare is invested in treating episodic models of sickness but does nothing to push through ideas of prevention because multi-million dollar industries would suffer. Smart people often look for the bling than the substance. Prevention is boring. It is obvious that lung cancer rates will plummet once the smoking cessation programs are in place. However, it requires research in behavioural and psychological space on how best to serve a motivation for people to keep off substance abuse. Yet, I see entire conferences devoted to finding the elusive pathway which I cannot use for therapeutics.