The Costs of a Cure

I am a scientist who spent decades studying cancer and agree that we've made great strides in treatments [Editor's Note: "Winning the War on Cancer?" November 3-10]. However, unless we rein in the costs of the biologics developed to treat cancer, no one will benefit but the wealthy. The test for the BRACA gene mutation (which is responsible for 5 to 10 percent of breast cancers) costs up to $3,000 and is covered by insurance only if you show family history. This is a strange requirement given that more than half of these women with the mutation have no family history of breast cancer. A biologic used to treat HER2-positive breast cancer costs $40,000 a year. The costs are outrageous.

Jeff Kreisberg, Ph.D., Dallas

I remember, quite vividly, watching President Nixon announce the National Cancer Act and, with it, funding of the National Cancer Institute. He proclaimed, (paraphrasing) "and with this we shall find the cure for cancer within the decade." This legislation and accompanying speech took place during the height of the Vietnam War. It struck me as an approach to divert attention from the war and as an attempt to emulate the actions taken 10 years earlier by John Kennedy when he declared that this nation shall place a man on the moon and return him safely to Earth within the decade. Kennedy was smart and knew that we could meet his challenge and accomplish the goal. Discovery, on the other hand, is serendipitous. Failure contributes to understanding, but one can never predict a "Eureka!" moment. Forty years later, we are still waiting for someone with a discovery that will send thousands to the laboratory. When it happens, within six months, confirmation will occur and a cure will be forthcoming. Until then, it is a long, uphill climb with small, hard-fought battles to be won along the way.

James Selevan, M.D., Laguna Beach, Calif.

Having lost a mother to multiple myeloma, one brother to esophagus cancer, another brother to leukemia, a father-in-law to lymphoma, a mother-in-law and a wife to breast cancer, I have learned that cancer is a big business. Don't expect to win the war on cancer too soon.

Elbert Smith, Weaverville, N.C.