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Along the way, though, scientists have amassed a wealth of information about how cancer works at the molecular level, from its first awakening in the aberrant DNA of a single cell's nucleus to its rapacious, all-out assault on the body. Armed with that information, they have been developing a broad array of weapons to attack the disease every step along the way. Many of these therapies are just beginning to reach clinical trials and won't be available to save lives for years to come. If you have cancer today, these treatments are likely to come too late to help you. But, says Dr. Larry Norton, a medical director at Memorial Sloan-Kettering Cancer Center in New York City: "I think there is no question that the war on cancer is winnable."
That sentiment was pounded home last week at the annual meeting of the American Society of Clinical Oncology in San Francisco, where a record 26,000 cancer specialists from around the world briefed each other on the good news starting to pour out of their laboratories. Unlike chemo and radiation, which use carpet-bombing tactics that destroy cancer cells and healthy cells alike, these new medicines are like a troop of snipers, firing on cancer cells alone and targeting their weakest links.
Some of these therapies prevent a class of chemicals called growth factors from reaching a tumor, blocking signals that would otherwise instruct the cell to grow out of control. Others tip the delicate balance that every cell maintains between life and death, driving cancerous cells to self-destruct. Still others block enzymes that cancer cells use to chew openings in normal tissues and give themselves room to expand. And, most famously, the class of compounds known as angiogenesis inhibitors keep tumors from building new blood vessels to supply themselves with food and oxygen. Three years ago, Nobel laureate James Watson, co-discoverer of the structure of DNA, was quoted as saying Dr. Judah Folkman, the Harvard researcher, would use these inhibitors to "cure cancer within two years."
He later claimed that he had been misquoted--and no wonder. Scientists who know anything about cancer are exceedingly cautious about using the C word. That's partly because it too easily raises false hopes and partly because doctors are increasingly convinced that a cure is not the only way to beat cancer. Instead, experts believe, by throwing a series of monkey wrenches into the cancer cell's machinery, the new therapies could transform cancer from an intractable, frequently lethal illness to a chronic but manageable one akin to diabetes and high blood pressure. Says Dr. Leonard Saltz, a colon-cancer specialist at Memorial Sloan-Kettering: "I don't think we're going to hit home runs, but if we can get a series of line-drive singles going and put enough singles back to back, we can score runs."