I don’t think the cancer community is even close to ready for the “what’s next”. We have yet to figure out how to reduce cancer mortality rates by 60% simply by providing access to health care (public policy). We have yet to develop treatments that have significantly bumped our survival rates from where they were decades ago (medicine). We have yet to fully understand how to use detection methods to our advantage nor have we even made a dent in inspecting the environment to understand the causes of cancer (prevention).

The only reason the HIV community is able to focus on the “what’s next” is because they were so successful at the public policy, medicine, and prevention so as to achieve a 32 to 50 year survival rate from the time of diagnosis. They were also able to achieve their progress because HIV is one disease, where as cancer is thousands of disease types. Because the HIV community was active and smart as hell in knowing how to stand up to and make demands to the government, where as the cancer community largely things of politics as a dirty word.

I think the reason doctors are not so focused on ‘the cure’ is not out of desire to move beyond it, but simply because we are so far away from achieving it and we need another way of operating, a holding place for life until we can do better at saving lives than we are doing now. In the midst of improving quality of life, we’ve gotta be careful not to lose sight of the ball: the cure. Survival is only a word that pertains to the living.

To the fault of the government, scientific community, and patient advocacy groups, doctors are forced to operate in the reality of a forty year time span in which not much progress has been made; they are left to say to patients – “Well crap – ummmm, we’re going to do everything we can to try to make your quality of life better cause we still have not much else to go on.”