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    Cancer: the Good, the Bad, and the Ugly

    We've made great progress since President Nixon declared war on cancer 30 years ago, but can the war be won?

    Cancer: the Bad and the Ugly

    "Some tumors are ugly," says Robert J. Morgan Jr., MD, the section head of neuro-oncology and a physician in the division of medical oncology and therapeutics research at the City of Hope National Medical Center in Duarte, Calif. For example, there has been little progress with treating and beating brain cancer, he says. "There are two problems," Morgan tells WebMD. "The first is finding an effective agent and the second is making sure this agent can cross the blood-brain barrier and get to the tumor," he says.

    In 2005, doctors will diagnose 18,500 malignant tumors of the brain or spinal cord in the U.S. and approximately 12,760 people will die from these tumors, according to the ACS.

    "Pancreatic cancer too turns out to be difficult to detect and treat," he says. In fact, pancreatic cancer is the fourth leading cause of cancer death.

    Another cancer that doctors have not mastered yet is ovarian cancer. "Unfortunately, we do not have a reliable screening test for ovarian cancer because it's a tumor that is 100% curable if caught in stage I with surgery alone or surgery and chemotherapy, whereas once it has traveled the chances of cure can drop to as low 5%," he says.

    A good screening tool for lung cancer could also help doctors turn a corner on the disease that recently took the life of ABC News Anchor Peter Jennings. "People are being hammered to not smoke, but a large number of patients who don't smoke do develop lung cancers," he says. "We do know that tumors are different in smokers vs. nonsmokers and we need a better screening test because low-dose spiral computed tomography (CT) scans are expensive, insurance doesn't pay, and it has a high rate of false-positives leading to unnecessary surgeries to remove the suspicious nodules."

    Melanoma is also proving tricky, says City of Hope's Trisal. "The major reason is that we don't have any effective therapy for melanoma except surgical therapy," he tells WebMD. "We don't have any effective chemotherapy drugs, and we have been looking to vaccines and biological therapy, but the response rate is minimal." Biological therapies such as interferon utilize substances that occur naturally in the body to attack cancer cells.

    "Earlier detection of melanoma is very effective and we are picking it up earlier now [due to routine skin checks], but it will take 10 years to see if we made a difference," he says. But right now, "it's an all-or-none phenomenon, [meaning that] if you have metastatic (spreading) melanoma in the lymph nodes, we are fighting a losing battle." If not, it looks good. It's a big watershed area where people will either be OK or not be OK."

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