Rethinking the War on Cancer | Newsweek War on Cancer | Newsweek.com

There is a blueprint for writing about cancer, one that calls for an uplifting account of, say, a woman whose breast tumor was detected early by one of the mammograms she faithfully had and who remains alive and cancer-free decades later, or the story of a man whose cancer was eradicated by one of the new rock-star therapies that precisely target a molecule that spurs the growth of malignant cells. It invokes Lance Armstrong, who was diagnosed with testicular cancer in 1996 and, after surgery and chemotherapy beat it back, went on to seven straight victories in the Tour de France. It describes how scientists wrestled childhood leukemia into near submission, turning it from a disease that killed 75 percent of the children it struck in the 1970s to one that 73 percent survive today.

But we are going to tell you instead about Robert Mayberry. In 2002 a routine physical found a lesion on his lung, which turned out to be cancer. Surgeons removed the malignancy, which had not spread, and told Mayberry he was cured. "That's how it works with lung cancer," says oncologist Edward Kim of the University of Texas M. D. Anderson Cancer Center in Houston, who treated Mayberry. "We take it out and say, 'You're all set, enjoy the rest of your life,' because really, what else can we do until it comes back?" Two years later it did. The cancerous cells in Mayberry's lung had metastasized to his brain—either after the surgery, since such operations rarely excise every single microscopic cancer cell, or long before, since in some cancers rogue cells break away from the primary tumor as soon as it forms and make their insidious way to distant organs. It's impossible to know. Radiation therapy shrank but did not eliminate the brain tumors. "With that level of metastasis," says Kim, "it's not about cure. It's about just controlling the disease." When new tumors showed up in Mayberry's bones, Kim prescribed Tarceva, one of the new targeted therapies that block a molecule called epidermal growth factor receptor (EGFR) that acts like the antenna from hell: it grabs growth-promoting signals out of the goop surrounding a cancer cell and uses them to stimulate proliferation. Within six months—it was now the autumn of 2005—the tumors receded, and Mayberry, who had been unable to walk when the cancer infiltrated his brainstem and bones, was playing golf again. "I have no idea why Tarceva worked on him," says Kim. "We've given the same drug to patients in the same boat, and had no luck." But the luck ran out. The cancer came back, spreading to Mayberry's bones and liver. He lost his battle last summer.