The Best Treatment Is Still Prevention

 
"We are living in a golden age of medicine. The scientific understanding of disease at the genetic and molecular level has allowed for treatments that could not have even been imagined just a few years ago. Advances are coming rapidly – recently, researchers have demonstrated the ability to edit a single gene in an embryo to prevent development of a lethal heart condition!"  

In my own specialty of oncology, we have seen remarkable progress in the treatment of metastatic cancers. Just 5 years ago, the average person diagnosed with metastatic melanoma (the most aggressive form of skin cancer) lived less than one year. Now, however, more than 80% of patients will still be doing well on treatment 1 year after their diagnosis, and many of them will continue to have their disease controlled for years to come. Research into new treatments involving the immune system in 2016 led to the first new therapy for patients with advanced bladder in almost 20 years. The Food and Drug Administration has granted approval to 5 new treatments for patients with advanced lung cancer thus far in 2017! Such dramatic shifts in our ability to treat difficult diseases are uncommon in the history of cancer. The progress we have made in oncology in the past 10 years is unprecedented. 

Nevertheless, most of the patients that will benefit from these significant improvements will eventually succumb to their disease and, unfortunately die. We are extending many lives but still not curing the majority of patients with advanced cancer. Similar patterns have been seen in many other areas of medicine. Through a catheter inserted in a blood vessel cardiologists are able to intervene on blocked artery or change entire heart valves! These amazing interventions can be done without a surgery, offering significant relief to many patients without the risk of a major operation.

Truly, we live in exciting times. But much of this progress comes into play only when treating advanced disease. Far preferable to these improvements would be to avoid disease completely. It is impossible to overstate the importance of prevention in medicine. The impact of new cancer medicines, cardiology interventions, and even gene editing cannot compare to the improvement in health from historical measures like establishing clean water and administering vaccines. Now, in America, most deaths are from heart disease and cancer. And our current efforts at disease prevention are able to dramatically reduce the risk of developing heart disease or stroke, and can successfully identify early stage cancer when it is still very curable. While my colleagues and I continue to work on better ways to treat the most challenging forms of late stages of cancer, I would much prefer to reduce the number of people in need of these treatments. That can only be done with effective primary care and preventative medicine. 

Tim Jones left an important legacy. He recognized the need to motivate people and make them advocates in their own health care. He understood the potential of preventative medicine. I hope his life and memory can inspire many people to seek potentially life-saving care.

Nicklas Pfanzelter, MD

Assistant Professor of Medicine

Rush University

Dr. Pfanzelter was Tim's oncologist at Rush Cancer Center. To learn more about Dr. Pfanzelter, Rush's Cancer Center and Rush University Medical Center use our partner or resource pages links or go to https://www.rush.edu/.