An issue in remission

Cancer annually kills about 560,000 Americans, and it remains the No. 1 killer of people under 85. Yet the leading 2008 presidential candidates, as in previous electoral cycles, have been relatively silent on how they would lead a fight against the disease. None of them has made research funding and treatment of the disease a signature issue despite the fact that cancer has affected nearly half of the candidates’ lives.

On the Democratic side, the breast cancer of former Sen. John Edwards’ wife has spread to her bones. Sen. Barack Obama’s mother died of ovarian cancer, and Sen. Hillary Rodham Clinton’s mother-in-law died of complications from breast cancer. Among the Republicans, former New York City Mayor Rudy Giuliani is a prostate cancer survivor, while Sen. John McCain and former Sen. Fred Thompson have successfully battled skin cancer and lymphoma, respectively. Sen. Sam Brownback had melanoma in the mid-1990s, and former Arkansas Gov. Mike Huckabee’s wife had spinal cancer when she was 19.

Fortunately, the political indifference to cancer may be changing. Last month, four of the Democratic candidates (Edwards, Clinton, Rep. Dennis Kucinich and New Mexico Gov. Bill Richardson) and two Republicans (Brownback and Huckabee) participated in a forum on cancer sponsored by MSNBC and Lance Armstrong’s LiveStrong foundation. Not since President Nixon launched a war against the disease in 1971 has the search for its cure been the subject of American politics. But candidate attendance at the forum was still surprisingly low. Much of the media ignored the forums, and if history is a guide, the subject of cancer will be dropped all too quickly from the political agenda.

The cancer question has remained on the margins of politics for at least three reasons.

The first is because no politician wants to be associated with a failed war against an intractable disease. The wars on poverty, drugs and illegal immigration have all been largely discredited as ineffectual. President Johnson’s Great Society program helped lower the poverty rate from 22% to 12% during the 1960s, but conservatives have successfully portrayed it as little more than a government handout program, which has had a chilling effect on similar campaigns. In the 1980s, First Lady Nancy Reagan’s admonishment to America’s youth to “just say no” to drugs became gist for late-night comedians.

Another reason is that cancer advocacy groups -- unlike the AIDS community, which created a major movement to fight the virus -- lack a cohesive political organization. Cancer survivors, their families and the medical community break into sub-groups focused on individual types of cancer. Breast cancer survivors raise money for breast cancer research; Katie Couric, whose husband died of colon cancer, urges people to have colonoscopies; and men older than 50 are advised to get a PSA blood test to detect prostate cancer.

But beyond Armstrong’s group, there are few organizations pushing for more funding for basic cancer research.

Finally, in the minds of many Americans, cancer seems an immutable law of nature that cannot be altered. Doctors can detect it earlier; surgeons and oncologists can treat it more effectively and raise a person’s odds of survival. But the thinking is that we can’t cure this disease as we did with, say, polio.

What would a credible cancer policy look like?

First, it would make fighting the disease a policy priority because cancer causes far more deaths and anxiety in America than terrorism, the topic most discussed by the presidential candidates.

Second, a credible policy would call for a huge infusion of federal funding for cancer research with the twin goals of furthering basic research, as well as research on particular kinds of cancer. Shamefully, President Bush has cut the National Cancer Institute’s budget by a total of 12% in the last four years. Dr. Allen Lichter, the chief executive of the American Society of Clinical Oncology, recently said that “we are now in the midst of the longest sustained period of flat funding in research in decades.” The cancer research community increasingly struggles to attract grant money from any source. The shortage of funds is raising fears among some veteran researchers that many younger scientists will be dissuaded from devoting their careers to cancer research.

Third, it would call on the federal government to lead a public relations campaign to raise awareness of the need for early detection. The government is the only entity with the resources to communicate with virtually all Americans, and such a campaign would probably save tens of thousands of lives each year.

During CNN’s YouTube Democratic presidential debate, a Long Island breast cancer survivor implied that fellow survivors and their families should make cancer prevention and treatment a key issue on which they cast their ballots. If the millions affected, directly and indirectly, by cancer followed her advice, political candidates might develop a credible anti-cancer policy and start paying attention to a disease that is much costlier and deadlier than terrorism.