Lymphoma, Leukemia Are on the Rise

0 Comments | Insight on the News, April 5, 1999 | by Ruth Larson

Though less well-known than breast or lung cancers, specialists say 'blood cancers' are reaching epidemic proportions. Some are calling for major increases in federal research budgets.

The recent death of Jordan's King Hussein from non-Hodgkin's lymphoma briefly raised public awareness of "blood cancers"--lymphoma, leukemia and myeloma. But surveys show that Americans know far less about these diseases than they do about lung or breast cancers.

Blood cancers interfere with the body's ability to produce healthy blood cells, rendering it vulnerable to infection. From 1973 to 1991, the number of lymphoma cases increased by 73 percent, making it the third most rapidly increasing type of cancer, behind skin and lung, according to the Leukemia Society of America. Leukemia and lymphoma are the leading fatal cancers among people younger than 35.

Bruce Douglass, for example, was only 16 when he was diagnosed with leukemia 22 years ago. At the time, bone-marrow transplants were performed only with an exact donor. But his doctor, E. Donnall Thomas, gambled that the marrow from Douglass' sister was a close-enough match. He became one of the first patients to survive such a "mismatch" bone-marrow transplant.

Thomas, who received the 1990 Nobel Prize for medicine, noted at a recent press conference that medicine has achieved stunning advances in the treatment of bone-marrow cancer, including the development of the National Bone Marrow Donor Program, a database of more than 5 million tissue types worldwide. Still, said Thomas, "we're about halfway there" since roughly half of all patients are cured or survive long-term.

Researchers don't yet know what disrupts the body's infection-fighting process and "why cells that are normally policemen become criminals" according to Margaret A. Shipp of the Dana-Farber Cancer Institute. Scientists believe viral infections or exposure to toxins somehow may damage cells of the immune system. Patients living with HIV for more than six years are 100 times more likely to get lymphoma. But even lifesaving procedures such as heart transplants increase the odds of getting lymphoma by 5 percent.

Traditional treatments have included chemotherapy, radiation or both. Such treatments can have toxic side effects because they kill healthy cells as well as cancerous ones. But new drugs have shown promise in curing some types of leukemia, and gene therapy may help disrupt development of the cancer cells, notes Marshall A. Lichtman, executive vice president for research and medical affairs at the Leukemia Society of America. The next decade promises still more successful treatments. Molecular biology and genetics may help researchers identify the cause of the diseases--but only if researchers get the funding they need, cautions Lichtman.

Dwayne Howell, president and chief executive officer of the Leukemia Society, has urged Congress to boost funding for the National Institutes of Health, or NIH, by 15 percent next year, and to double the NIH budget to $30 billion by 2003. He also recommends expanding clinical trials so that more patients have access to promising cancer treatments. Just 3 percent of adult cancer patients are enrolled in clinical trials. By contrast, any child with leukemia is eligible for treatment in a clinical trial. As a result, childhood leukemia has an 80 percent survival rate.

RELATED ARTICLE: Politicized Science Is Bad for Health

Americans are being "scared sick" by health warnings based on faulty and incomplete science that's sometimes driven by political ideology, according to experts such as Marcia Angell, executive editor of the New England Journal of Medicine. She and other prominent physicians, scientists and academics gathered for a conference sponsored by the Independent Women's Forum to examine how unfounded fear affects health and science policies, how ideology affects research and how the media cover health and science issues.

"Many reports are trivial, many more are just plain wrong ... and a lot of what we're told is inconsistent," said Angell, who expressed concern about people making judgments about diet or behavior on political rather than scientific grounds.

"Fear is a prelude to the sale of snake oil, and it's widespread," added Paul Gross, professor emeritus of life sciences at the University of Virginia. "What's new is the participation of academic intellectuals in the subversion of science--all of whom come from a particular political point of view."

Gross heaped special scorn on feminists in academia, citing one scholar who insists "no progress" has been made against cancer. Feminists have become the "locus of the shrillest denunciation of science" because they believe science, like society as a whole, "needs to be transformed" to their specifications.

Likewise, Elizabeth Whelan, president of the American Council on Science and Health, criticized "self-appointed feminists who are now discouraging women from using estrogen-replacement therapy" because of concerns it might cause breast cancer. Whelan said postmenopausal women need to balance "a small risk of cancer against the serious risk of osteoporosis," which they may get without estrogen-replacement therapy.