So how did I go from last month’s topic about geoengineering to cancer treatment? Well, for one, keeping the Earth healthy is a bit like doing the same for humans: harder than you’d think. Systems engineering on a fairly complex level that we don’t entirely understand. This is also a personal topic. Cancer used to be an academic concept for me. Not any more. Science fiction lost a brilliant voice to cancer earlier this year, when Kage Baker died of it. Now I have friends and family with cancer, and it has become a palpable evil rather than something distant that I don’t want, like elephantiasis or malaria. I’ve seen it, and I don’t like it.

So as usual, remember that I’m a generalist futurist, and more than usual, I’d love expert comments on this post. I always learn from what readers share back.

What’s Happening

At ground level today, the most common cancer treatments have been used for decades, and appear to be an attempt to remove the cancer followed by attempts to poison the cancer, with the side affect of poisoning ourselves. It’s kind of a race to see if we can kill the cancer before the treatment kills us. It’s not pretty.

On the better-news side, there are a ton of new treatments actually being used. Here are two:

There are a variety of takes on the concept of immunotherapy, or getting your own body to do a better job of fighting the cancer. One of the drugs used in this therapy is Interluekin-2, or IL2, but there are multiple approaches that vary by diagnosis (Cancer seems like a bunch of different and related diseases).

There are perfusion treatments that use chemotherapy in a more targeted way than usual. For example, to apply ten times the normal dose of chemotherapy by directly to the affected organ. This has been used to treat liver cancer successfully.

There are also new directions heading into trials or into the approval phase. For example:

• Angiogenesis management: Apparently, successful tumors (and for that matter, successful fat deposits) need blood vessels to feed them. In a process called, angiogenesis, our bodies betray us by doing just that, generating blood vessels to feed things we don’t really want. Diet can be used to fight angiogenesis, and ani-angiogenesis drugs are being developed. We might gain a tool for both fighting tumors and fighting fat with this one.
• There is a lot of work being done on cancer vaccines. Even though the first one, Provenge, was just approved by the FDA for use in the United States, vaccines are not yet available for most cancers, or available in any widespread way. Provenge, which is actually used for people who already have cancer, appears to provide a longer life by a few months, and to cost about $93,000 per patient today. But hey, computers were as big as houses, and as expensive, not very long ago. So it’s a start.

My prediction?

My futurist hat, unfortunately, puts a real cure for cancer in the same category as flying cars and space travel. It’s hard. It may not even be possible to completely eradicate it: remember that cancer is a series of diseases, a myriad of ways that our own bodies can betray us by making tumors.

The good news is that there are a lot of people working on it, funding and doing research, willing to donate, willing to help change the landscape. Cancer has touched almost everyone in some way. All you need to do to understand the human will to beat this thing is go to a cancer walk and listen to the survivors and the sufferers and the supporters. They’re passionate.

So we’ll get there, or at least we’ll get close. We’ll get a lot closer than we are today. Step by step, death by death, change in habit by change in habit. There are vectors making the fight harder since a more toxic world seems to breed cancers even as we’re learning to stop cancer-causing habits like smoking. So there’s still going to a lot of price to pay as we get from here to a world where cancer is rare.

I still believe in flying cars and space travel, too.

Science Fiction and Cancer

When I write anything very far off into the future, I tend to assume we’ve stomped out malaria and killed cancer and maybe even finished off the common cold. I’m really ready for one of Larry Niven’s Autodocs. Unfortunately, they aren’t here yet, although the iPhone apparently has an app that saved a man’s life in the Haiti Earthquake.

Since I’ve been both really busy and slightly distracted by the cancer-wolves all around me, I reached out to my social network for some ideas about stories, and of course, it delivered. Thanks to Alastair Mayer for pointing out Norman Spinrad’s story, “Carcinoma Angels,” which does a great job of making cancer as big and scary as it ought to be (but doesn’t end particularly well). Thanks also to Clif Davis for mentioning David Brin’s anti-onc cream from the fantastic novel Earth.

For a last recommendation, I’ll go back to the real world, and suggest a forthcoming book called “The Specific Gravity of Grief,” by Jay Lake, which will be out from Fairwood Press this year. For that matter, drop by his blog at jaylake.com to follow his journey as he works to defeat cancer. Although the book itself is neither science fiction nor fantasy, Jay writes both rather well, so this fits on a stretch.

Here’s a few links for those of you who want further research:

• Opinion piece on the state of cancer trials in the US from the New York Times
• Whole genome sequencing of tumor cells achieved, implication in monitoring cancer
• CNN video on the high Cost of Kidney Cancer
• Cancer Immunotherapy
• The Angiogenesis Foundation

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Brenda Cooper’s latest science fiction novel, Wings of Creation, is out now from Tor Books. For more information, see her website!