Answers to Cancer

In the study of cancer, never have the concomitant factors that can transform a healthy cell into a malignant cell been so well understood as they are today; for this, we have mainly molecular biology, genomics and post-genomics to thank. Today we are at last beginning to understand the underlying mechanisms by which cancer develops. This scientific and medical progress has led to changes in our therapeutic arsenal, holding out strong hopes that one day we will be able to eradicate the disease or at least the suffering it causes. The day will come when chemotherapy will give way to targeted, "smart" treatments capable of blocking precise mechanisms without disturbing the fragile balances of life. I firmly believe that, when that time comes, cancer will be no more than just another curable disease, and that we will all feel justifiably proud of the immense chal-lenges we have faced and overcome, and of the equally immense successes we will have achieved.

In the field of cervical cancer, for example, the future is full of hope: by 2007, there should be a vaccine on the market to protect against infection by human papillo-mavirus, a common cause of this type of cancer. This could reduce the incidence of a disease that affects close on 500,000 women around the world and kills 250,000. But the burning question, given that this cancer affects mainly women in developing countries, is how are these countries to find the funds to pay for the vaccine?

And obviously, when you are dealing with cancer, it is important also to consider prevention and awareness. In France, for example, which is our main remit, the Cancer Plan must provide an opportunity to resume the dialogue with all those who put themselves at risk to convince them not to subject their bodies to the ill-effects of carcinogenic substances such as tobacco.

Tobacco is not the only culprit, however. The rise in obesity gives me equal cause for concern, since it leads to long-term damage. With 40 per cent of children overweight or obese in the U.S. and 15 per cent in France, the figures clearly reveal the harmful trend in our eating habits. If we are to halt the spread of obesity, we need to change people's habits. As with tobacco, though, it is no easy matter to encourage people to change the way they behave.

Changes in our behaviour and lifestyle lead me to won-der about another public health issue: avian influenza, or bird flu. The way we live is closely implicated in the possible spread of the disease: we live in a world of globalisation, a widening web of contacts, faster forms of transport. In this world we have created for ourselves, are we really prepared to set up the barriers needed to stop the virus?

I am also keenly aware of other major global challenges. If we look at recent events around the world, it seems difficult to separate health issues from their societal or economic context.

All too often, the news brings us stories of violence. Human violence in the form of terrorism in different parts of the world, the violence of the elements with hurricanes Katrina and Rita or drought in Niger...

The rise of terrorism as an expression of resentment, all over the world, bears witness to the failure of educational programmes, too often disconnected from reality and out of reach for most of the population. These have-nots then lock themselves into a worrying communalism, in the belief that such introversion offers a satisfactory response to their daily problems.

The natural disasters we have witnessed recently inspire in me two contradictory feelings. One is hope, since the speed at which poignant, hard-hitting images straight from the disaster sites has prompted great compassion and made it possible to bring aid and support to those in need. Another is despair, as we are forced to realise, yet again, that mankind is unable to learn the lessons of history.

One natural disaster follows another, as if each were the first, each with its aftermath of shock, fear, lack of organisation... although the greatest contributions to hu-man advancement have always come from our ability to learn.

Everyday, and all the more so since my appointment as head of INCa, I realise that knowledge, learning, research and prevention are essential conditions for progress, whatever the field of endeavour.

Submitted By:
DAVID KHAYAT

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