BATTLE TO ERADICATE CANCER AT A STANDSTILL AFTER 25 YEARS.

Byline: Lauran Neergaard Associated Press 

Dr. Wendy Harpham is living the paradox of the war on cancer: New treatments are keeping her alive without poisoning her. But fellow physicians still can't cure her.

Twenty-five years - and $29 billion - after President Nixon declared the war on cancer, the disease is about to become the nation's No. 1 killer. More people die of it today than in 1971.

One in three Americans will get cancer. Half a million will die this year.

The news is not all bad: Cancer patients do live longer today. Chemotherapy is becoming less toxic. Some cancers, especially those that hit children, are curable now. And the death toll slightly dropped in 1990.

But progress is measurable only in inches, said Ellen Stovall of the National Coalition for Cancer Survivorship. ``The war on cancer got stuck and there's no will to unglue it.''

Indeed, more and more frustrated patients are traveling to Capitol Hill to vent anger at mainstream medicine's lack of cures and to demand untested alternative therapies.

And Congress repeatedly asks the nation's top doctors: Why are there significant new drugs to fight AIDS, but nothing as exciting for the cancers that strike millions more Americans?

``For too long we've made false promises,'' acknowledged Dr. Richard Klausner, director of the National Cancer Institute.

``We don't know when we're going to cure cancer. . . . But we cannot confuse the frustration with not curing it, with the conclusion we're not making progress.''

The hopelessness and distrust also trouble Harpham, a physician who has battled five recurrences of non-Hodgkins lymphoma and educates fellow patients about finding the best therapy while avoiding quacks.

``I have looked at this with the mind of the scientist but the heart of someone desperate to survive,'' said the Richardson, Texas, mother of three.

Small improvements are allowing patients ``to genuinely have hope that if what is available now can keep you alive, there'll be better stuff down the road,'' she said.

Many childhood cancers today are 60 percent to 90 percent curable. Testicular cancer is almost always cured. Earlier detection has helped deaths from breast, cervical and colorectal cancers drop.

And drugs approved in the past year block nausea, blood infections and other chemotherapy side effects.

But 25 years ago, cancer killed 162 of every 100,000 Americans. By 1990, cancer's mortality rate had jumped to 174 deaths.

What happened? One answer is smoking, doctors say. Deaths from all malignancies except lung cancer have dropped since 1971, from 127 deaths per 100,000 to 122. If Americans quit smoking, doctors agree, cancer would plummet.

Cancer's overall death rate did inch down two points between 1990 and 1992, the latest figures available. But it still is poised to become the nation's top killer by 2000 - because heart disease is dropping faster.

Frustrated patients note that most cancer drugs approved by the Food and Drug Administration in recent years have merely offered dying patients a few more months.

Only 2 percent to 3 percent of cancer patients even participate in clinical trials of potential new cures.

Where do they go instead? Often to the Internet, where scientific research vies with companies that tout miracle cures. Such companies often claim that a conspiracy to help chemotherapy makers profit is deliberately blocking a cure, said Diane Blum of Cancer Care Inc.

``Some of the stuff I see with cancer . . . is crazy,'' said Blum, whose group helps patients sort out the data. ``If we had better, more effective treatments, people wouldn't do this.''

Dr. John Bailar of the University of Chicago says preventing cancer - by fighting smoking, sun exposure and other controllable risks - may be the best option for a disease now considered too complex for a magic bullet.

``The flow of (significant) new drugs is essentially zero now,'' Bailar said. ``I am simply no longer convinced that there are a lot of wonderful cures waiting to be found.''

But the NCI's Klausner insists scientists only now are unlocking crucial genetic mysteries.

The question is whether patients will believe scientists' claim - again - that they're closing in.

Take Janice Temple of San Francisco, who opted in 1994 for a controversial therapy called antineoplastons to help prevent her breast tumors from recurring. So far they haven't.

Temple says mainstream medicine ``truly is an erroneous system'' because it discourages innovation in favor of drugs as toxic as the disease they treat.

But Harpham argues that she already sees a change in cancer treatment. Her first chemotherapy in 1990 poisoned her, but ``magical drugs'' protected her from side effects last year.

If her cancer returns again, she'll try higher doses of a genetically engineered - but still experimental - antibody that targets cancer cells. Low doses helped her stave off lymphoma for a while.

``I truly believe we are on the brink of a cascade of discoveries that will translate into'' better therapies, Harpham said. ``That's a lifeline.''

CAPTION(S):

Photo

PHOTO Wendy Harpham

Sees change in treatment