Waging WAR on CANCER

One thing was evident as Cindy Perry swept through the doors of the Post Falls Kootenai Cancer Center on a Wednesday morning.

This wasn't her first treatment.

No directions needed, Perry beelined for the radiation room, past the cushioned decor where the bitter medicinal scent pinches the nostrils. She tossed a wave at staff, swapped the usual hello with Linda, another morning patient.

"Only two left," Perry said after tracing the path to the treatment room for the 31st time. "I'm pretty excited."

She likes to think about what she'll do afterward, she said, while she lays on the table with arms overhead, ballerina style. Maybe horseback riding, she sketches in her mind, as staff angles her beneath the linear accelerator, a faceless machine that buzzes as it beams radiation on her torso.

That's what the Hayden woman has always thought about: What she'll do next. Not about how none of this is a guaranteed cure for her rare form of triple negative breast cancer.

Nor is it for many kinds of cancer.

Not the eight weeks of radiation that has left her skin burned, not the six rounds of chemotherapy that left her bewildered, nauseated, bald. Not the partial mastectomy.

Even though the mother of two's prognosis is dour if the cancer returns, Perry meticulously keeps her focus elsewhere.

"I'm optimistic we'll find a cure," said Perry, who has Google set to email her the latest trials on her scientifically frustrating malady. "It keeps me hopeful all the time."

How hard could a cure for all cancer be, after all, Perry asked. Just find a way to tell cells that keep stubbornly dividing to quit.

Perry believes she'll see it. That we all will. And that's what keeps her fighting.

"I feel they're just so close," she said, her pink ribbon earrings gleaming under the cancer center light. "I think it can happen."

You Will Care

That will matter someday to at least half the people reading this story.

In Idaho, one in two men and one in three women will be diagnosed with cancer in their lifetimes, according to Idaho cancer incidence and mortality data from 2005-09, collected by the Cancer Data Registry of Idaho.

Roughly 2,500 Idaho residents die from cancer each year, according to the Comprehensive Cancer Alliance for Idaho. Of those diagnosed across the state this year, 33 percent will die of cancer within five years.

Many are chasing after fixes, quick and otherwise, for the uncontrolled growth of abnormal cells that invade and destroy other tissues, a condition that can develop in most organs or tissues. Online debate has wavered on whether Houston-based Dr. Stanislaw Burzynski's alternative antineoplaston therapy, still in FDA trials, is a cancer cure or a hoax.

Meanwhile, Coeur d'Alene chiropractor Dr. Ryan Sousley is offering services he says will prevent cancer entirely: a five-prong attack of proper nutrition, stress reduction, eliminating body toxins, boosting exercise and, of course, a healthy spine.

"It's just logic that cancer can't survive or exist in a healthy environment," Sousley said, adding that some cancer patients who have climbed on his table have boasted full remission. "What we specialize in is getting your body so incredibly healthy that whatever you have, whether cancer or headaches, will go away."

Billions of dollars are spent every year scouring for other answers.

The 2010 budget for the National Cancer Institute, the country's principal agency for cancer research, was $5.1 billion. The American Cancer Society has spent $3.8 billion on cancer research since 1946, and the Susan G. Komen Foundation has invested over $685 million in the last 30 years.

So, we're motivated.

So, we're well funded.

But how close are we to closing the case on cancer, and espousing that ever-distant word: Cure?

Slim Chances

It probably will never happen, said Epidemiologist Chris Johnson, with Cancer Data Registry of Idaho.

At least, the chances are microscopically slim.

It could be within the grasp of ambitious scientists if cancer were simply one disease, Johnson said. But, "It's important we consider cancer to be lots of different diseases," he said.

That's putting it lightly. Cancer, simply an umbrella term, encompasses a constellation of more than 100 diseases, or tumor types. Each tumor is its own unique, diabolical snowflake. Its behavior depends on the cells where it originated, its aggressiveness, how far it's spread, and sundry other factors.

Kootenai Cancer Center Oncologist Karie-Lynn Kelly compares cancer to the variety of existing infections. The term "infection" includes the flu, a cold and the deadly Ebola virus, she pointed out.

Some are easy to eradicate, with correct treatment. Some are fatal.

"It is a similar story with cancer," Kelly said. "The risk factors for each of these tumors is different, the biology is different, the treatments are different and the prognosis is different."

So finding a cure for them all? Unlikely. But medicine has developed methods akin to a cure, Johnson said, pointing to "great strides in prevention."

Colon and rectal cancers can easily be avoided, he said, by removal of pre-cancerous tissue during screening. And there's now a vaccination for the human papillomavirus that causes about 90 percent of all cervical cancers.

"Almost all cancers of the cervix can be prevented," Johnson said.

Claims like Sousley's, encouraging nutrition and exercise, are valid in staving off cancer and extending the life of cancer patients, Johnson added.

"A third of cancer deaths are related to obesity, physical inactivity and poor nutrition," he pointed out. "Those could be prevented."

Early screening very nearly guarantees a life saved, too, Johnson said. The earlier a cancer is found, the higher the chance of survival.

The 5-year colorectal cancer survival rate, for instance, is 85 percent if the cancer is discovered at a localized stage, versus 10 percent if found at an advanced stage.

"By not smoking, having good health habits, and proper cancer screening, we could expect that about half of all new cancer cases could be prevented," Johnson said.

Great Expectations

On the other side of diagnosis, some hail treatment to be as close to a cure as we can expect.

Kelly, a radiology oncologist, said roughly 60 to 65 percent of radiation treatment at KCC is administered "with intent of curing the cancer."

The success is different per type of cancer, and per stage, she said. But if five years of follow-up scans don't reveal the tumor's return, doctors apply the word "cured."

"That's not to say it can't come back," Kelly said. "I have seen tumor recurrence after 20 years. But the chances of it coming back are less."

Some cancers, like testicular cancer and early stage lymphomas, are essentially curable, she said. Others, like pancreatic cancer and glioblastoma multiforme, an aggressive brain cancer, persist with high mortality rates "no matter what treatments we use."

She said Burzynski's targeted antineoplaston therapy in fact looks promising for future treatment of rare brain tumors, but clinical trial results on his method won't be available for several years.

An irrevocable solution for all cancers is a long shot, Kelly said.

"There's not just one blanket cure for all cancer," Kelly said. "Stage one breast cancer is so different from lung cancer, which is so different from low-risk prostate cancer. Such different diseases, each needs the most appropriate treatment."

A cancer cure is possible but would require a daunting breadth of research, acknowledged Jeanne Atha, KCC director.

"Based on time intensity, clinical trials to get us to that point, we may not see that," Atha said.

So is it all for nothing, the races and volleyball tournaments and car washes for the cure? Are we all giddily throwing money at a mirage?

"I would never take that perspective," Atha said. "If we could find a cure for one type of cancer, it would all be worthwhile."

Cracking It

A multitude of organizations are on it, toiling to crack individual cancers' riddles by supplying a jet stream of research funding.

But even the finely humming machine of fundraising can't provide a miracle.

Pancreatic cancer has a long way to go just in finding early diagnostic tools, let alone a cure, said Faith See, spokeswoman for the Pancreatic Center Action Network. Although pancreatic cancer is the fourth leading cause of cancer death, she said, research has lagged.

"The pancreatic cancer survival rate has not changed in the past 40 years," See said. "The sad truth is, there are few survivors to advocate for more research funding."

The group is trying to change that. PCAN has provided $13 million in research grants since the grant program's inception in 2003. The Inland Northwest Chapter has raised $80,000.

So far, the group's funded research has led to discoveries like the first genetic mouse model of pancreatic cancer, which mimics the human disease and opens more doors to lab research. A vaccine that stimulates the immune system to attack cancer cells is also being investigated.

Of course an overall cure is ideal, See said, but the group's prerogative for now is to double the cancer's 6 percent survival rate.

"We chose to focus on the survival rate. Ultimately, it leads to all other goals we have," See said.

Breast Cancer Cure

The Susan G. Komen for the Cure mission is stated with ironclad resolve on its website, committing to "ending breast cancer forever" by "empowering people" and "energizing science."

But eradicating the disease that impacts one in eight women is complicated, said Jennifer Poole, Boise affiliate mission manager.

For starters, there are myriad kinds of breast cancers, Poole pointed out.

Sniffing out a cure for each requires exhaustive study of so many factors - causes, early detection, the patterns of metastases, genetic mutations, hormones, and much more.

"It's a difficult thing to say for sure," Poole said of how close they are to achieving the overarching goal.

The nonprofit's list of granted research projects for 2012 looks like a phone book. It includes projects that cover: Mammary stem cells factoring into recurrence, mutated breast cancer genes, tailoring radiation to tumors, combination therapies for HER2-positive breast cancer, the role of RNA in promoting breast cancer associated genome instability.

"There are so many areas," Poole said.

A cure, she admitted, is "like finding a needle in a haystack."

American Cancer Society

The American Cancer Society's research hasn't been lazy, either. Over the past 60 years, 46 of the organization's funded researchers have snagged a Nobel Prize.

The organization's nationwide cancer research encompasses biology, cause, treatment, prevention, early detection, survivorship, scientific model systems.

Current research projects on the ACS website boast a dizzying range. They cover subjects like microparticle-based cancer vaccines, single molecule studies of breast cancer mutations, and chemotherapy-induced premature menopause in Latina women with breast cancer.

Spokesperson Alissa Kensok dubbed research progress so far as "nothing short of remarkable."

She listed benchmarks like establishing mammography for breast cancer detection, discovering the Herceptin and Tamoxifen cancer treatments, and pinpointing genes that cause breast cancer.

And a cure? Is it just around the bend?

"How far they've come, I don't know," Kensok said. "I think it's absolutely a possibility, but that's just me saying that, it's not me saying for sure that's going to happen."

Current Research

Cheryl Jorcyk, associate professor in the Department of Biological Sciences at Boise State University, is optimistic about her breast cancer research funded by the Susan G. Komen Foundation and the American Cancer Society.

With a lab team and collaborator, Jorcyk is investigating how a particular protein contributes to breast cancer's metastasis to bone. Injecting mice with tumor cells that lacked the specific protein were successful, she said, effectively inhibiting the tumors from spreading to bone.

"What we hope to do is develop a new treatment," Jorcyk said. "It would be used for certain women with breast cancer, to prevent it from metastasizing to bone."

Her research has a tangible goal in sight, possibly as soon as a few years.

But finding a cure for all breast cancers?

That's "not really anything we're on the edge of doing," Jorcyk said.

She, too, pointed to how each cancer kind is "a collection of a lot of different things gone wrong," making one overall cure an impossibility.

That's why current research is focused on treating individual cancers, she said.

"I'm not sure in our lifetime we'll get to the point that we can say people are cured," Jorcyk said. "But we're to the point that everybody is treated successfully."

Still No Guarantee

Poole herself went through treatment similar to Perry's.

Facing a different form of breast cancer, HER2, Poole underwent surgeries, chemotherapy, five years of hormone suppression.

Six years later, past the golden 5-year benchmark, the cancer is still gone. Poole feels generally well, though the treatment delivered her into menopause in her 30s.

She has more time with her four children. She is giving back by working with the Susan G. Komen Foundation.

Poole still knows she hasn't necessarily been cured.

"You'll always have that in the back of your mind, when you have an ache that goes on too long," she said. "It never completely goes away."

But like Perry, she holds onto optimism. Even if the treatment was agony, even if there's no guarantee it defeated the disease, at least she can say it's worked so far.

"It's a slow process, but you know what? It's better than the alternative," Poole said. "I'll take aches and pains over not being here."

In this series

- Today kicks off a four-part, comprehensive cancer series.

The stories, to be published one at a time over the next few days, will examine cancer's burdens and causes, available treatment and progress in finding a cure.

Here is what you can expect to learn about in the ensuing articles:

- Today's story:

Analyzes how close we are to curing cancer. Includes health care professionals' opinions of whether a cure is possible, as well as analysis of current research efforts.

- Monday:

A breakdown of cancer-related costs, including screening and treatment. Includes medical professionals' explanation of why cancer is so expensive, and individual accounts of the financial burdens cancer creates.

- Tuesday:

Analysis of current treatment available for cancer, and how methods are chosen and used. Includes health care experts' comparisons of complimentary and conventional treatments.

- Wednesday:

Breakdown of cancer causes and screening guidelines.