At 66 years old, Vincent Motyl has the gravelly voice and rumbling laugh of a man who's spent much of his life in a halo of cigarette smoke. He grew up amid the industrial soot of Pittsburgh in a houseful of smokers and started a two-pack-a-day habit at 18.
Motyl's father died of lung cancer 22 years ago, at 86; but the old man's longevity doesn't comfort the Culver City mortgage banker, who says he's tried to quit "30, maybe 40 times." He's down to about half a pack a day now. "But of course I think of lung cancer," he says.
So Motyl didn't hesitate to enroll when UCLA's Jonsson Comprehensive Cancer Center launched a clinical trial to test whether medication -- in this case, the arthritis drug celecoxib (also known as Celebrex) -- might reduce the odds of developing lung cancer in a smoker or ex-smoker. He didn't ask what the medication was, and he didn't worry about side effects.
It just made sense, Motyl thought: If a daily pill could prevent cancer, who would not take it?
It is a simple and compelling idea: If some chemical agent -- a common nutrient or a medication already in wide use, for instance -- could block, disrupt or reverse the processes that lead to runaway cell growth, then cancer might never need to be cured. It could be prevented.
If only, say experts in the field, the quest for cancer-preventing drugs were as simple as it sounds, or as readily embraced by physicians and patient advocates as it is by patients like Vincent Motyl. But the effort is an uphill struggle, for several reasons.
Focus and funding are two. Compared with the effort to find drugs to cure and treat cancer, the search for preventive medicine "has been the stepchild" of cancer research, motivating just a small corner of the cancer research community, says Dr. Victor Vogel, a researcher and breast cancer oncologist at the Magee-Womens Hospital/University of Pittsburgh Cancer Institute. "It's not sexy, it's not fancy, and for the pharmaceutical companies, it may not always be very profitable."
Vast stores of money, brainpower and hope have brought forth drugs capable of extending cancer patients' survival by months and sometimes years, say prevention researchers such as Vogel. Meanwhile, drugs shown to have driven down cancer rates in high-risk populations -- ones that have been shown, in studies, to spare people from the ordeal of becoming cancer patients in the first place -- have been mired in debates over side effects.
