'Cancer is almost impossible to conquer'
/ Korea Times photo by Jung Min-ho
Treatment evolves, but so do cancer cells, says a renowned doctor
By Jung Min-ho, Kim Eil-chul
Billions of dollars have been spent on cancer research every year since former U.S. President Richard Nixon declared war on the disease in 1971. Yet the disease remains a leading cause of death worldwide.
Many people are still hopeful that disease will be conquered someday, including U.S. President Barack Obama, who encouraged scientists to continue working toward a cure during his final State of the Union in January. But Kim Eui-shin, one of the world’s most renowned cancer experts, is not one of them. He is certain that there will be no cure for cancer.
“New technologies often create the illusion that cancer may be conquered someday. But no. I don’t believe this will happen,” said the former tenured professor at the University of Texas at M.D. Anderson Cancer Center. “What I have realized over the past 50 years of my career is that there are so many things scientists can’t do about treating the disease.”
What makes cancer treatment difficult is the fact that cancer cells continue to evolve. “Every time genetic mutations occur in cancer cells, the patient needs a new drug to treat them. In other words, no drug remains effective in the long run,” he said.
Thus, even though many patients have their cancer cells removed, the cancer returns a few months later in a trickier form. “New drugs work only temporarily and lead to cancer cells becoming more resistant,” he said.
Two other main cancer treatments ― surgical resection and radiation therapy ― are ineffective and dangerous if the cancer cells are already widely spread. Also, since cancer is a genetic disease that can affect any part of body, chemotherapy is needed to fundamentally treat it, he noted.
The U.S. government alone has spent more than $100 billion on cancer research since its war on cancer began. Yet the overall death rate from cancer has not appreciably decreased. The battle is increasingly being regarded as a failure.
According to the U.S. Centers for Disease Control and Prevention, the overall cancer death rate for Americans fell by 1.5 percent per year from 2003 to 2012. But, many cancer experts believe that the reduced mortality is largely attributable to reductions of tobacco use, not to medical breakthroughs.
Cancer is still responsible for a quarter of all deaths in the United States, just like in many other countries, according to the World Health Organization. Despite the significant progress in certain cancers, such as childhood leukemia, the big picture remains unchanged.
“If you look at the age distribution of cancer, most patients are in their 60s, 70s and 80s. This also makes treatment difficult because aging issues are also involved,” Kim said. “So the line between fighting against cancer and fighting against death often becomes blurry.”
“After all, we are all going to die. This never changes.”
Better but underrated treatment methods
Despite his strong belief that it is impossible to conquer cancer, Kim reckons there are better but underrated ― or intentionally overlooked ― ways to fight the disease.
“One of the biggest problems in cancer treatment is that we cannot tell whether certain drugs will work for a certain patient,” he said, “Everyone has a different genetic makeup, which influences their response to the treatment. Without knowing the best combination of drugs for each patient, doctors have to choose drugs based on their experience and hope that their guess was right.”
The cost of selecting wrong drugs is enormous, not only financially but also in terms of excruciating pain the patients have to experience for nothing, he noted.
To solve these problems, Kim came up with the idea of using radiolabeled antibodies in 1976. “Simply put, radioimmunodetection, which I coined, enables doctors to see whether certain drugs work in the body of a patient via images so that they can decide whether to continue to use the same drugs,” he said.
“It is important to understand that stopping ineffective anti-cancer drugs as early as possible is critical because they destroy both cancerous and healthy cells. This is why there is a limit to the number of drugs that can be used for one patient.”
About 10 years ago, many of his assumptions about the method were proved correct through animal testing, and the method was granted a patent in the United States. “But it could not pass through the Food and Drug Administration (FDA). The opposition from pharmaceutical companies was very fierce,” he said.
So he tried to test the method in Korea, but the nation’s Ministry of Food and Drug Safety has not been cooperative. “I think one for the reasons of the ministry’s skepticism comes from its officials’ overreliance on FDA records in determining what is eligible for approval, and this problematic process makes people question the necessity of the ministry’s existence,” he said.
Also, he said, Korean doctors’ large ignorance of oriental medicine, which is practiced mainly in China and Korea, hinders cancer research in the country.
“Most medicines were herbal remedies not long ago,” Kim, who has also been an eminent scholar at Kyung Hee University since 2012, said. “We should not forget that aspirin, morphine and taxol are made from plants or are based on plant molecules.” Last year, Tu Youyou became the first Chinese to win the Nobel Prize in Physiology or Medicine for discovering artemisinin, the latest malaria treatment, drawing global attention to oriental medicine.
“With help from Korean doctors, experts in oriental medicine here can also better establish a scientific base of their knowledge. The two sides may be missing opportunities for medical breakthroughs by refusing to work together. It’s time for them to find ways to cooperate,” he said. “Do you know that there is a department at M.D. Anderson Cancer Center dedicated to studying oriental medicine with about 50 researchers? Many of the major hospitals in the United States have their own such team.”
His frustration partly comes from the ministry’s refusal to approve the Phase 2 clinical trial of SB Injection, which contains Pulsatilla saponin D, an element from the root of Pulsatilla koreana. For years, he has been trying to convince the ministry to test the element, which he believes could be a revolutionary anti-cancer medicine.
“It was reported that hundreds of end-stage cancer patients, not just one or two, recovered after getting SB Injection,” he said. “Honestly, I think the biggest reason for the ministry’s rejection is its prejudice against anything related to oriental medicine.”
Two most important life lessons
Kim was born in 1941 in a small village of Gunsan, North Jeolla Province, when Korea was still under Japanese rule. Everyone was poor at that time, and his parents were no exception.
“From my parents, I learned the two most important life lessons: with the love of God, there is nothing I can’t do, and, for me to have a happy, fulfilling life, I should live for others rather than for myself. That is what my parents always told me,” Kim said.
He was an optimistic, curious boy, who liked to try new things. “And one day, I saw American pilots from a U.S. Air Force base in my town. I still remember how much I was fascinated by how they looked, and they were very kind to me,” he said.
It also was a great opportunity for him to learn English, which later gave him an opportunity to serve as a tropical diseases researcher for his mandatory military duty during the Vietnam War.
“While working with American researchers in Vietnam, I realized that my medical knowledge was far behind theirs. I met a researcher from Johns Hopkins University there. We became close and he invited me to his school,” he said. “So after getting my master’s degree in preventive medicine from Seoul National University College of Medicine in 1966, I moved to the school.”
From there, he studied various medical fields, including nuclear medicine, radiology and immunology at some of the nation’s best medical schools before settling down in M.D. Anderson Cancer Center in Houston in 1980. He worked there as a researcher and professor for 31 years.
“My life has been nothing but blessings from God,” Kim said. “Of course, I worked hard and kept trying to improve myself. But looking back, I didn’t plan any of the important things in my life. They somehow happened, and I just happened to be there.”