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Lewis Thomas, MD, noted in an essay that the present management of cancer—surgery, radiation, and chemotherapy—is representative of a "halfway technology," meaning measures directed at the existence of already-established disease. By comparison, "decisive technology" is an understanding of the ways in which cells become neoplastic.
His essay appeared in 1971 (N Engl J Med 1971; 285:1366-1368), the year Congress passed the National Cancer Act. That legislation raised public expectations that the defeat of cancer was in sight. Thirteen years after Thomas' essay, the attack on cancer is entering that decisive technological stage.
Advances in biomedical technology are making a substantive impact on the cell, normal and abnormal. Likening the cell to the proverbial black box, Vincent T. DeVita, Jr, MD, director of the National Cancer Institute, says: "We could turn it, we could weigh it, we could ponder it, but we could not look inside to really understand it."
Marwick C. Decisive stage foreseen in attack on cancer. JAMA. 1984;252(16):2120–2125. doi:10.1001/jama.1984.03350160008004
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