Progress against cancer

This brief and highly selective overview glimpses a few of the conceptual and practical advances in molecular medicine that are changing our understanding of disease pathogenesis. By so doing, these discoveries are continuing to open new clinical avenues that, with continued refinement, promise to move us closer to the goal of eradication of death and suffering from cancer. The long-standing collaborations between Japan and the United States in the many disciplines of cancer research continue to be critical to the attainment of this goal. And yet, with this knowledge, we also face new challenges-perhaps the most ironic is emerging from the stunning technological advances that hold the realistic promise of being able to pinpoint individual cancer risk with astonishing precision and accuracy. Ultimately, the fulfillment of this promise will be the successful modification of that risk through rationally designed interventions. At the present time, however, our abilities to identify accurately and, what is more important, to modify such cancer risk for the majority of malignancies are just beginning to unfold. In some cases we will identify risk without being able to offer satisfactory interventions. And so we are in the unenviable position now of having molecular knowledge which may not confer a clinical benefit. However, as we steadily accrue more knowledge, we will have the opportunity to change the natural history of many cancers from being destructive and fatal to being treatable, preventable and, perhaps in some cases, completely curable.