More Enthusiasm, Please: Preventing, Screening, Treating, Classifying, circa 1960 to 1990

Abstract

By the late 1960s lung cancer had turned into the most common form of cancer worldwide, with a death rate almost as high as the death rate from all other forms of cancer combined.¹ Not only could there be little doubt that smoking was not good for smokers’ health (it said so on cigarette packs from 1967 in the US and from 1971 in the UK). It was also becoming increasingly clear that once diagnosed with lung cancer, patients had very limited hopes of surviving the disease. And it did not look as if this was about to change. In this respect developments for lung cancer were strikingly different especially to childhood cancers, where the outlook for patients had been dire in the 1950s and which were increasingly viewed as curable with new chemotherapy regimes.² Patients diagnosed with lung cancer not well enough for surgery, with tumours in awkward locations or cell types known as so malignant that an operation was going to be futile, ran out of options very quickly. To be sure, lobectomies or pneumonectomies on lung cancer patients still constituted much of the daily work of thoracic surgeons, but this was not the most rewarding work. The low survival rates could be depressing, and as we heard in the previous chapter, surgeons expected little change. Results for radiotherapy or chemotherapy were equally disappointing. But what could be done about this disease?