More than 40 years after the war on cancer was declared, we have spent billions fighting the good fight. The National Cancer Institute has spent some $90 billion on research and treatment during that time. Some 260 nonprofit organizations in the United States have dedicated themselves to cancer—more than the number established for heart disease, AIDS, Alzheimer’s disease, and stroke combined. Together, these 260 organizations have budgets that top $2.2 billion.

As a result, we know much more about the disease than we once did, but we are not much closer to curing it. From 1975 to 2007, breast cancer rates increased by one third and prostate cancer rates soared by 50 percent. Widespread screening played a significant role in detecting these cases, making direct comparisons difficult. Still we clearly have a problem. Almost 1.6 million people were diagnosed with cancer in 2011. Meanwhile, the rates of certain cancers are rising. An upward trend is especially apparent in kidney, liver, and thyroid cancer and in melanoma and lymphoma. The steady increase in the incidence of childhood leukemia and brain cancer since the mid-1970s is a particularly alarming trend. When have Americans ever waged such a long, drawn-out, and costly war, with no end in sight?…

Simply put, we have not adequately channeled our scientific know-how, funding, and energy into a full exploration of the one path certain to save lives: prevention. That it should become the ultimate goal of cancer research has been recognized since the war on cancer began. When I look at NCI’s budget request for fiscal year 2012, I’m deeply disappointed, though past experience tells me I shouldn’t be surprised. It is business as usual at the nation’s foremost cancer research establishment. More than $2 billion is requested for basic research into the mechanism and causes of cancer. Another $1.3 billion is requested for treatment. And cancer prevention and control? It gets $232 million altogether. (Remarkably, in the very same budget report, the NCI states, “Much of the progress against cancer in recent decades has stemmed from successes in the areas of prevention and control.”)