For the cancer patient, the effort has paid off in new facilities, new medical equipment and sophisticated treatment. To a great degree, the hurdles described by Dr. del Regato - geography, organization, skill and the rest - are down. Worldwide, 680 research and treatment institutions in 82 countries serve the potential or actual cancer victim. In the United States, more than 90 per cent of the population lives within 200 miles of one of the institutions described by the National Cancer Institute as cancer centers, which offer the most up-to-date cancer treatment and also carry on research into new methods of treatment. And in any hospital specializing in cancer care, a patient can expect certain standardized, effective models of diagnosis and treatment.

The rigor and thoroughness of these models can be seen in the sequence of steps, called a protocol, in the treatment of cancer of the colon or lower intestine. To begin with, a doctor takes a look at the interior of the colon, using an instrument called a sigmoidoscope or colonoscope. If he finds a tumorous growth, he calls upon specialists to perform a biopsy - to remove a piece of it for laboratory analysis to determine whether it is benign or malignant. Usually, he will want the growth cut out in either case.

If the growth is a polyp, or small tumor and is located near the rectum, the doctor himself may remove it. To treat a growth further up the colon, he will call in a surgeon, who also proceeds according to the steps of a protocol. The surgeon generally removes a benign tumor by simply cutting it away at its base; when operating on a malignant tumor, he removes a portion of the colon above and below the growth as well. If the portion is relatively small, the severed ends of the colon are sewed together; if it is large, an opening is made in the wall of the abdomen to let the patient pass bowel movements into a plastic pouch. Finally, to complete the protocol, surgery is generally followed by chemotherapy or by a combination of radiation therapy and chemotherapy.

Such treatments are the work of skilled scientists and craftsmen - the professional soldiers in the war against cancer. The ranks of such professionals range from the field marshals who direct the national and international campaigns, down to the foot soldiers who run tests in laboratories. By comparison, the potential cancer victim is a civilian, who may seem helpless while the battle rages. But this civilian can prevent the battle by simply avoiding the disease. A handful of common cancer-causing agents is responsible for most of the cancer in the world. Armed with knowledge and prudence, the civilians in the cancer war have it in their power to deny cancer most of its chances to attack.

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The cancer fighter generally deploys more than one kind of weapon; a combination suited to specific cancers and patients is more effective.  Surgery or radiation of an original tumor may be backed up by chemotherapy to eliminate metastases, and as many as 10 drugs maybe used in combination or succession to kill every last malignant cell. Or any of the three therapies may begin a course of treatment to reduce the size of a large tumor, with the others coming in as needed.

Each of the three brings its own risks and costs. Surgery is never completely safe, and cancer surgery can be disfiguring. Radiation and chemotherapy can be hazardous even when closely monitored and both have side effects ranging from mild discomfort to outright illness. But for many patients the very harshness of cancer treatments comes as a challenge to fight the disease through. Ruth Cullen - a victim of Hodgkin's disease - noticed that her first dose of anticancer drugs came in a syringe labeled 'poison'. "It was a turning point", she recalled. "It marked a real loss of innocence. Up until then, i hadn't admitted that there was anything wrong inside. Putting that stuff in there made it very real to  me that there was something inside my body that was trying to kill me". Two years later, after a grueling course of radiation and chemotherapy, not a trace of her disease could be found - and she felt , she said, "like one of a charmed circle".

To enter that circle, a cancer patient must get the right treatment, in the right amount, at the right time. Not all do. Dr.Juan del Regato of the University of South Florida, in a comprehensive textbook on cancer treatment, wryly described various hurdles  on the path to the best possible treatment. They include, he wrote, "wishful thinking (to which physicians are not immune), geography, luck, misinformation (lay and professional), organization, luck, facilities, skills and a great deal of luck".

The hurdles are real enough, yet almost every cancer victim can leap over all of them - including the hurdle of luck. A worldwide network of laboratories and hospitals, of research scientists and physicians have been established to pursue the search for cancer cures, exchange information on new findings and therapies and make the best professional services available to every patient who needs them.

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Smoking is only one among many avoidable causes of cancer. Alcohol is another; so are certain foods and certain substances added to foods to preserve or flavor them. Over-exposure to the sun's radiation can produce a skin cancer, the penetrating radiation of X-ray can cause cancers deep in the body. Most insidious and diverse of all are the cancer-causing chemicals encountered in factories, mines and almost every other area in which materials are processed or chemically changed. Hardly a month passes in which cancer detectives do not identify a new suspect for this rogues gallery or find a new outbreak of a known criminal.

Substances and forces that cause cancer are called carcinogens. The hunt for them goes on and campaigns to eradicate them are only beginning to have an effect. But if every carcinogen now recognized could be eliminated overnight, the incidence of cancer would be cut in half by the year 2000.

It is in the light of such hard facts that Dr.Vincent De Vita's statement on cancer's curability assumes its full dimensions. Half of all cancers can be prevented; more than half of those that cannot be prevented can be cured. Over the next generation, because of these 2 facts alone, the annual number of cancer deaths in the industrrialized world can be reduced from 183 to 55 per 100,000. The estimate is conservative; further-and almost certain-advances in prevention and cure would improve it. Clearly, the war against cancer is winnable and it is being won.

The war is far from over. Cancer remains a major killer. On many fronts, campaigns against the disease falter or do not move all. Avoiding carcinogens in everyday life means giving up cherished habits; eliminating them from the workplace has heavy economic consequences - lost jobs, lost revenues and increased costs. Early detection and diagnosis, which offer the best chance of curing a cancer, are often neglected or ignored; and some types of cancer still stubbornly resist the best available treatment.

The battles that have been won in the desperate war on cancer are almost entirely victories of recent years. Until the end of the 19th century, the disease was indeed essentially incurable; some superficial cancers could be removed by surgery, but nothing more. At the turn of the 20th the range of therapy broadened to include X-ray treatments, which can burn away both surface and deep cancers; the nature and causes of the disease, however were still matters of speculation. Then with the explosive growth of medical knowledge following World War II, scientist and physicians acquired four major resources in their unending battle, all new and all further strengthened with each passing year. They know how to prevent most cancers. they have superb diagnostic tools to catch it early, often long before any ordinary symptoms of illness appear. They have an arsenal of marvelously effective weapons against it; treatments by surgery, radiation and drugs that far surpass anything the world has ever known. And perhaps most important, they know what cancer is.

To enrich our knowledge about cancer, these are quality books to read :

The Biology of Cancer by Robert A.Weinberg

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