The Reuters feature on lung cancer (October 11) is a good example of medical journalism of no practical value to the public.

Pathologists have known for at least 50 years that cancers evolve in a multi-step fashion from innocent changes (pre-cancerous) to an established primary cancerous focus and then possibly acquire the ability to spread to other parts of the body, which is why many cancers (not all) kill. This multi-step process may take many years.

In more recent years we learnt that the multi-step pre-cancer/cancer progression observed by pathologists is accompanied by genetic changes within the abnormal cells, that is, their genetic information (similar to a computer programme) is changing and, the more the drastic changes, the more aggressive features of the evolving cancer.

The Reuters feature hinted at development of blood tests capable of identifying the early genetic changes of pre-cancerous changes in the lung, although no surgeon can remove pre-cancerous changes in the lung which cannot be identified on a scan. However, as the article alludes to, future immune-therapeutic drugs might be able to halt or reverse the pre-cancerous changes detected by a blood test. For the time being this remains in the realm of science fiction. What we already know for sure is the huge funding problem facing all public and private health systems – the astronomic prices pharmaceutical companies are charging for these new molecularly-targeted anti-cancer drugs.