title: "No patient left behind": an alternative to "the War on Cancer" metaphor.
abstract: The War on Cancer began with President Nixon's National Cancer Act of 1971. Treatment-related 'collateral damage' to healthy cells and tissues that reduces quality of life is an unfortunate but inevitable consequence of the overriding imperative to "win the war." In the face of a quality of life decrement, patients are encouraged with militaristic turns-of-phrases to "soldier on," "fight it," and "never say die." Rather than this dysfunctional imagery, which relegates patients to the status of mere cogs in the ever-grinding wheel of the clinical war machine and encourages the practice of disease-centered medicine, we propose an alternate analogy/organizing principle borrowed from the realm of education: No patient left behind.
authors.affiliation: EpicentRx, Inc., 800 W El Camino Real, Suite 180, Mountain View, CA, 94040, USA. boronsky@epicentrx.com.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Oronsky
authors.affiliation: Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD, 20889, USA.
authors.forename: Corey A
authors.initials: CA
authors.lastname: Carter
authors.affiliation: InterWest Partners, 2710 Sand Hill Rd #200, Menlo Park, CA, 94025, USA.
authors.forename: Arnold L
authors.initials: AL
authors.lastname: Oronsky
authors.affiliation: University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Salacz
authors.affiliation: University of California San Diego (UCSD), Moores Cancer Center, 3855 Health Sciences Dr, La Jolla, CA, 92093, USA.
authors.forename: Tony
authors.initials: T
authors.lastname: Reid
mesh_terms: D006801:Humans; D007883:Legislation, Medical; D008495:Medical Oncology / Q000331:legislation & jurisprudence*; D019365:Metaphor; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D012109:Research Support as Topic / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Chemotherapy; Maximally tolerated dose; No patient left behind; Resistance; Toxicity; War on Cancer