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"I have great confidence that by the end of the decade we'll know in vast detail how cancer cells arise," says microbiologist Robert Weinberg, an expert on cancer. "But." he cautions, "some people have the idea that once one understands the causes, the cure will rapidly follow. Consider Pasteur. He discovered the causes of many kinds of infections, but it was fifty or sixty years before cures were available."
This year, 50 percent of the 910,000 people who suffer from cancer will survive ai least five years. In the year 2000. the National Cancer Institute estimates, that figure will be 75 percent. For some skin cancers, the five-year survival rate is as high as 90 percent. But other survival statistics are still discouraging-13 percent for lung cancer. and 2 percent for cancer of the pancreas（胰腺）。
With as many as 120 varieties in existence, discovering how cancer works is not easy. The researchers madegreat progress in the early 1970s. when they discovered that oncogenes. which are cancer-causing genes (基因), are inactive in normal cells. Anything from cosmic rays to radiation to diet may activate a dormant oncogene. but how remains unknown. If several oncogenes are driven into action the cell. unable to turn them off. becomes cancerous.
The exact mechanisms involved are still mysterious, but the likelihood that many cancers are initiated ai the level of genes suggests that we will never prevent all cancers. "Changes are a normal pan of the evolutionary process." says oncologist William Hayward. Environmental factors can never be totally eliminated; as Hayward points out, "We can't prepare a medicine against cosmic rays. "
The prospects for cure.though still distant, are brighter.
"First we need io understand how the normal cell controls itself. Second,we have to determine whether there are a limited number of genes in cells which are always responsible for al least pan of the trouble. If we can understand how cancer works. we can counteract its action."
