Forty-two years ago when President Richard Nixon vowed to make curing cancer a national crusade, many anticipated quick results.

That expectation was raised in part by the PR campaign, complete with ads suggesting we could cure cancer by the bicentennial, that successfully pushed President Nixon to support what came to be called his “War on Cancer.”

Since then, the United States government has spent over 100 billion dollars on research and scientists have learned a great deal about how cancer works. While some drugs do extend life, we’ve also seen numerous new drugs and treatments, like Interferon, bone marrow transplants for breast cancer or Interleukin-2 heralded as “breakthroughs,” only to disappoint or even harm patients over time.

There has been long-term success treating a few types of cancer, including lymphomas and leukemias as well as testicular cancer. Early detection and screening, while controversial for some cancers, has also prevented many deaths from cervical and colorectal cancer. But after all these years, all this money, and all of these drugs, most cancers still kill once they metastacize, and over half a million Americans die from the disease each year. Despite the fact that treatments get the most press coverage, the greatest reductions in cancer mortality rates can be credited to lifestyle changes, like quitting smoking. But as we become more obese, and more sedentary, that progress may prove elusive, too.