Cancer Moonshot: Shared Hope, Yet Still Not Enough Cooperation

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President Nixon announced the war on cancer in 1971, in which we as a society are still slogging through, this immense battlefield. Vice President Biden, who ends his term in January, says one of his regrets is that he wouldn’t have been the commander-in-chief to preside over the “end of cancer, as we know it.”

He knows the heartbreak that cancer could cause, with the loss of his eldest son, Beau, who died at age 46 in 2015.

Of the VP’s vision to end cancer, he noted, “I said it, because I believe it’s possible.”

Is it?

There’s much to be happy about the progress we’ve made, as Biden said delivering the Cancer Moonshot task force report, a strategic plan to transform cancer research and care, to President Obama, since its work began in January.

Some of the areas of innovation and hope are wrapped around coordination and cooperation, the possibility  for penultimate team approaches.

There is still much to be concerned about, however: because there is still not enough coordination and cooperation, holes significant enough to stymie progress. Moreover, there may be questions ahead about research funding, because without the money, no matter how big the dreams, research will only go so far.

There is a $1 billion plan, but there are questions now with the GOP- led Congress and an incoming Donald J. Trump administration, and  how much money will actually be pumped into research, in which the new president-elect has not tipped his hand, or has shown conflicted interest.

Sharing Information

Let’s start with the question of sharing information to get us moving along the best path of the Cancer Moonshot. In science and elsewhere, it’s not easy. Biden notes there has been much progress, but there are still outstanding issues to be resolved.

The existing obstacles cited by Biden, in the words of the report:

  • Rapidly and effectively poor retention and recruitment in cancer clinical research trials
  • An antiquated culture of research and funding
  • Failure of sharing of medical records
  • Insufficient collaboration, (and) slow dissemination of cancer center knowledge.

What Biden Sees Ahead

Biden said he was convinced that the obstacles are not insurmountable.

The vice president didn’t want to dwell on the pitfalls. He noted the tremendous progress that has been made in bringing together some teams in research. Inevitably, the idea is to have more people understand the impact of the data and help them control their own healthcare.

Five years ago, oncologists weren’t routinely working closely with immunologists, virologists, genetics, chemical engineers and others – now they are, Biden said.

It’s different today. There are at least 70 commitments of partnerships, public and private, under Cancer Moonshot. Among them: the National Cancer Institute, Amazon Web Services and Microsoft are announcing a collaboration to build a sustainable model for maintaining cancer genomic data in the cloud. In addition, the Department of Defense  is establishing a groundbreaking new study to transform an  understanding of the biological basis of cancer. The administration says researchers will have at their fingertips potentially 250,000 samples to uncover new connections between the earliest signs of cancer.

The Money Issue

What’s ahead next year is uncertain as the GOP swept the House and Senate as well as the White House. Some analysts believe that Trump isn’t inclined to be a large booster of research programs in science, but the verdict as of yet is pretty unclear.r

Some analysts believe that President-elect Trump is not inclined to be a large booster of research programs in science, while others do not. It’s a mixed forecast, according to the Verge.  The media outlet noted that Trump had told a conservative radio host the NIH was “terrible” but told  Scientific American “we must make the commitment to invest in science, engineering, healthcare and other areas that will make the lives of Americans better, safer and more prosperous.”

When the Obama administration launched the National Cancer Moonshot program, officials described it as a $1 billion initiative to provide funding for researchers to speed up development of new cancer detection and treatments the White House said. The initiative would begin immediately with $195 million slated for new cancer initiatives at the National Institutes of Health (NIH) in fiscal year 2016.

Recently, the American Association for Cancer Research has asked Congress in its “lame duck” session to support a $2 billion increase for the National Institutes of Health in a fiscal year 2017 appropriations bill. That includes $216 million for the National Cancer Institute.

The AACR  calls for “alternative funding stream for targeted multi-year initiatives” such as the National Cancer Moonshot Initiatives, and other programs.

Nearly everyone involved, as one official told me, “has their fingers crossed.”

“The mission of this Cancer Moonshot is not to start another war on cancer, but to win the one President Nixon declared in 1971,” Biden said.

To do so, the battles must be consistently – and cooperatively – fought.

 

 

Progress Against Tobacco Use. Yes. But…36 Million Smokers…Still

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Lots of people are quitting cigarette smoking, current federal data  released  yesterday show, but there is a lot more to do to crash that fogged-up window of nasty tobacco use, with an uneven effort seen in too many states to enact tobacco prevention or control programs. Indeed, there are still 36 million smokers in this country, according to the Centers for Disease Control and Prevention.

“Sadly, nearly half (of the people) could die prematurely from tobacco-related illnesses, including 6 million from cancer, unless we implement the programs that will help smokers quit,” said CDC Director Tom Frieden in a statement.

Forty percent of cancers diagnosed in the U.S. may have a link to tobacco use, according to the CDC’s Vital Signs report.

Tobacco use is the leading preventable cause of cancer and cancer deaths. Each year, between 2009 and 2013, about 660,000 people in the U.S. were diagnosed with, and about 343,000 people died, from a type of cancer-related to tobacco use, according to the  CDC. Three in 10 cancer deaths are linked to cigarette smoking, but since 1990 about 1.3 million tobacco-related cancer deaths have been avoided, the agency said.

“When states invest in comprehensive cancer control programs – including tobacco control – we see greater benefits for everyone and fewer deaths from tobacco-related cancers,” said Lisa C. Richardson, director of CDC’s division of cancer prevention and control.

“We have made progress, but our work is not done,” Richardson said.

There has been progress indeed. Cigarette smoking among U.S. adults declined from 29.0 % (45.1 million) in 2005 to 15.1% (36.5 million) in 2015.

During 2014-2015 alone, there was a 1.7 percentage point decline, resulting in the lowest prevalence of adult cigarette smoking since the CDC’s National Health Interview Survey began collecting data in 1965.

The CDC has touted “comprehensive cancer control programs” that the agency says “focuses on reducing cancer risk, detecting cancer early and improving cancer treatments.” That helps more people survive cancer, or improve survivors’ quality of life.

But “not all states or all people have experienced the benefits of these efforts,” the CDC says, noting: “tobacco prevention and control resources, along with access to medical care and cancer treatment, vary widely across the U.S.”

The incidence and death rates were highest:

  • Among African-Americans compared with other races or ethnicities
  • People who live in counties with a low proportion of college graduates
  • People who live in counties with high poverty levels.

Tobacco use was highest in the Northeast (202 per 100,000 people) and lowest in the West, (17 per 100,000 people). Tobacco-related  cancers were higher among men (250 per 100,000 people) =then women (148 per 100,000 people).

It’s time for states, counties and local communities to help our neighbors stop smoking. Smokers can get free help by calling 1-800-QUIT-NOW. You can also get additional  resources from the CDC on the internet.