Can a Cancer Moonshot End Cancer as We Know It?
(Image courtesy of Christopher Dilts' Flikr page - Creative Commons License)
February 1, 2016. Today Vice-president Joe Biden will convene a task force to begin his “cancer moonshot.” He has described the project as a “first-of-its-kind federal task force to carry out our call for a moonshot to end cancer as we know it.” He says the task force is “charged with a simple mission"Š—"Šmaking sure we’re all working from the same playbook.”
Putting a man on the moon seems simple compared to ending cancer. Cancer is not a single disease. Cancers share a common characteristic: unregulated cell growth. However, that cell growth is triggered by different factors and each type responds to different treatments, if it responds at all.
There are at least ten different types of breast cancer. Drugs that have worked well against the most common types have proved useless for other kinds like triple negative tumors or inflammatory breast cancer. People who have been active in the breast cancer community have seen drugs that looked promising in the first stages of research prove no better or even worse than the standard of care in the next phase of testing. We have learned to be skeptical about great results in mice or petri dishes.
Still advances have come, if gradually. When I was young, children with leukemia died. The only question was how much time did they have, enduring painful treatments before they left their grieving families. Today 85 percent of children with the most common type of childhood leukemia live.
People with inflammatory breast cancer used to be sent home to die, usually within about eighteen months. Then researchers learned that a three-pronged approach of chemotherapy, surgery, and radiation could dramatically improve survival rates to almost half of patients. Yet it cannot be said that childhood leukemia or inflammatory breast cancer have been ended.
Will the cancer moonshot be just one more tangle of government bureaucracy? If anyone has the skills to get this project off the ground, Biden does. He knows cancer first hand, and he knows Washington. The task force aims to work from areas of consensus among cancer researchers, speeding up the breakthroughs in new approaches like immunology and genomics while breaking down the walls that keep scientists from accessing each others’ data. Other goals are increasing participation in clinical trials and reducing treatment costs.
The idea of getting scientists from different disciplines talking to each other has been part of the National Breast Cancer Coalition’s 2020 Deadline Project. The moonshot expands this concept to all types of cancer and adds the weight of a federally funded project.
These are great goals which will make a difference in cancer survival rates and perhaps even in preventing some types of cancer. However, cancer is a wily beast that often learns how to overcome treatments that threaten it, so I don’t expect to see the end of cancer in my lifetime. But we have to keep trying, and the “cancer moonshot” is a good way to mobilize scientists for our best effort.
I’ve been reading what cancer researchers think about the project. Margaret Foti, CEO of the American Association for Cancer Research seems to speak for many when she said after President Obama announced the moonshot in his State of the Union address, “There are 14.5 million cancer survivors who are alive today because of cancer research, and tonight’s announcement has the potential to dramatically increase this number.”
Not every scientist will be on board with some aspects of sharing data. Pharmaceutical companies use their research to produce drugs for a profit. Scientists in academic institutions keep their jobs by publishing original research. Ethical considerations and patient privacy policies may make it harder for certain types of information to be shared. It will take all of Biden’s political acumen to get everyone on board in a meaningful way. Congress will need to increase funding. Some laws designed to protect drug company profits will need changing if patients are to be able to afford breakthroughs in treatments.
As I write this, three notes sit on my desk to be mailed later today. One is to a woman who has just learned she has ovarian cancer. Another is to a young woman in the hospital for serious complications from her treatments for lymphoma—complications that she has been fighting for over a year since her bone marrow transplant. I don’t know if the note to my third friend will reach her while she is still alive and conscious to hear her sister read it to her. She has managed to keep going for several years despite metastatic inflammatory breast cancer, but she is near the end of her life on earth.
I want more than notes. I want real change.
For Further Reading
Biden, J. The Cancer Moonshot Task Force: Removing Bureaucratic Hurdles and Supporting Scientific Advances January 28, 2016. Accessed from https://medium.com/@VPOTUS/the-cancer-moonshot-task-force-removing-bureaucratic-hurdles-and-supporting-scientific-advances-65e66fafa3f0#.s3n1i65wh February 1, 2016.