The cancer moonshot: Here's how we get there

A generation ago we spoke of cancer in hushed tones. We whispered about the suspected "Big C," diagnoses were kept secret, and that was that. 

Our collective will to tackle this killer changed the game: death rates dropped nearly 30 percent in a generation. Today, 16 million Americans are cancer survivors.

It's time to recommit to saving more lives as President Biden has proposed in his plan to reignite the Cancer Moonshot. Here are our recommendations to help reach the goal of reducing the cancer death rate by at least 50 percent over the next 25 years and improving the lives of people living with cancer.

First, one of the best ways to reduce the overall burden of cancer is to improve diagnostics. Many cancers today are detected too late. More than 60percent of cancer diagnoses and deaths are among people with cancers that do not have screening tests — exams such as mammography for breast cancer and colonoscopy for colorectal cancer. For example, for challenging cancers such as those of the pancreas or ovaries, the rate of survival plummets from more than 80% for early-stage tumors to less than 5-10% for late-stage disease. And many of those cancers are not found until they have spread. It is vital to invest in more research and science to advance diagnostics.

Second, as a nation, we have to be sure we have the resources to provide early detection, diagnostic, treatment, and support services. The number of people diagnosed with cancer will increase by 50 percent in the next 20 years, according to the American Cancer Society, due to the aging of the population and multiple other factors. There are already 1,700 people dying from cancer every day in this country, a number that will likely increase. It is estimated that in the future, 1 in 2 men and 1 in 3 women will deal with cancer in their lifetimes. Although the death rate from cancer has already fallen, there will be an increase in the total number of people living with or surviving cancer. Cancer care is also tremendously expensive, with some $16 billion in patient out-of-pocket costs annually in the United States.

Additionally, there needs to be more equity in cancer prevention, detection and treatment. Evidence shows that minority populations and those living in certain areas of the country do not have proper or timely access to innovative therapies or even standard cancer care. Black women are 40 times more likely to die of breast cancer than white women. For African American men, the risk of dying from low-grade prostate cancer is double that of men of other races, according to the National Cancer Institute. We must end these unacceptable gaps in care.

There's no question that the renewed national effort against cancer is very timely. Cancer research is undergoing a true revolution: by some estimates, there are close to 10,000 new oncology drugs in the research pipeline.

We must build on the extraordinary progress in the 50 years since the National Cancer Act was passed in 1971, declaring the "War on Cancer." For example, we now understand how one tumor can differ at the molecular level from another and behave differently rather than thinking about cancer exclusively as a tumor that develops in a particular organ. This insight has resulted in the development of highly targeted therapies.

Researchers have also vastly expanded our knowledge of the interplay between the immune system and cancer. Some tumors have the ability to manipulate certain proteins that put the brakes on the immune response, enabling cancer cells to travel throughout the body while evading detection from the immune system. Several types of immunotherapies are now approved by the FDA and are extending patients' lives.

Similarly for blood cancers, we have created a treatment called CAR T-cell therapy, one of the biggest breakthroughs in a generation. It trains a patient's white blood cells called T cells to recognize a protein on their cancer cells, multiply these empowered T cells in a lab, and return them to the patient's body, where they seek and destroy cancer cells. 

Additionally, the Human Genome Project, which was a moonshot project itself in the early 2000s, has enabled rapid genetic sequencing of individual genomes as well as genomic profiling of cancers. We believe that in the future, it will be possible to sequence a person's genome at birth and if at high risk for cancer, teach someone how to modify risk factors to reduce the likelihood of developing cancer.

Let's harness that same spirit that transformed cancer care in America to continue this extraordinary mission of Cancer Moonshot. We have the power to make cancer a treatable chronic illness and perhaps one day even prevent it from occurring. 

Robert C. Garrett is CEO of Hackensack Meridian Health, New Jersey's largest health network with 17 hospitals, more than 500 patient care locations and the Hackensack Meridian School of Medicine. André Goy, MD, MS is Chairman and Executive Director of Hackensack Meridian John Theurer Cancer Center

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