Cancer: the New Reality
M.S. Stack, Ann F Dunne & Elizabeth Riley Director, Harper Cancer Research Institute
Kleiderer-Pezold Professor of Chemistry & Biochemistry
University of Notre Dame
In his last State of the Union speech, President Obama unexpectedly called for a “moonshot” to make America the country that cures cancer “once and for all”. The original “moonshot”, the Apollo program, rallied a nation in fascination as we put a man on the moon and what was once believed impossible became the new reality. The cost of the original moonshot in 2016 dollars would be well over $100 billion. Imagine what we could accomplish if that level of resources was devoted to eradicating cancer. According to the American Cancer Society, we can expect over 1,600,000 new cancer cases in the United States in 2016, with approximately 35,000 of those here in Indiana. Cancer is a highly complex family of diseases that will not be eradicated with a single magic bullet. Instead, we need to delve deeply to develop a molecular-level understanding of each cancer type, or subtype, to identify disease-specific targets. Additional benefits will result from this detailed level of understanding, including better ways to detect cancer early and to predict which subset of patients will benefit from more aggressive therapies. We know that research cures cancer and when resources to support research are made available, the results are amazing. Consider, for example, the statistics on breast cancer. This year there will be almost a quarter million women newly diagnosed with breast cancer. If this were 1970, half of these women would not be alive in five years. Today, however, the overall 5-year survival for breast cancer is almost 90%, and when diagnosed at early stage, most patients have a 5-year survival probability of close to 100%. Similar statistics are true in men diagnosed with prostate cancer, who have a 5-year survival of 99%. This is certainly a cause for pride and celebration and is demonstrated proof of the results that we can expect when resources are devoted to research. Indeed, research directed at breast and prostate cancer typically consumes ~20% of federal dollars from the National Cancer Institute with additional support available from other federal and foundation sources. Many talented scientists specifically chose to focus their intellectual efforts on breast and prostate cancer due to the availability of sufficient resources to support research in these areas. There is no reason to expect that similar results cannot be obtained in other cancer types. Take, for example, pancreatic cancer – a devastating disease with very poor 5-year survival rate of only 8%. If significant resources are devoted to pancreatic cancer, research will increase, and with research comes results. This is not to advocate a removal of resources from breast or prostate cancer research, as significant problems still remain, particularly with patients with late-stage diagnoses. Long-term cancer survivors also face unique challenges that require further study. Furthermore, cancer patients in other countries die at an alarming rate from cancer types considered rare in the United States. Rather, an overall increase in federal support of cancer research would enable the United States to confront the complex challenges of cancer and to recruit the best minds from all disciplines into the future cancer workforce. As President Obama, Vice-President Biden, and those that serve us in the House and Senate proceed to identify specific mechanisms to fund their moonshot program, the 14.5 million cancer survivors alive today stand in ready testament to the fact that research cures cancer. Those of us who have watched a child, a parent, a sibling, spouse or friend lose their life to cancer are ready to imagine the new reality.