- The White House has announced an ambitious plan to halve cancer mortality by 2047.
- The plan will reinvigorate cancer research and address barriers to cancer screening and care, but it doesn’t include any new funding.
- Improving cancer screening and developing treatments that allow cancer patients to live longer, more fulfilling lives are critical to the program’s success.
The White House called on the health and science communities to do their best to reduce cancer mortality by at least 50 percent over the next 25 years, and in doing so “end cancer as we know it today.”
President Joe Biden has revamped the Beau Biden cancer moonshot he led during his last year as vice president in the Barack Obama administration.
Nearly 2 million new cancer cases are expected to be diagnosed by 2022, and more than 600,000 deaths are expected. But with reinvestment in cancer prevention, detection and treatment, the government says it has the potential to cut cancer deaths by at least half over the next two decades.
“It’s bold, it’s ambitious, but it’s totally doable,” Biden said.
The moonshot, named after Biden’s eldest son who died of brain cancer in 2015, began five years ago and is scheduled to continue for another two years.
Congress allocated $1.8 billion in 2016 to support the moonshot over seven years. Another $400 million in 2022 and 2023. But the restart didn’t include any new funding.
The comprehensive plan calls on experts to come together to accelerate scientific discovery, increase data sharing and institutional collaboration, and improve cancer care in underserved segments of society.
“The Biden administration’s relaunch of the moonshot really tells us, as cancer researchers, how committed the administration is to what we do and how much we can impact the lives of cancer patients,” said Kevin Haigis, Ph.D., chief scientific officer at Dana-Farber Cancer. The School of Medicine’s Institute of Medicine and associate professor told Weaverwell. “What we’re seeing with cancer researchers is a real, concrete, long-term commitment to curing cancer by studying it.”
Program to reduce cancer deaths
The Moonshot Blueprint calls for a “cancer cabinet” in which representatives from 19 federal departments and agencies collaborate to develop and achieve goals to improve cancer detection and prevention.
In 2016, then-Vice President Joe Biden assembled a panel of top cancer researchers and health care providers to inform the new initiative. Dr. Deborah K. Mayer, a professor at the University of North Carolina School of Nursing, and a registered nurse were named nurse representatives to the group. Mayer said she was impressed by Biden’s ability to forge partnerships and encourage collaboration in cancer care.
“Involving all these different agencies will be very helpful in reducing barriers to care,” Mayer told VigorTip.
Unlike previous moonshot iterations, the revitalization program goes beyond research to support practical medicine, such as facilitating screening and improving access to electronic records.
The first step in reducing cancer deaths is to minimize the number of cancer cases. The White House announced a call for action to make up for the more than 9.5 million cancer screenings missed due to the COVID-19 pandemic.
Increased home testing capacity and expanded use of community health centers during the pandemic could make it easier to detect diseases like cervical and colon cancer.
Several moonshots have found new ways to detect cancer early — a key tool for effective cancer treatment. “Five years ago, detecting multiple cancers in one blood test was a dream,” the White House said.
Now, blood tests can help diagnose many cancers, and new “liquid biopsies” show promise in detecting DNA fragments from dozens of cancers in the blood.
Still, screening all Americans for a variety of cancers is no easy task. Better investment of energy into developing treatments that will allow cancer patients to live longer, more fulfilling lives, Haigis said. Extending the life expectancy of cancer patients also reduces mortality.
“Early detection is more of a pie-in-the-sky approach to lowering cancer mortality,” Hedges said. “I would say a more realistic approach to reducing mortality, especially in such a short period of time — 25 years — is to turn cancer into a chronic disease rather than a death-causing disease.”
Making strides in personalised treatment
National Cancer Institute-funded projects are looking at ways to prevent cancer in the first place. The COVID-19 pandemic has ushered in a practical mRNA vaccine technology long in development. The platform could be used to train the immune system to stop cancer cells when they first appear, just as they do to fight viruses.
Cancer patients may receive treatments such as chemotherapy and radiation, which broadly target rapidly proliferating cells. Now, researchers have come a long way toward immunotherapies that harness the immune system to attack cancer cells. This approach would allow providers to target cancerous growths more directly and minimize damage to other tissues.
“Currently, we have very effective immunotherapies, but they are very effective in a small number of people,” Hedges said. “What we really need to do is expand the number of different immunotherapies available to patients.”
Facilitating the development of machine learning, tumor genotyping, blood-based biomarkers and health record systems could help scientists create more personalized treatments for cancer patients.
Government calls to address barriers to collecting and sharing data could further speed up discovery. For example, through the Human Tumor Atlas network, scientists can map the characteristics of cancer over time.
Focusing on fighting the most common cancers — including breast, lung, prostate and colorectal cancers — could improve outcomes for many cancer patients. But investing in better understanding, diagnosing and treating rarer cancers can also make a big difference.
“Meaningful advances may lie in understanding how a rare type of cancer develops — which may apply to many more cancers,” Mayer said. “What we learn anywhere may be applied in places we can’t even imagine.”
While working to reduce mortality through new diagnostic and treatment technologies, it’s important to leverage existing cancer prevention knowledge to help reduce cancer rates in the long-term, Mayer said.
People working with cancer have long been aware of the risk factors for some of the most common cancers, including behavioral factors such as smoking, an unbalanced diet and lack of exercise.
“If we apply what we know today, we’re moving toward that goal. The problem is that we’re not systematically implementing what we know will make a difference,” Mayer said.
Narrowing the gap
During the pandemic, efforts to expand health services to hard-to-reach communities through at-home screening, mobile testing sites, and strengthening community health networks have reduced barriers to care in a number of ways. Leveraging these approaches can make cancer care more equitable.
“This pandemic has impacted everything we do, from the way we treat our patients, the way our hospitals operate, and the way we think about cancer care and treatment,” Hedges said.
Also in research, collecting trial samples without the need for participants to travel can improve diversity by race, gender, region, and resource.
Even if cancer screening and treatment are available, the method of obtaining them can be a key difference in outcomes. The Affordable Care Act expanded health insurance coverage for tens of millions of Americans. Still, prescription drugs can be very expensive, and the expensive treatments and lifestyle adjustments that accompany a cancer diagnosis can exacerbate disparities.
Health care has been “very slow” in adapting to change, Mayer said. But she said the introduction of telehealth during the pandemic has changed the way many health professionals deliver care and could become a permanent fixture.
In addition to cancer research and treatment, minimizing cancer risk factors may have long-term effects. For example, the Environmental Protection Agency might consider how environmental pollutants disproportionately affect people living in certain areas or with lower incomes.
Reducing disparities and keeping patients first will remain important for years to come when providing care and developing new diagnostics or treatments, Mayer said.
“It’s not just about disease, it’s about people who have it,” she said. “If we don’t keep that in mind, it can be really problematic. You can reduce mortality, but if their quality of life is not maintained, what are we doing?”
made the moon landing possible
Clinical trials and cancer centers are expensive to operate. To continue funding cancer research, Biden urged Congress to pass the Advanced Research Projects Agency’s health plan. It seeks $6.5 billion in seed funding to improve the government’s ability to accelerate research to improve human health, and will initially focus on diseases such as cancer and Alzheimer’s.
It is unclear how much money will be needed to achieve the moonshot goal, or whether Congress will provide it. Meanwhile, the remaining funds can support research.
Halving cancer deaths in just 25 years is an ambitious goal worth citing the title of John F. Kennedy’s campaign to put humans on the moon, Hedges said. He said he is encouraged by the many people bringing their ideas and expertise to cancer research in various fields.
“Cancer is not a simple problem — that’s why we haven’t had a cure for it in the past 50 years,” Hedges said. “We’re definitely not going to cure it in the next 25 years, but we have a clear place to go, and it requires expertise from all areas of science and technology.”
what does this mean to you
The cancer moonshot is a long-term plan. But certain measures, such as increased preventive screening and continued use of telemedicine, may help reduce cancer rates and improve outcomes for cancer patients in the short term.