World Cancer Day 2013: Dispelling Myths & Misconceptions About “The Enemy Within”

1.5 million premature cancer deaths could be prevented each year if targets set to reduce non-communicable diseases are met by 2025.  Today, on World Cancer Day, the Union for International Cancer Control and the International Agency for Research on Cancer reveal the real life impact of achieving this goal.

World Cancer Day 2013

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“… 1.5 million people saved from an early death due to cancer is equal to the entire populations of Philadelphia, Auckland, Barcelona or Maputo each and every year.”

World Cancer Day is the one initiative under which the entire world can unite in the fight against the global cancer epidemic.It takes place every year on February 4th. World Cancer Day aims to save millions of preventable deaths each year by raising awareness and education about cancer, and pressing governments and individuals across the world to take action against the disease.

World Cancer Day is an initiative of the Union for International Cancer Control (UICC), a leading international non-governmental organization dedicated to the prevention and control of cancer worldwide. Founded in 1933 and based in Geneva, UICC’s growing membership of over 765 organizations across 155 countries, features the world’s major cancer societies, ministries of health, research institutes, treatment centers, and patient groups. Additionally, the organization is a founding member of the NCD Alliance, a global civil society network that now represents almost 3,000 organizations in 170 countries.

Target “25 by 25:” Reduce 25% of Premature Non-Communicable Disease Deaths by 2025

The UICC and the International Agency for Research on Cancer (IARC) today announced that 1.5 million lives which would be lost to cancer, could be saved each year if decisive measures are taken to achieve the World Health Organization’s (WHO) “25 by 25” target; to reduce premature deaths due to non-communicable diseases (NCDs), including cancer, by 25% by 2025.

Currently, 7.6 million people die from cancer worldwide every year, out of which, 4 million people die prematurely (aged 30 to 69 years). So unless urgent action is taken to raise awareness about the disease and to develop practical strategies to address cancer, by 2025, this is projected to increase to an alarming 6 million premature cancer deaths per year.

“The estimate of 1.5 million lives lost per year to cancer that could be prevented must serve to galvanize our efforts in implementing the WHO’s ‘25 by 25’ target,” said Dr.  Christopher Wild, Director of IARC. “There is now a need for a global commitment to help drive advancements in policy and encourage implementation of comprehensive National Cancer Control Plans. If we are to succeed in this, we have a collective responsibility to support low- and middle-income countries who are tackling a cancer epidemic with insufficient resources.”

The 1.5 million lives lost per year represent 25% of the estimated 6 million premature cancer deaths that will occur by 2025, and the 6 million figure is itself based on population projections of current numbers and aging.

“Cancer — Did You Know?”

On World Cancer Day, UICC and its members are urging the public and governments alike to speak out with one voice to dispel damaging myths and misconceptions on cancer. Under the theme “Cancer – Did you know?” individuals and communities are encouraged to shed light on four key cancer “myths” and the corresponding “truth” via the UICC World Cancer Day Facebook App.

Myth #1: Cancer is just a health issue.

Truth #1: Cancer is not just a health issue. It has wide-reaching social, economic, development and human rights implications.

———-

Myth #2: Cancer is primarily a disease of the wealthy, elderly, and developed countries.

Truth #2: Cancer is a global epidemic, affecting all ages and socio-economic groups, with developing countries bearing a disproportionate burden.

———-

Myth #3: Cancer is a death sentence.

Truth #3: Many cancers that were once considered a death sentence can now be cured and for many more people their cancer can now be treated effectively.

———-

Myth #4: Cancer is my fate.

Truth #4: With the right strategies, at least 30% of cancer cases can be prevented based on current knowledge.

———-

Mr. Cary Adams, UICC Chief Exective Officer said:

“This World Cancer Day UICC, its members and partners urge everyone from individuals to governments to take a stand against damaging myths on cancer. By truly understanding this deadly disease, governments can develop appropriate strategies to reduce premature deaths and reach the WHO ‘25 by 25’ goal. The figures today announced by IARC and UICC reveal the fundamental human value of achieving this target. 1.5 million people saved from an early death due to cancer is equal to the entire populations of Philadelphia, Auckland, Barcelona or Maputo each and every year.”

What Can You Do?

In 2008, UICC developed the World Cancer Declaration as a tool to help bring the growing cancer crisis to the attention of government leaders and health policymakers. The 11 Declaration targets, designed to significantly reduce the global cancer burden by 2020, have served as the basis for UICC recommendations to the WHO. This year’s goal — #5 Declaration target — is to dispel damaging cancer myths and misconceptions. The Declaration, with more than half a million signatories, has also been instrumental in generating political will for cancer control targets both at the United Nations and grassroots levels. In close collaboration with the NCD Alliance, UICC played a key role recently in securing WHO’s global health target of a 25% reduction in premature deaths from NCDs by 2025 (known as “25 by 25”), at the World Health Assembly in May 2012 – demonstrating the important role advocacy plays in the global flight against cancer.

To sign the World Cancer Declaration, click here.

To download the World Cancer Day Facebook App, and play your part in reducing the unacceptable burden of cancer, visit https://apps.facebook.com/world_cancer_day.

Review and circulate the cancer truth fact sheets hyperlinked above under the “Cancer — Did You Know?” section of this article.

For more ideas on how you can get involved and take local action against the global crisis of cancer, visit worldcancerday.org.

Understanding Cancer:  “The Enemy Within” Documentary

In the documentary posted below, Vivienne Parry OBE tells the incredible story of our fight against cancer over the last 50 years. Through the eyes of scientists, researchers, and patients, we see how far we have come and how far we have yet to go, including contributions from Professor Robert Weinberg, Professor Umberto Veronesi, Lord Ara Darzi, Cancer Research UK, David Nathan, M.D., Brian Druker, M.D., and many more.

The film is a non-commercial, editorially independent piece of work which has been supported by Cancer Research UK and funded by an educational grant from Roche. The purpose is to educate and inform those who are affected by cancer. It’s now freely available to all who may want to use it, so please feel free to embed on your own websites and share as you see fit.

An Attitude of Gratitude On Thanksgiving Day

“Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.” — Melody Beattie

Today, many of us will celebrate a national day of Thanksgiving with family and friends. You know the drill — eating turkey, mash potatoes, stuffing, and pumpkin or apple pie; watching football (your pick of Green Bay Packers vs. Detroit Lions, Miami Dolphins vs. Dallas Cowboys, or San Francisco 49ers vs. Baltimore Ravens); and napping, after which the whole cycle begins anew.

Why Be Grateful?

Within this traditional celebration, it is all too easy for us to lose sight of the real meaning of the holiday; that is, to give thanks for the many blessings bestowed upon us in our daily lives. Yesterday, I overheard two adults speaking about Thanksgiving in a grocery store line. One individual said to the second in a serious tone: “What do I have to be thankful for?” At first blush, it seems like a fair question when you consider the following:

  • The U.S. is currently engaged in two major armed conflicts. As of November 22, the total number of Americans killed in Afghanistan and Iraq is 4,984, and the number of wounded is over 47,000. The conflict in Afghanistan hit the 10-year mark in October. In contrast, the U.S. forced the unconditional surrender of Nazi Germany and the Imperial Empire of Japan in 3 years and 8 months, thereby ending World War II in August 1945.
  • The U.S. is experiencing the worst economic downturn since “The Great Depression” of the 20th century.
  • The bipartisan U.S. Congressional “Super Committee” failed to reach agreement on $1.2 trillion of federal budget spending cuts over the next ten years, as part of Congress’ ongoing theater of the absurd in which its utter and total failure is “spun” as success.
  • The U.S. Congress’ approval rating, based upon a recent New York Times poll, sits at an all-time low of 9 percent. By comparison, former President Richard Nixon’s final approval rating after the Watergate Scandal and upon his resignation was 23%.
  • The U.S. National Cancer Institute (NCI) continues to fight for increased federal funding for cancer research in a time when 50% of men and 33% of women woman will experience cancer at some point during their lifetimes.
  • It is estimated that 15,460 U.S. women will die from ovarian cancer in 2011, which represents the death of one woman every 37 minutes. The annual U.S. ovarian cancer death toll is equal to the number of passenger deaths that would result from 30 Boeing 747 airplane crashes every year.
  • According to a recently published U.K. report, the median survival of women with ovarian cancer only increased from 8 months to 3 years over the past 40 years.

There is little doubt that the current state of U.S. affairs as described above is indeed daunting. The unsettling situation in the U.S., however, pales in comparison to the average life experience of those living in extreme poverty around the world (including the U.S.).

  • In 2005, the World Bank reported that 1.4 billion people in the developing world (one in four) were living on less than US$1.25 per day, of which 162 million live on less than $0.50 per day. The latter category of individuals are referred to as the “ultra poor” by the International Food Policy Research Institute.
  • Number of children in the world: 2.2 billion. Number of children living in poverty: 1 billion.
  • According to the World Health Organization, there are approximately 33 million people living with HIV/AIDS today, with 2 million AIDS-related deaths anticipated each year. It is estimated that 76% of those deaths will occur in sub-Saharan Africa.
  • The United Nations estimates that 34,000 children and 16,000 adults die each day from hunger or preventable diseases with poverty-related causes. The annual death total is 18 million per year, which is nearly two times greater than the total number of deaths that occurred throughout “The Holocaust” between 1933 and 1945.
  • Approximately 1.1 billion people in developing countries have inadequate access to clean water, and 2.6 billion lack basic sanitation. Approximately 12 percent of the world’s population uses 85 percent of its water, and the individuals represented by the 12 percent do not live in the Third World.
  • In 1997, it was estimated that less than 1 percent of annual world weapons expenditures was needed to put every child into school by the year 2000.
  • Nearly one billion people entered the 21st century unable to read a book or sign their names.
  • 1.6 billion people live without electricity.
  • The U.S. has the widest gap between rich and poor of any industrialized nation.
  • In 2008, 7.6 million people died of cancer or 13% of all deaths worldwide. About 70% of all cancer deaths occur in low- and middle-income countries.

In light of the above-mentioned global poverty statistics, it should be possible for even the most pessimistic U.S. citizen to be grateful on Thanksgiving Day. For the women and families who are dealing with ovarian cancer in their lives, we also believe that gratitude and hope is not only possible; it is essential.

  • While cancers (including ovarian) constitute an incredibly diverse and bewilderingly complex set of diseases, we have at hand the methods to identify essentially all of the genetic changes in a cell and to use that knowledge to rework the landscape of cancer research and cancer care, from basic science to prevention, diagnosis, and treatment.
  • With this better understanding of cancer and recent technological advances in many fields, such as genomics, molecular biology, biochemistry, and computational sciences, progress has been made on many fronts, and a portrait is beginning to emerge for several cancers including ovarian.
  • It has been established that there are at least four major subtypes of epithelial ovarian cancer which should be treated as separate and distinct diseases.
  • In The Cancer Genome Atlas (TCGA) study findings recently published with respect to the most common form of epithelial ovarian cancer, the investigators reported that a class of drugs known as “PARP inhibitors” may benefit up to 50% of high-grade, serous ovarian cancer (HGS-OvCa) survivors. In that same study, the investigators identified 22 genomic targets that occur in 10% or more of these cases, along with nearly 100 preclinical, clinical and FDA-approved drugs which are capable of “hitting” those targets.
  • The TCGA study of HGS-OvCa is arguably the world’s largest genomic study of any form of cancer to date.
  • Never before in human history has so much healthcare information been so readily available to the general public, thereby allowing cancer survivors and their families to proactively participate with their doctors in decisions relating to cancer diagnoses, treatments, and survivorship.
  • Given the rapid technological and pharmacological developments described above, it is important to “live to fight another day.”
  • Studies suggest that gratitude may improve overall health by leading to (i) better diet, (ii) increased amounts of exercise, (iii) reduced stress, and (iv) a stronger immune system. In other words, if you want to promote health, try giving thanks.

Thanksgiving In Times of Adversity & Plenty

“… As we gather in our communities and in our homes, around the table or near the hearth, we give thanks to each other and to God for the many kindnesses and comforts that grace our lives. Let us pause to recount the simple gifts that sustain us, and resolve to pay them forward in the year to come. …” — President Barack Obama

On November 16, 2011, U.S. President Barack Obama issued a Presidential Proclamation for Thanksgiving Day 2011. The proclamation is befitting of the true meaning underlying this traditional holiday. Although the origins of the modern U.S. Thanksgiving holiday can be traced back to the early 17th century, it is worth noting that the first Thanksgiving to be celebrated by all U.S. states on the same day (i.e., the final Thursday of November, which was not enacted into law by Congress until December 1941) was first proclaimed by President Abraham Lincoln on October 3, 1863. The year 1863 was arguably one of the darkest time periods in U.S. history because it occurred in the midst of the Civil War; a conflict that pitted brother against brother, and resulted in more American deaths than all subsequent U.S. conflicts combined. Despite that fact, President Lincoln believed strongly that we should give thanks for our daily blessings even in times of great adversity.

The main text of President Obama’s proclamation, which is provided below, echoes the sentiments of Lincoln and reminds all Americans that in good times and bad times, “… we have lifted our hearts by giving humble thanks for the blessings we have received and for those who bring meaning to our lives.”

“One of our Nation’s oldest and most cherished traditions, Thanksgiving Day brings us closer to our loved ones and invites us to reflect on the blessings that enrich our lives. The observance recalls the celebration of an autumn harvest centuries ago, when the Wampanoag tribe joined the Pilgrims at Plymouth Colony to share in the fruits of a bountiful season. The feast honored the Wampanoag for generously extending their knowledge of local game and agriculture to the Pilgrims, and today we renew our gratitude to all American Indians and Alaska Natives. We take this time to remember the ways that the First Americans have enriched our Nation’s heritage, from their generosity centuries ago to the everyday contributions they make to all facets of American life. As we come together with friends, family, and neighbors to celebrate, let us set aside our daily concerns and give thanks for the providence bestowed upon us.

Though our traditions have evolved, the spirit of grace and humility at the heart of Thanksgiving has persisted through every chapter of our story. When President George Washington proclaimed our country’s first Thanksgiving, he praised a generous and knowing God for shepherding our young Republic through its uncertain beginnings. Decades later, President Abraham Lincoln looked to the divine to protect those who had known the worst of civil war, and to restore the Nation “to the full enjoyment of peace, harmony, tranquility, and union.”

In times of adversity and times of plenty, we have lifted our hearts by giving humble thanks for the blessings we have received and for those who bring meaning to our lives. Today, let us offer gratitude to our men and women in uniform for their many sacrifices, and keep in our thoughts the families who save an empty seat at the table for a loved one stationed in harm’s way. And as members of our American family make do with less, let us rededicate ourselves to our friends and fellow citizens in need of a helping hand.

As we gather in our communities and in our homes, around the table or near the hearth, we give thanks to each other and to God for the many kindnesses and comforts that grace our lives. Let us pause to recount the simple gifts that sustain us, and resolve to pay them forward in the year to come. …” — Barack Obama’s Presidential Proclamation — Thanksgiving Day, 2011

If All Else Fails  — Try Humor

If you are still having trouble cultivating an attitude of gratitude on Thanksgiving Day, it is always helpful to enjoy the humor created by a child’s perspective. Thanksgiving is a time for food, family and fun, and we all know that children and grandchildren are a big part of the fun. Save Mart Supermarkets dared to create a video which captures a child’s perspective on the traditional Thanksgiving experience.  We should warn you that a broad smile is a common side effect of watching this video. Enjoy!

What Are We Thankful For?

Our Thanksgiving Day gratitude list includes the following:

  • Ovarian cancer survivors and their families, who teach us every day about the importance of hope, perseverance, courage, compassion, love, and acceptance.
  • The compassion of medical clinicians who treat ovarian cancer patients every day.
  • The intelligence and dedication of U.S. and international medical and scientific researchers, who doggedly pursue methods to control, and ultimately conquer, ovarian cancer.
  • The generous assistance provided to us by the Women’s Oncology Research & Dialogue (WORD) gynecological cancer awareness organization. Dr. Kelly Manahan (WORD Co-Founder), Dr. John Geisler (WORD Co-Founder), Nate Manahan (WORD Executive Director) and Chad Braham (WORD Director of Media Productions) provide Libby’s H*O*P*E* with invaluable substantive and technical assistance throughout the year, including the newest joint collaboration called “WORD of HOPE Ovarian Cancer Podcast.”
  • The ongoing generosity, encouragement and hope provided by Douglas and Diana Gray through the Gray Family Ovarian Clear Cell Carcinoma Research Resource, a multi-year research project dedicated to understanding, and ultimately defeating, one of the most lethal subtypes of epithelial ovarian cancer.  The Talmud says: “And whoever saves a life, it is considered as if he saved an entire world.” Doug and Diana Gray are passionate about pioneering ovarian cancer research aimed at saving women’s lives.
  • Our families who provide seemingly endless support and understanding, while we advocate on behalf of ovarian cancer survivors and their families.
  • The inspiration provided by Libby’s eternal spirit.
  • The ovarian cancer advocacy communities represented on Facebook, Twitter, Inspire.com, etc., who demonstrate on a daily basis that there is patient empowerment, joy, kindness, compassion, and synergy created by a large number of passionate and dedicated survivors and advocates who band together in cyberspace.
  • The dedicated service of our U.S. military personnel (and their families), who allow us to rise and sleep under the blanket of freedom which they provide each day through blood, sweat, and tears.
  • The roofs over our heads, the food on our tables, the clean water from our faucets, the freedom of speech and religious practice upon which our country was founded, the ability to vote in fair elections, and the simple acts of kindness that we are able to provide to and receive from others.

From our family to yours, let us take this opportunity to wish you a safe and enjoyable Thanksgiving holiday.

President of M.D. Anderson Outlines 10 Steps To Achieve Progress Against Cancer.

“The Houston Chronicle recently published a commentary by John Mendelsohn, M.D., president of M. D. Anderson, outlining actions the nation should take to achieve great progress against cancer. … Here are 10 steps we can take to ensure that deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place. …”

“Ten Pieces Help Solve Cancer Puzzle

John Mendelsohn, M.D., President, The University of Texas M.D. Anderson Cancer Center

John Mendelsohn, M.D., President, The University of Texas M.D. Anderson Cancer Center

The Houston Chronicle recently published a commentary by John Mendelsohn, M.D., president of M. D. Anderson, outlining actions the nation should take to achieve great progress against cancer.

An American diagnosed with cancer today is very likely to join the growing ranks of survivors, who are estimated to total 12 million and will reach 18 million by 2020. The five-year survival rate for all forms of cancer combined has risen to 66%, more than double what it was 50 years ago.

Along with the improving five-year survival rates, the cancer death rate has been falling by 1% to 2% annually since 1990.

According to the World Health Organization, cancer will be the leading worldwide cause of death in 2010. Over 40% of Americans will develop cancer during their lifetime.

While survival rates improve and death rates fall, cancer still accounts for one in every five deaths in the U.S., and cost this nation $89.0 billion in direct medical costs and another $18.2 billion in lost productivity during the illness in 2007, according to the National Institutes of Health.

Here are 10 steps we can take to ensure that deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.

#1.  Therapeutic cancer research should focus on human genetics and the regulation of gene expression.

Cancer is a disease of cells that have either inherited or acquired abnormalities in the activities of critical genes and the proteins for which they code. Most cancers involve several abnormally functioning genes – not just one – which makes understanding and treating cancer terribly complex. The good news is that screening for genes and their products can be done with new techniques that accomplish in days what once took years.

Knowledge of the human genome and mechanisms regulating gene expression, advances in technology, experience from clinical trials, and a greater understanding of the impact of environmental factors have led to exciting new research approaches to cancer treatment, all of which are being pursued at M. D. Anderson:

  • Targeted therapies.  These therapies are designed to counteract the growth and survival of cancer cells by modifying, replacing or correcting abnormally functioning genes or their RNA and protein products, and by attacking abnormal biochemical pathways within these cells.
  • Molecular markers.  Identifying the presence of particular abnormal genes and proteins in a patient’s cancer cells, or in the blood, will enable physicians to select the treatments most likely to be effective for that individual patient.
  • Molecular imaging.  New diagnostic imaging technologies that detect genetic and molecular abnormalities in cancers in individual patients can help select optimal therapy and determine the effectiveness of treatment within hours.
  • Angiogenesis.  Anti-angiogenesis agents and inhibitors of other normal tissues that surround cancers can starve the cancer cells of their blood supply and deprive them of essential growth-promoting factors which must come from the tumor’s environment.
  • Immunotherapy. Discovering ways to elicit or boost immune responses in cancer patients may target destruction of cancer cells and lead to the development of cancer vaccines.

#2.  Better tests to predict cancer risk and enable earlier detection must be developed.

New predictive tests, based on abnormalities in blood, other body fluids or tissue samples, will be able to detect abnormalities in the structure or expression of cancer-related genes and proteins. Such tests may predict the risk of cancer in individuals and could detect early cancer years before any symptoms are present.

The prostate-specific antigen test for prostate cancer currently is the best known marker test to detect the possible presence of early cancer before it has spread. Abnormalities in the BRCA 1 and BRCA 2 genes predict a high risk for breast cancer, which can guide the decisions of physicians and patients on preventive measures. Many more gene-based predictors are needed to further our progress in risk assessment and early detection.

#3.  More cancers can and must be prevented.

In an ideal world, cancer “care” would begin with risk assessment and counseling of a person when no malignant disease is present. Risk factors include both inherited or acquired genetic abnormalities and those related to lifestyle and the environment.

The largest risk factor for cancer is tobacco smoking, which accounts for nearly one-third of all cancer deaths. Tobacco use should be discouraged with cost disincentives, and medical management of discontinuing tobacco use must be reimbursed by government and private sector payors.

Cancer risk assessment should be followed by appropriate interventions (either behavioral or medical) at a pre-malignant stage, before a cancer develops. Diagnosis and treatment of a confirmed cancer would occur only when these preventive measures fail.

A full understanding of cancer requires research to identify more completely the genetic, environmental, lifestyle and social factors that contribute to the varying types and rates of cancer in different groups in this country and around the world. A common cancer in Japan or India, for example, often is not a common cancer in the U.S. When prostate cancer occurs in African-Americans it is more severe than in Caucasians. A better understanding of the factors that influence differences in cancer incidence and deaths will provide important clues to preventing cancer in diverse populations worldwide.

#4.  The needs of cancer survivors must become a priority.

Surviving cancer means many things: reducing pain, disability and stress related to the cancer or the side effects of therapy; helping patients and their loved ones lead a full life from diagnosis forward; preventing a second primary cancer or recurrence of the original cancer; treating a difficult cancer optimally to ensure achieving the most healthy years possible, and more.  Since many more patients are surviving their cancers – or living much longer with cancer – helping them manage all the consequences of their disease and its treatment is critically important.  It is an area ripe for innovative research and for improvement in delivery of care.

#5.  We must train future researchers and providers of cancer care.

Shortages are predicted in the supply of physicians, nurses and technically trained support staff needed to provide expert care for patients with cancer.  On top of this, patient numbers are projected to increase.  We are heading toward a “perfect storm” unless we ramp up our training programs for cancer professionals at all levels.   The pipeline for academic researchers in cancer also is threatened due to the increasing difficulty in obtaining peer-reviewed research funding. We must designate more funding from the NIH and other sources specifically for promising young investigators, to enable them to initiate their careers.

#6.  Federal funding for research should be increased.

After growing by nearly 100% from 1998-2002, the National Cancer Institute budget has been in decline for the past four years. Through budget cuts and the effects of inflation, the NCI budget has lost approximately 12% of its purchasing power.  Important programs in tobacco control, cancer survivorship and support for interdisciplinary research have had significant cuts.  The average age at which a biomedical researcher receives his or her first R01 grant (the gold standard) now stands at 42, hardly an inducement to pursue this field. This shrinks the pipeline of talented young Americans who are interested in careers in science, but can find easier paths to more promising careers elsewhere.  Lack of adequate funding also discourages seasoned scientists with outstanding track records of contributions from undertaking innovative, but risky research projects.  The U.S. leadership in biomedical research could be lost.

Biomedical research in academic institutions needs steady funding that at least keeps up with inflation and enables continued growth.

#7.  The pace of clinical research must accelerate.

As research ideas move from the laboratory to patients, they must be assessed in clinical trials to test their safety and efficacy. Clinical trials are complicated, lengthy and expensive, and they often require large numbers of patients.  Further steps must be taken to ensure that efficient and cost-effective clinical trials are designed to measure, in addition to outcomes, the effects of new agents on the intended molecular targets. Innovative therapies should move forward more rapidly from the laboratory into clinical trials.

The public needs to be better educated about clinical trials, which in many cases may provide them with access to the best care available.  Greater participation in trials will speed up drug development, in addition to providing patients with the best options if standard treatments fail.  The potential risks and benefits of clinical trials must continue to be fully disclosed to the patients involved, and the trials must continue to be carefully monitored.

The issue of how to pay for clinical trials must be addressed. The non-experimental portion of the costs of care in clinical trials currently are borne in part by Medicare, and should be covered fully by all payors. The experimental portion of costs of care should be covered by the owner of the new drug, who stands to benefit from a new indication for therapeutic use.

#8.  New partnerships will encourage drug and device development.

One way to shorten the time for drug and device development is to encourage and reward collaboration among research institutions, and collaboration between academia and industry.  Increasingly, partnerships are required to bring together sufficient expertise and resources needed to confront the complex challenges of treating cancer. There is enormous opportunity here, but many challenges, as well.

Academic institutions already do collaborate, but we need new ways to stimulate increased participation in cooperative enterprises.

Traditionally, academic institutions have worked with biotech and pharmaceutical companies by conducting sponsored research and participating in clinical trials.  By forming more collaborative alliances during the preclinical and translational phases prior to entering the clinic, industry and academia can build on each other’s strengths to safely speed drug development to the bedside. The challenge is that this must be done with agreements that involve sharing, but also protect the property rights and independence of both parties.

The results of all clinical trials must be reported completely and accurately, without any influence from conflicts of interest and with full disclosure of potential conflicts of interest.

#9. We must provide access to cancer care for everyone who lives in the U.S.

More than 47 million Americans are uninsured, and many others are underinsured for major illnesses like cancer. Others are uninsurable because of a prior illness such as cancer.  And many are indigent, so that payment for care is totally impossible.

Depending on where they live and what they can afford, Americans have unequal access to quality cancer care. Treatment options vary significantly nationwide. We must find better ways to disseminate the best standards of high-quality care from leading medical centers to widespread community practice throughout the country.

Cancer incidence and deaths vary tremendously among ethnic and economic groups in this country. We need to address the causes of disparities in health outcomes and move to eliminate them.

We are unique among Western countries in not providing direct access to medical care for all who live here. There is consensus today among most Americans and both political parties that this is unacceptable.  Especially for catastrophic illnesses like cancer, we must create an insurance system that guarantees access to care.

A number of proposals involving income tax rebates, vouchers, insurance mandates and expanded government insurance programs address this issue. Whatever system is selected should ensure access and include mechanisms for caring for underserved Americans.  The solution will require give-and-take among major stakeholders, many of which benefit from the status quo.  However, the social and economic costs have risen to the point that we have no choice.

#10.  Greater attention must be paid to enhancing the quality of cancer care and reducing costs.

New therapies and medical instruments are expensive to develop and are a major contributor to the rising cost of medical care in the U.S.  The current payment system rewards procedures, tests and treatments rather than outcomes.  At the same time, cancer prevention measures and services are not widely covered.  A new system of payment must be designed to reward outcomes, as well as the use of prevention services.

Quality of care can be improved and costs can be reduced by increasing our efforts to reduce medical errors and to prescribe diagnostic tests and treatments only on the basis of objective evidence of efficacy.

A standardized electronic medical record, accessible nationwide, is essential to ensuring quality care for patients who see multiple providers at multiple sites, and we are far behind many other nations.  Beyond that, a national electronic medical record could provide enormous opportunities for reducing overhead costs, identifying factors contributing to many illnesses (including cancer), determining optimal treatment and detecting uncommon side effects of treatment.

What the future holds in store.

I am optimistic. I see a future in which more cancers are prevented, more are cured and, when not curable, more are managed as effectively as other chronic, life-long diseases. I see a future in which deaths due to cancer continue to decrease.

Achieving that vision will require greater collaboration among academic institutions, government, industry and the public.  Barriers to quality care must be removed.  Tobacco use must be eradicated.  Research must have increased funding.  Mindful that our priority focus is on the patient, we must continue to speed the pace of bringing scientific breakthroughs from the laboratory to the bedside.

M. D. Anderson resources:

John Mendelsohn, M.D.”

Primary SourceTen Pieces Help Solve Cancer Puzzle, by John Mendelsohn, M.D., Feature Article, The University of Texas M.D. Anderson Cancer Center Cancer News, Mar. 2009.