A Shot to the Moon, for Cancer Cure

“I think we’re going to the moon because it’s in the nature of the human being to face challenges. It’s by the nature of his deep inner soul… we’re required to do these things just as salmon swim upstream.” Neil Armstrong

Image via Mashable

“Only together can we seize this moment to defeat cancer,” Vice President Joe Biden declared, with his wife Dr. Jill Biden, the founder of the Biden Breast Health Initiative, by his side in front of the captive Social Good Summit in New York City earlier this week. The unfortunate loss of Joe’s son, “Beau”, to stage IV glioblastoma in 2015 and a plethora of human experience, the lessons of the Biden Breast Health Initiative have united them in a joint cause, Cancer Moonshot.

“In October, when Joe announced that he would not seek the nomination for the Pres, we had already decided to focus on another campaign. This campaign. This fight… Making the seemingly impossible, possible,” Jill proudly proclaimed.

Cancer Moonshot, aptly named, though even the most optimistic researchers bristle with concern at such a lofty goal of eradicating cancer in the United States and around the world, is an initiative that was announced by President Barak Obama in January 2016, appointing Vice President Biden as its head. The aim to accelerate cancer therapy, focusing on the field of combination immunotherapy, is proposed as accomplishable through unprecidented global collaboration from pharmacology, community, oncology, government and multiple scientific fields in engineering and medicine. Open data, a shared language and measurement of clinical trial results, responsible research with incentives and the cooperation by researchers and clinicians around the world are all facets of Cancer Moonshot. All of which, to those in the world of biomedical science, sound beautiful. A larger but similar ecosystem was built for genomics (back in my day) and resulted in an ever-growing, always improving on itself, National Center for Biotechnology Information database, used by laboratory scientists across the world. A common language, a centralized journal digital archive, peer-reviewed assays, tools, genetic sequences are just the tip of the iceberg that is NCBI. It was my playground for nearly a decade. The plethora of data gave researchers and students power to learn, collaborate and delve further into biomedical research than ever before.

Photo via Mashable

Cancer is personal. “This is personal. This is about the fighters and the survivors. The caretakers and the researchers. The philanthropists and the patient advocates. It’s about the millions of Americans, their loved ones and all those around the world who are confronting cancer,” Jill Biden concludes. There’s no denying that it has touched all of us, whether personally or within our circles of family and friends. I can relate to this on many levels: as a friend of cancer survivors, as a family member who has lost multiple relatives, as a former breast cancer research specialist, as a former epigentics lab assistant when I was in college, and now in the world of public health and communications, where the language of cancer takes on a strangely unfamiliar sound. That disconnect between research and the public happens across the world at levels I can only surmise. But, since cancer is quite personal, that deafening lack of communication between researchers and those who are affected most by it, has serious implications. We see it every day. Every time you have asked for your medical records and come up against an obstacle. Every time someone doesn’t know how to ask their specialist if there’s literature out there about their specific type of cancer. Every time you don’t know what experimental therapy may be available to you. Every time you hear someone like me tell you to take charge of your healthcare and you realize you have no idea how to even begin. By the time you are diagnosed with cancer, you are likely neck deep in murky territory with time running out. That’s one massive disconnect — the gap of knowledge, it’s out there, but not easily accessible.

There’s another disconnect though revolving around a lack of inter-field communication. VP Biden has discovered over the past nine months during his visits to clinicians and others in the cancer sector across the globe that there’s a huge lack of cooperation and contact between them in spite of a common end goal. He calls it ‘cancer politics.’ A lot of that is attributable to a competition for limited funds. There’s also a lag time between data collection, analysis and publication. Some of that may be attributable to overly cautious scientists. Some may be due to fear of losing ownership of the findings and potential follow-ups. My belief is that most scientists I’ve worked with or come across don’t have a selfish vanity driving their work so it’s really all about the constant struggle to fulfill grant aims and reapply for funding in an ever-shifting world where there’s one pool of money in the midst of changing priorities. At a recent event I was asked what happens to my HIV research when SARS or Ebola or Zika or Avian flu or another flavor-of-the-season floods the headlines. They were surprised by the answer. In a recent plea, Dr. Tom Frieden (CDC) and Dr. Anthony S. Fauci (NIH) penned the state of affairs in a Washington Post article this past August.

Pending a supplemental appropriation to meet this emerging [Zika] crisis, the Obama administration has twice repurposed or transferred funding away from other pressing health priorities — more than $670 million in total. This has exacted its own cost. The most recently transferred funds supported the CDC’s work to immunize children, fight HIV/AIDS, and stop other outbreaks. NIH had to take more than $7 million out of its research into fighting cancer and more than $4 million from our work to turn the tide on the illness that claims more American lives than any other: heart disease.

Cancer Moonshot is indeed aiming high. But that’s what it will take to break this cycle. Interdisciplinary approaches have led to breakthroughs in many fields. Fifty-five years ago, President John F. Kennedy challenged the U.S. to go to the moon. In 1971, President Richard Nixon declared the war on cancer. https://www.youtube.com/watch?v=E2dzEDnGqHY

The war is far from over, many say we have come full circle, but as VP Biden has said, this time, we have “coalitions of cancer organizations aggregating patients genomics data, medical records, family history… We have supercomputing capability… If we can aggregate enough data on all the cancer patients in the world and put it in one place, we have the ability to in fact use this to find patterns and understand why one therapy works on one person and not another. We can sequence cancer genes in a matter of hours now. We have capacity to analyze proteogenomics.” We have each other. In essence, what we have far outweighs what we lack.

In the world Cancer Moonshot envisions, “cancer is not a national problem. It is not an international problem. It is a humanitarian problem.”

Cancer Moonshot’s proposals for action currently include the following:

· 10 new commitments with nine nations to support international cancer research and care. The U.S. will work with institutions in Canada, China, Germany, Switzerland, Taiwan, Japan and South Korea in the field of proteogenomics, and with Serbia, Sweden and Japan to discuss better prevention, screenings, treatment and research collaborations. The U.S. Department of Energy will work with Norway to share 1.7 million cervical screening results over the course of 25 years to seek out patterns in diagnoses and treatments.

· Regional hubs — collaborative centers to decrease disparities in cancer research around the world. They will be funded by the National Cancer Institute, working with Australia, China, Denmark, France, Germany, Ireland, Japan, South Korea, New Zealand, the Netherlands, Norway and Sweden. This initiative will focus on areas of the world where specific types of cancers are leading killers.

· Secretary of State John Kerry will strengthen U.S. bilateral science and technology engagements to support Cancer Moonshot. The purpose will be to promote mobile diagnostics and screenings and wearable tech, so people can track their health more efficiently.

· The National Institutes of Health will make its database of clinical trials (Trials.Cancer.gov) searchable to help cancer patients find the right clinical trials.

· The Department of Health and Human Services also created a policy that makes sure the general public receives important information about clinical trials, “and that there are real penalties for failing to report and share information.”

· Hospitals and researchers who don’t publish results of cancer studies will face a $10,000 per day fine. This will be put in place within the next six months.

According to Biden, nearly 50% of cancers are preventable. “Take cervical cancer for example. 530,000 new cases annually. 270,000 of them die each year. 80% live in developing countries. With more education, screening and vaccines (ie — HPV vaccine) it’s preventable.”

“We are at an inflection point…Imagine what the world can look like in 2030 if we are smart and we work like hell,” Vice President Joe Biden pleas to a crowd already won over by the promise of #2030Now and a CancerFree world.

*Let me know if you liked this, hated it, enjoyed it or learned anything from it at all :) It is a component (the less scientific) of my very first (yah, first!) submission to the University of Southern California Annenberg Center for Health Journalism.