Aiming Higher in Cancer Medicine
Margaret I. Cuomo is an American radiologist, philanthropist, and national advocate for the prevention of cancer, heart disease and diabetes. Dr. Cuomo is the author of the book “A World Without Cancer” as well as writer and host of the PBS program “A World Without Cancer: The Real Promise of Prevention”.
Thomas A Bock, MD is a German cancer physician and researcher as well as the former Global Medical Affairs Head of Novartis Oncology and Celgene. Following the diagnosis of his wife with two inherited BRCA cancers, he founded HeritX as the first organization exclusively focused on developing preventive vaccines and other preventive medicines for inherited cancer.
Have we reached our goal of ending cancer?
On World Cancer Day, February 4th, we noted the 27% decrease in annual cancer deaths across the US, as recently reported by the American Cancer Society [1]. Reflecting the enormity of society’s cancer challenge, this percentage means that in 2017, as many as 200,000 fewer people died from this malady compared to 1991. This is important progress.
Yet, we must not conclude that medicine is on track to eliminating cancer. Despite decades of war on cancer and billions spent on cancer research, the annual number of new cancer cases is not declining. In contrast, the global number of new cancer cases per year is predicted to increase by more than fifty percent over the next two decades (population aging, growth and lifestyle are contributing factors) [2, 3].
The reason is simple. Eliminating cancer requires intervening before cancer occurs. But science and medicine are overwhelmingly focused on treating cancer after it has already occurred.
Already now, one in three people will be diagnosed with cancer during their lifetime [2]. The total annual economic cost of cancer has already exceeded US$ 1 trillion years ago [3]. Imagine the medical and economic consequences of the predicted cancer growth.
We believe that winning the war against cancer requires shifting our focus from treatment to prevention (today less than five percent of cancer research are directed to prevention). Of course, the development of new and more effective cancer treatments will always be necessary. However, there could be, and should be, a greater share of our intellectual and financial resources, on prevention. Only prevention can reduce and eventually eliminate cancer.
Three actions could get us there. 1. Reduce carcinogens: With smoking cessation being a primary driver of the reported cancer death decrease [1], continuing related programs and reducing exposure to carcinogens such as asbestos will prevent cancer deaths especially in populations and geographies that have not yet been targeted by such initiatives. But this action cannot be the hallmark of our scientific ability and ambition. We should protect consumers from harmful chemicals and other ingredients in food, water, air, soil, as well as cleaning products, cosmetics, construction materials, toys, clothing, and many other products, that raise our risk for cancer.
2. Healthy lifestyle: More compelling is the progress in nutrition science and integrative health that provide us with direction and tools to protect our health right now [4]. The strategies that will reduce the risk for cancer, such as maintaining a healthy weight, eating a plant-based diet, being physically active, getting adequate sleep, and managing stress, will also reduce the risk for diabetes and heart disease.
3. Preventive therapies (pre-cancer therapies): Vaccines preventing infectious diseases as well as statins that prevent heart attacks and strokes have transformed medicine and mortality in other fields. Vaccines against HPV have proven effective by eradicating a virus that triggers the development of cervical, vaginal, vulvar, anal, penile, and cancers of the throat and tongue.[5]. Early examples of cancer immuno-prevention pursued by forward-looking scientists are vaccines that teach our immune system to eliminate cancer cell precursors (pre-cancer cells), years before those turn into cancer. Other strategies include medicines to increase DNA repair with the goal of impeding the development of cancer.
Already today, between 30–50% of all cancers are deemed preventable by avoiding risk factors and implementing existing evidence-based prevention strategies [6]. But, we must aim higher. To significantly reduce the number of new cancer cases, and cancer deaths, let’s focus on the development of therapies and strategies that prevent cancer.
Throughout history, seemingly impossible goals have been reached when our best and brightest focused and collaborated effectively. The prevention of cancer should be our new “moon shot.”
Margaret I. Cuomo, MD
Cancer Prevention Advocate
Thomas A. Bock, MD
Founder, HeritX — Preventing Inherited Cancer
1) Dockser Marcus, A. Cancer Deaths Decline 27% Over 25 Years. Wall Street Journal. Available online at: https://www.wsj.com/articles/cancer-deaths-decline-27-over-25-years-11546959600. [accessed 21 January 2019].
2) National Cancer Institute. Cancer Statistics. [Online]. Available at: https://www.cancer.gov/about-cancer/understanding/statistics. [accessed 21 January 2019].
3) World Health Organization-International Agency for Research on Cancer. Stewart BW, Wild CP, editors. World Cancer Report 2014. Lyon: International Agency for Research on Cancer; 2014. Available online at: https://www.drugsandalcohol.ie/28525/1/World%20Cancer%20Report.pdf
4) World Cancer Research Fund — American Institute for Cancer Research: Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. The Third Expert Report. [Online]. Available at: https://www.wcrf.org/dietandcancer [accessed 21 January 2019].
5) Arbyn M, Xu L, et al.. Prophylactic Vaccination Against Human Papillomaviruses to Prevent Cervical Cancer and its Precursors. [Online]. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009069.pub3/abstract. [accessed 21 January 2019].
6) World Health Organization. Cancer. [Online]. Available at: https://www.who.int/news-room/fact-sheets/detail/cancer. [accessed 21 January 2019].
