Ending cancer as we know it

Noted philanthropist and cancer research advocate Mary Lasker once said, “If you think research is expensive, try disease!” This philosophy has been a driving force behind decades of progress against cancer, made possible by the robust congressional investment in cancer research since the National Cancer Act was signed into law over 50 years ago.

A recent study from SWOG Cancer Research Network reported that more than 14 million years of life have been saved through National Cancer Institute (NCI)-sponsored clinical trials since 1980. Beyond the immeasurable benefit that added years of life and better health brings to patients and loved ones, the economic impact can’t be ignored: years of life saved means fewer lost workdays and less stress on the health care system. As the COVID-19 pandemic has taught us, we are just one unexpected public health crisis away from the system being overwhelmed, which could put cancer patients at risk. 

But this recent report is just one barometer of progress. By many measures, spending on cancer research has been worth every dollar, leading to unprecedented progress. Years of funding this investigative work have put all of us in the cancer research community in a position to make even more progress in the coming years — particularly now that President Joe Biden has reignited the Cancer Moonshot initiative. As NCI Director Norman E. Sharpless has said, “We are in a golden age of cancer research.” 

Perhaps the biggest return on investment is the understanding that cancer is not a single disease, but thousands. The last 50 years of funding has also resulted in declining cancer mortality; innovative new detection, screening and treatment methods; as well as a recasting of cancer as a manageable disease that is no longer a death sentence. Critics may say that we have not found success over the last 50 years because we have not cured all cancers. But given what we knew about cancer in the early 1970s, it is easy to see why finding a single “cure” was the original goal, which we now know was not realistic.

Thanks to research breakthroughs, metastatic melanoma and other cancers can be cured, survival rates for many cancers have dramatically improved and a record number of cancer drugs have been approved by the U.S. Food and Drug Administration (FDA), including lifesaving immunotherapies that harness the patients’ own immune systems to fight their cancers. From 2015 to 2020, the number of FDA oncology approvals for drug supplements, new drugs, biologics and biosimilars more than tripled from 22 to 76, and the FDA issued a total of 255 oncology approval actions.

The Annual Report to the Nation on the Status of Cancer — jointly issued by the NCI, American Cancer Society, the Centers for Disease Control and Prevention, as well as the North American Association of Central Cancer Registries — has documented more than 25 consecutive years of declining cancer deaths. And according to the American Cancer Society, cancer deaths declined 31 percent between 1991 and 2018. Building on decades of success, this month Biden announced his goal to cut the cancer death rate in half within 25 years.

Despite this progress, cancer is projected to cost the U.S. $245 billion by 2030, according to a 2020 report from the American Association for Cancer Research. And this year alone, 1.9 million cases and 600,000 deaths were forecast by the American Cancer Society. We can’t afford not to significantly invest in cancer research if we want to reduce or eliminate these staggering costs to society. 

As we reflect on 50 years of progress, we must look ahead to more discoveries and innovative solutions in our battle against cancer. A greater investment is needed to make progress against intractable cancers, such as pancreatic, gastric, lung, brain and ovarian cancers, as well as the crisis of health inequity and disparities in cancer screening, diagnosis, treatment and outcomes.

In the business world, a steady return on investment results in greater expenditures in anticipation of greater gains. The same is true of cancer research. Now is the time for Congress to invest in cancer research to support the president’s plan to end cancer as we know it. We all stand to benefit.

Caryn Lerman, Ph.D., is president of the Association of American Cancer Institutes (AACI) and director of USC Norris Comprehensive Cancer Center with Keck Medicine.  

Robert A. Winn, MD, is vice president and current president-elect of AACI as well as director of VCU Massey Cancer Center.