Forty years ago this month President Richard Nixon launched the "War on Cancer". In his State of the Union address delivered on January 22, 1971, the President said, "I will also ask for an appropriation of an extra $100 million to launch an intensive campaign to find a cure for cancer, and I will ask later for whatever additional funds can effectively be used. The time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease. Let us make a total national commitment to achieve this goal." This led to the signing of the National Cancer Act in December, 1971 which was intended to financially strengthen the National Cancer Institute to more effectively carry out a national effort against cancer.
So where are we in January, 2011? It can be a bit discouraging to think 40 years have passed since that important piece of legislation was enacted and people are still being diagnosed with, and often dying from, this insidious disease. While great strides have been made since 1971, including a better understanding of the genetic components underlying certain cancers and substantial leaps forward in the development of more effective, less toxic, targeted treatments, those accomplishments offer little comfort when one loses a mother to metastatic breast cancer, a spouse after a long battle with colon cancer or a friend to pancreatic cancer.
Cancer's reach is global but its burdens can often feel local, indeed highly personal, especially for the caregivers, family members and friends who stand beside their loved ones as they undergo treatment. Cancer is an extraordinarily complicated disease for oncologists and researchers to understand; it can be doubly frustrating for those in the trenches–patients and families who are trying to determine where and who to turn to for opinions, treatment plans and support resources. To add to the seeming confusion, recommendations and treatments are constantly changing. One year a team of experts recommends that women receive mammograms every year after the age of forty while the next year, a different panel suggests that women receive mammograms every two years after the age of fifty. Men are perplexed about whether PSA screening for prostate cancer is recommended or not. For a while a drug like bevacizumab (Avastin) seems like a promising treatment for women with advanced breast cancer and then suddenly the FDA recommends pulling it from the shelf as a standard treatment for that illness but continues to approve its use for other cancers. Media reports talk about promising cancer detection and treatment breakthroughs, like the recent blood test that might someday be able to detect microscopic cancer cells, but if, when, and how such a test might enter practice is uncertain.
Nonetheless there is some cause for celebration and much reason for hope. Progress in cancer research and care is not as rapid as we might hope. Nonetheless, overall mortality from cancer continues to drop each year in the Unites States, and that is in large part thanks to our continued efforts to understand the many different ways this disease works. Now is not the time to take a break from all of our hard work – it is the time to continue pushing through any barriers that may stand in our way so we can continue to improve our understanding of cancer biology, develop more effective treatments and identify new prevention strategies. In order to do this, of course, we will need to garner resources to attract the best minds to the challenge and provide the things that they need to thrive and succeed. Critical to their support is continued funding from the National Institutes of Health, the single largest supporter of cancer research in the United States. Equally critical is the commitment to move promising findings into clinical investigation and ultimately into clinical practice.
This month our federal government will begin to implement the first elements of health care reform through the Affordable Health Care for America Act. In addition those charged with passing the 2011 federal budget will review expenditures including those for important entities like the National Institutes of Health. Legislators in Harrisburg are also confronted with a large budget deficit and must make tough decisions. Surely few issues are more important than cancer, which affects 1 of every 2 men and 1 of every 3 women in the US during their life time. I encourage everyone to pay attention to these issues and to do what they can to support continued funding for cancer care and cancer research. This is a time for continued investment to build on the momentum in cancer discovery.
While we advocate on behalf of support for cancer care and research at a national and state level, we at UPCI and UPMC CancerCenter will continue to do our absolute best to serve our patients and our community. As we continue the celebration of our 25th anniversary year, we promise to conduct the very best research, provide the most state-of-the-art-care, and serve as the most trustworthy source for information about cancer. These are our resolutions for the 2011 and we intend to keep them!