COMMENTARY

Dark Side of the Moon: Destination for Cancer Moon Shot?

Bruce D. Cheson, MD

Disclosures

March 04, 2016

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Hello, again. This is Bruce Cheson, from Georgetown University Hospital and the Lombardi Comprehensive Cancer Center, talking to you from Medscape Hematology.

Today's installment was precipitated by the recent announcement by President Obama of the "moon shot," where out of his $4.1 trillion budget, he was going to assign almost $1 billion toward curing cancer. This would be over 2 years, and Vice President Joe Biden is going to be put in charge of this 2-year project—two guys who are going to be around for less than a year.

It's great. I mean, it's great that someone really wants to pay attention to cancer, and that a president has really stood up, and we're going to get things done. Yes, but then there was the National Cancer Act in 1971, signed by President Nixon.[1] And 55 years later, where are we?

The dark side of the moon. That may be where the moon shot ends up, unless things are done carefully, and unless we have a whole lot of luck.

It's a good idea, but let's not forget a few things. Yes, I already mentioned the National Cancer Act flub. Then, there was the idea of the moon shot—JFK's moon shot: Let's send men to the moon.[2] And that program is kind of defunct.

I guess one of my biggest concerns is, how is such an enormous budget going to get through a Republican Congress? I just don't see it happening, at least in the foreseeable future. There's a bit of naivety in here as well.

Number one, cancer is an innumerable number of diseases that are so biologically distinct. Yes, they want us to cure it, but there are so many of them.

We also need to look at prevention. I mean, yes, we can cure cancer, but if we don't prevent it [we are missing an important opportunity]. And cancer, in most cases, is a preventable disease.

 
We need a Kumbaya moment...Yeah, like that's ever going to happen.
 

But I think the biggest problem is the concept that we need a Kumbaya moment: All the cancer centers need to get together, join hands with all the investigators internationally, and work together. Yeah, like that's ever going to happen. It would be nice.

It reminds me of a book that I just finished, Vince DeVita's The Death of Cancer.[3] In 336 pages, he told us about how he made all these big bits of progress that have advanced the field of cancer. He and Jay Freireich[4] were instrumental in so much. That's what I kept reading about in the book. He stated there that we are at the beginning of the end.

 
Right now, cancer is damn smarter than we are.
 

Well, this has been going on for a long time. It's not just money, and it's not just working together—both of which would be great. But it's a better understanding of cancer. Right now, cancer is damn smarter than we are. We're catching up, but we have a ways to go.

There's a lot of hyperbole in this moon shot thing. It would be nice if it would happen, but somehow I am a little bit skeptical that the current program in the current political climate will get us to where we want to go.

This is Bruce Cheson, signing off again for Medscape Hematology. Thank you to my friends Pink Floyd. And I look forward to speaking to you again in the near future. Goodbye.

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