Cancer moon shots

M. D. Anderson Cancer Center announced a $3 billion research program today aimed at six specific forms of cancer.

  • Acute myeloid leukemia and myelodysplastic syndrome (AML and MDS)
  • Chronic lymphocytic leukemia (CLL)
  • Lung cancer
  • Melanoma
  • Prostate cancer
  • Triple negative breast and ovarian cancer

These special areas of research are being called “moon shots” by analogy with John F. Kennedy’s challenge to put a man on the moon. This isn’t a new idea. In fact, a few months after the first moon landing, there was a full-page ad in the Washington Post that began “Mr. Nixon: You can cure cancer.” The thinking was the familiar refrain “If we can put a man on the moon, we can …” President Nixon and other politicians were excited about the idea and announced a “war on cancer.” Scientists, however, were more skeptical. Sol Spiegelman said at the time

An all-out effort at this time would be like trying to land a man on the moon without knowing Newton’s laws of gravity.

The new moon shots are not a national attempt to “cure cancer” in the abstract. They are six initiatives at one institution to focus research on specific kinds of cancer. And while we do not yet know the analog of Newton’s laws for cancer, we do know far more about the basic biology of cancer than we did in the 1970′s.

There are results that suggest that there is some unity beyond the diversity of cancer, that ultimately there are a few common biological pathways involved in all cancers. Maybe some day we will be able to treat cancer in general, but for now it looks like the road forward is specialization. Perhaps specialized research programs will uncover some of these common patters in all cancer.

Related links:

cancermoonshots.org
Ph.D. Comics on cancer
Bayesian clinical trials in one zip code

14 thoughts on “Cancer moon shots

  1. But survival rates for some specific cancers have improved greatly — e.g. childhood leukemia, testicular cancer, breast cancer — so there’s reason to hope that we can make progress in specific areas.

  2. It’s a poor analogy, I think. The moon landing wasn’t about “accelerating the advancement of knowledge” about space. It was a well-defined goal, and success or failure in reaching it would be clear to everyone.

  3. SteveBrooklineMA: I agree it’s still not as crisp a goal as “put an man on the moon and bring him safely back by the end of the decade.” But relative to most cancer research goals, this is well-defined.

    In 2003, the head of the National Cancer Institute announced a goal “to eliminate the suffering and death from cancer” by 2015. A well-defined and laudable goal, but absurdly optimistic. Though we have three more years, so we’ll see.

  4. I like how the success we feel about putting people on the moon, or robots on Mars, cascades into other areas. We get to feel as though we might be able to accomplish something like curing cancer. PZ Myers had a post with a dramatic graph about childhood acute leukemia[1] and it would be stunning to see similar progress in other areas. I do think we often gloss over what it is that’s so different between landing a person on the moon and “curing cancer” (or making serious progress in some other messy biological research area).

    [1] http://scienceblogs.com/pharyngula/wp-content/blogs.dir/470/files/2012/04/i-05244788173cf61dddb14383e60794fc-cancer_survival.jpg

  5. @iamreddave

    Part of the problem is cancer is highly correlated with age. To the extent that heart disease becames survivable people will die of the other causes, so the percentage of death due to cancer goes up as things like diabetes, aids, heart disease etc become more manageable.

  6. Do you have any references about this: “There are results that suggest that there is some unity beyond the diversity of cancer”?

    My father-in-law is with prostate cancer and I’m studying a lot of the literature about prostate cancer these days, even though I”m a political scientist, not a physician (but once you know statistics, it’s easier to understand the findings). In any case, I’m interested in learning more about cancer, and would like to read more about this unity you talked about.

    Thanks

  7. Manoel: Sorry, I don’t have a reference, just a vague memory of things I’ve read or heard. And I don’t know enough about biology to give any details.

  8. @Manoel Galdino

    Not necessarily a reference but something I’ve been told in my work at cancer centres: a lot of tumors involve the build up of lots of blood vessels in and around the tumor. It makes sense since the tumor is growing quickly it needs more nutrients than most normal tissue. So a whole class of drugs try to manipulate that fact either by restricting blood flow and starving the tumor or actually the opposite if the patient is going to get radiation. Blood carries oxygen and it is oxygen primarily that causes the damage during radiation treatment (radiation creates free radicals, they bind to the DNA and the DNA can’t be replicated properly during cell division and the cell dies) (hence also why anti-oxidants should be avoided when getting radiation treatments).

    So a large class of cancers can be treated by manipulating their higher need for nutrients.

  9. Not only are they focusing on cerrtain species of cancer, but for at least some of those species they’re not even attempting a “cure,” and for many subspecies of those species they’re not attempting anything. E.g. melanoma:

    “GOALS
    - Expand a multi-faceted prevention approach that includes education, screening and public policy to reduce melanoma incidence
    - Personalize and optimize clinical management strategies for patients with clinically localized disease through the integration of clinical, pathological and molecular endpoints and emerging therapeutic approaches.
    - Deliverables of this effort include reduction in mortality, improvements in quality of life, and optimized use of health care resources
    - Develop personalized combinatorial approaches for patients with stage IV (distant metastatic) melanoma to significantly improve durable (>5 year) disease control and survival
    - Develop new diagnostic tests and therapies that will facilitate personalized and improved care across the full continuum of this disease.”

    My translation: for some kinds of melanoma, try to: prevent people getting it, diagnose it better, tailor the treatment, lengthen survival time, reduce suffering, save money.

  10. One of the early versions was actually to cure a handful of cancers. The final announcement backed away from that.

  11. @nick studies often consider 5 or 10 year survival rates as “cured”. A patient might care if they get a secondary tumor and die at say year 12 but studies generally don’t care.

    Its harsh but some cancers (lung and melanoma being the easiest examples) are so dominated by risk factors under the populations control (lung ~80% smoking, skin cancer ~65% sun exposure) that changing the level of risk factors is probably a much better solution than spending a bunch of money to solve the disease afterwards. Similar to an alcoholic suffering from liver sclerosis rightly or wrongly their is less compassion/desire to donate and work on something caused by the patient’s behavior versus say a 1% improvement in adolescent leukemia.

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