Despite president’s call, many cures needed for many cancers

In his State of the Union address, President Obama called for an effort to “cure cancer” led by Vice President Joe Biden. The idea seems like one everyone could accept. Who’s against curing cancer?

The disease kills almost 600,000 annually, and there are almost 1.7 million new cancer diagnoses each year, according to the American Cancer Society. But two challenges would have to be overcome. One, curing cancer would take a lot of money. Two, cancer is many diseases, not just one.

“We as cancer researchers and physicians have to do a better job of educating the public that there’ll never be a single cure for cancer because cancer is not one disease but in fact hundreds of diseases,” said Peter Emanuel, a medical oncologist and director of the Winthrop P. Rockefeller Cancer Institute at UAMS. “Some cancers we’ll find cures for, whereas other cancers will turn into chronic diseases, but there’ll never be one magic bullet, one single cure that’ll cure all of the various, various kinds of cancers that we have.”

For example, Emanuel said there are many types of lung cancer, and they are often caused by a specific genetic mutation where a drug works very well treating a small percentage of patients but not well with most others. Raye Rogers, a 90-year-old with stage four lung cancer, has been on a pill for three years and is in remission with almost no side effects, but that pill wouldn’t work with most lung cancer patients.

TARGETING CANCER MUTATIONS
Emanuel said researchers are seeing success with therapies that target the specific mutations causing the cancer. Another area of success is employing checkpoint inhibitors that take the brakes off the body’s immune system so it can better attack the cancer.

Both of those processes have been approved by the Food and Drug Administration. Not yet approved are efforts to genetically engineer white blood cells outside the body so they will attack the cancer once they’re returned to the body.

Jan Burford, president and CEO of CARTI, the Central Arkansas Radiation Therapy Institute, said progress has been made recently, with new drugs approved for melanoma, breast cancer, pancreatic cancer and kidney cancer. But the cost of some of those drugs are astronomical.

“We used to think $3,600 was incredibly high for a drug, and now we’ve got two (for leukemia) that are $15,000 a month,” she said.

CANCER POLITICS AND FUNDING
This is not the first time a president has called for a national effort against cancer. In his 1971 State of the Union, President Richard Nixon called for the United States to make the same kind of effort to conquering the disease as occurred in putting a man on the moon. Later that year, he signed the National Cancer Act into law.

Politically, U.S. Rep. Rick Crawford, R-Jonesboro, said there’s a limit to what the White House can do in the fight against cancer. What the White House can do, Crawford said, is advocate for the effort, set realistic goals with success measures, and work with the private sector, realizing that “tax dollars are a finite resource.” Crawford said the National Cancer Institute at the National Institutes of Health received a raise from $4.9 billion in fiscal year 2015 to $5.2 billion for 2016 in the recent omnibus bill.

“I don’t think that on either side of the aisle, anyone would disagree with the fact that we need to beat cancer,” he said. “I think where we run into the problem is, are we just going to ‘blank check’ this thing without any standards for progress, or are we going to try to harness every available mind that we can, private sector, public sector, and make the highest and best use of the funds that we have available to make this a reality?”

During the State of the Union address, Crawford wore a #TeamJonny bracelet in honor of Jonny Wade, an eight-year-old who died in December from brain cancer. His mother, Kimberly, had created a Facebook page to raise awareness about the disease and was at the State of the Union address as a guest of U.S. Rep. Rodney Davis, R-Ill.

For Crawford, a skin cancer survivor, the fight against the disease has special meaning. Crawford had a growth about five years ago that was removed via a Mohs surgery without chemotherapy and radiation. About a nickel-sized piece of flesh was cut away and then the skin reconstructed.

“Is this a Kennedy-esque statement that is geared toward securing a legacy?” he said of Obama’s call. “I don’t know. I mean, I’m not going to question his motives, but there sits Vice President Biden who just last year buried his son who succumbed to cancer. It was a poignant moment, I will grant you that. I don’t know what the president’s plan is other than to just say, ‘Here, we’re going to spend more money,’ but I would be willing to hear what plan he has and how he envisions a race for the cure, to coin a phrase, and how that is put together in his mind because just a checkbook will not get it done.”

MORE MONEY NEEDED, BUT NOT THE ONLY ANSWER
UAMS’ Emanuel said if Congress were to approve $100 billion next year to fight cancer, then cancer would not be cured. Medical research doesn’t work that way. It takes time, it must be sustained, and it’s composed of hitting mostly singles rather than home runs.

But more money would certainly help. Emanuel said doubling the National Institutes of Health’s current total budget of $32 billion “would markedly improve medical research in this country” because it would increase the number of clinical trials and the small percentage of grant proposals that are funded.

CARTI’s Burford, who lost both parents to cancer, said medical providers are already curing cancer. In addition to cures, what’s also needed are ways to prevent cancer, or at least catch it much earlier, she said. Cures are often dependent on how early cancer is diagnosed, which can be difficult with certain types of cancers that don’t have symptoms until the cancer is advanced. As Emanuel pointed out, tobacco and obesity are responsible for many cancer deaths.

“Prevention is way cheaper than treating cancer,” he said.