I’m not a fan of the ‘fighting cancer’ metaphor as a battle cry; scores tallied—winners and losers. I prefer the judo allegory: leveraging one’s full, innate healing capacity—utilizing numerous tools and approaches—to make cancer, or any other condition or pathology, more difficult to take root or gain an upper hand.
For those with cancer, it’s a personal health challenge to gain knowledge to make informed decisions, and take semblance of control but, for all of us, there is an all-encompassing, national crisis in which we must engage.
The Reality of the Battle
The real travesty—the pitched battle most affecting the human condition—is not cancer itself. Cancer, and the often deleterious side effects of treatment, is largely the byproduct of harmful policy, and economic conditions run amok.
Cancer is largely, but certainly not exclusively, a profound symptom of our environment and actions—our own choices and activities, and the actions and decisions heaped upon us by others.
We’ve allowed cancer to permeate our society by creating a situation—political, economic, and environmental—conducive to its development. We’ve allowed a thriving cancer industry with vast profitability. In short, those that drive society have actively participated in making us an easier prey for cancer. As a result, millions suffer physically, emotionally, and economically in cancer’s insidious grip.
Cost of Cancer Treatment and Anticancer Drugs
As long as cancer treatment and drug costs are not contained, individuals and families will continue to go bankrupt in the face of life-limiting, and often life-ending, disease. Right now, protection in the form of cost-controls, cost transparency, and a single-payer system remains missing in action.
Currently, health care in the U.S. is a privilege, not a right. Cancer is an economic adversary for many. Countless people financing their own cancer care risk bankruptcy. Some opt not to be treated conventionally in order to preserve the finances of their families. Economic devastation, and the mental health challenges it spawns—this is the real cancer battle.
U.S. Government Kills Cancer Prevention Efforts
The Centers for Disease Control and Prevention (CDC) oversee the Prevention and Public Health Fund (PPHF) which was created in 2010 as part of the Accountable Care Act. The core purpose of PPHF is to provide vaccine coverage, respond to outbreaks of foodborne infections, deal with waterborne diseases, and develop programs to prevent the leading causes of death and disability, including cancer.
However, congress has been slowly defunding the PPHC for years. It has redirected billions of ‘prevention’ dollars to cover other priorities such as preventing a cut to physician Medicare reimbursements, and funding the Children’s Health Insurance Program.
In December 2016, the fund was cut again by $3.5 billion over seven years (fiscal years 2018-24) to pay for the 21st Century Cures Act. Yes, billions were shifted away from prevention and back toward cancer ‘cures’.
Prevention as Cure
The bulk of malignant disease can and should be prevented altogether.
The cancer connection to smoking, alcohol consumption, obesity, processed foods, inactivity, air quality, agrichemicals, and water quality is irrefutable.
A few years back, I wrote an open letter to former U.S. Vice President Joe Biden when he launched his then-named Cancer Moonshot initiative. Biden had recently lost his son Beau Biden to glioblastoma multiforme. His commitment to personalized medicine, including new immunotherapies, and his quest to bring stakeholders together to innovate and reach the market more quickly, remains commendable.
Comprehensive cancer prevention may not be sexy to most, but it is to me. Prevention is typically not cutting-edge. It rarely spawns new economic engines and powerhouse enterprises.
We’ve done a lousy job at communicating that Cancer prevention may be the only true ‘cure’ for many types of malignancy.
Cancer is difficult and expensive to cure. We need to ‘do’ prevention because it’s less costly than treatment and cure, and the byproduct of prevention is less suffering. Healthy people are more productive than sick people; they contribute greatly to the economy through their employers, or as industry leaders and entrepreneurs.
Imagine the impact a small organization like Biden’s, now named Biden Cancer Initiative (BCI), could have if it focused on the political impediments to cancer prevention.
As an example, there are a growing number of U.S. state laws limiting government control over food and nutrition policies. These deleterious decrees preempt the ability of states to protect their constituents via litigation against the food industry. “Local governments are in a prime position to address public health issues, such as reducing health disparities, providing nutrition information and access to healthy food, and regulating the cost of unhealthy food. Unfortunately, state preemption hinders public health progress by impeding local food and nutrition policies and [state] government-initiated litigation,” said Jennifer L. Pomeranz, assistant professor of public health policy and management at NYU College of Global Public Health and lead author of this study, published in American Journal of Preventive Medicine.
BCI focuses on spurring innovation and cross-institutional collaboration to bring new drugs to market more quickly. This is noble and important work; BCI is not alone, and certainly not one of the bigger players.
But imagine if BCI had taken a different approach—such as a ‘cancer prevention change-agent’? Imagine the considerable influence and skills of Joe Biden directed toward preventing millions of cases of easily-preventable lifestyle-driven cancers?
Could Biden ultimately help prevent more cancer, and achieve greater impact more quickly, by unleashing his political savvy against the wider cancer battle?
The lack of a coherent and properly funded prevention strategy is the larger ‘cancer battle’ we face.
Sadly, there are no substantive, well-funded efforts in the U.S. aimed toward preventing cancer through sensible prevention measures. Meanwhile, we subsidize farmers to manufacture cancer-causing, harmful processed foods, while relaxing environmental regulations and allowing unchecked carcinogenic chemicals to pervade our water, cosmetics, and household goods
We have allowed the drug industry to flourish. Cancer cases continue to rise, even while actual death from the disease has precipitously declined. We’ve created a situation where there are more, and longer-term, ‘chronic cancer survivor’ customers for pharma to service with uber-expensive, unaffordable drugs.
I am neither ‘anti-pharma’ nor ‘anti-standard of care’ for cancer treatment. We need innovation in cancer treatment, and a faster process to getting viable drugs and other interventions to market. But what we desperately lack is collective, organized voices and the political capital to turn the tide against new cancer cases through preventive measures.
The only guarantee with today’s trajectory firmly in place—read: more cancer cases and longer survival—is that this will not end well.
Apparently, the incentives for industry—pharma, health care, agriculture—are too powerful and politically expedient compared to the current clout of a growing community of cancer survivors, many being treated in perpetuity with a chronic disease.
This is the larger battle we face.