Imagine a world free from cancer in our lifetime. It’s not a dream, but a mission rooted in past progress. Since 1990, the number of cancer survivors has doubled—from 6 million to 13 million—thanks to new cancer medicines. These new therapies have extended life by about 43 million life-years. These are not additional years of pain and desperation. Every dollar we spend on new cancer medicines reduces spending on hospitals and doctors by $7. And the added value of these longer lives is about $4.7 trillion. All told, such innovative treatments account for about 1% of total health-care spending.
We have made great strides in freeing millions from the threat and suffering associated with cancer. We can do more. Much more. However, business as usual won't cut it. Current research and cancer treatment is broadly focused on the disease patients have, not on the patients who have the disease. To accelerate innovation and create A World Free From Cancer by 2050, we need to make cancer treatment predictive, personalized, preventive, and participatory. Here's how:
1. Put patients in charge of cancer research.
In the 1980s, AIDS activists took control of the HIV research agenda, while knowing little about the disease except that it put thousands of lives in jeopardy. Today, cancer patients can use online communities to test treatments, design studies, and determine better ways to tackle their illness. We are already keeping tabs on our health and progress with fitness monitors and computerized tablets. Research should be shaped by these real-time, real-world experiences, in combination with discovering what genetic mechanisms make their particular kinds of tumors tick. Dr. Eric Topol, author of The Creative Destruction of Medicine, observes, ”It is time for a jailbreak; it is time for the rise of the consumers to drive the future of medicine. It is their DNA, their medical data, their cell phones, and their own health at stake.”
2. Replace one-size-fits-all research with personalized cancer studies.
The Human Genome Project gave us faster ways to sequence DNA. It took nearly a billion dollars and 10 years to develop a detailed map of the human genome. Now we can sequence an individual’s genome, or a tumor’s genome, in a few hours, and for under $500. With these innovations, we can now personalize medicine very specifically: my illness, my cure. Several cancer organizations, including the International Myeloma Foundation, StandUp2Cancer, and the Sarcoma Foundation of America, run research programs that require researchers to look for genetic cues that could lead to cures. That should be the rule, not the exception.
3. Cut the time it takes to develop new cancer medicines to as little as 2 years.
It takes even longer to develop new cancer medicines (8.8 years on average) than to develop other drugs. Most of that time and effort is spent on testing medicines in people who we know won’t benefit from that drug. If we simply focus on the individual tumor’s specific cancer-causing genetic mutations, we can rapidly find which therapies will work. That would mean approving cancer therapies as fast as HIV medicines were developed: in 2 to 3 years.
4. Require that health plans pay for personalized medicines.
Advances in cancer treatment are saving lives and cutting health-care costs. But many health-insurance plans haven’t caught up with the times. Nearly half of all cancer patients are forced to choose the treatment that is covered by their insurance, instead of being able to choose the treatment that would be most likely to save their lives. Insurers should pay for the right treatment, targeted to the right individual, instead of finding a way to shift costs to patients.
5. Create Charter Cancer Communities that focus on the value of care.
Under existing health-care regulations, decisions on how to treat cancer are often based on who gets paid, rather than on the true value of care. Innovations that save money are pitted against services that lose money. Like public charter schools, Charter Cancer Communities will have greater flexibility to use and pay for the combination of treatments that deliver value. And they will be accountable to their member organizations and to the patients they serve.
6. Ignite the movement to create A World Free From Cancer
We can all share in creating A World Free From Cancer by taking these and other actions. We must change how we develop and practice medicine. Our current approach has given us longer life and greater prosperity, but it is outdated and often reactionary.
It is our mission and our moment to remake medicine. It is both our choice and our challenge. It is time to cast off our old ways and create A World Free From Cancer.
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