War on Cancer

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I see people dying of cancer. I look into their eyes and they tell me, do you have any more drugs? Do you have something else to give me? And the answer is no. You know it's 40 years since Nixon declared the war on cancer. We've sequenced the human genome. We've sequenced the cancer genome.

We've learned a tremendous amount about cancer. We're not that much better in general at treating cancer. We have actually made progress but not enough. We are making strides against cancer, not enough of course. We're no better at treating cancer today than we were five decades ago, and so it worries me literally every night.

I have patients under my care and I worry for them, I worry for other cancer patients across the country who contact me. We have to do better. There're some cautions we need to take in terms of environmental pollutants. There're some cautions we need take in terms of drugs and medications and of course sun avoidance which can actually prevent a lot of skin cancers both squim cell cancers that are more of an annoyance as well as some of the melonomas that can actually kill.

You know cancer will metastasize to the liver in some cases because it likes to live in the liver. So it's incumbent for us to change that soil so that the cancer won't be there anymore. 20-22% of Americans still smoke cigarettes and know it causes 15 different kinds of cancers. We don't need to target the cancer cell per say, we can target the body, our complex system and make it so that cancer does not like to grow.

To me cancer is a verb. You are cancering. I don't want take you from that verb state 'cancering' to a health state. I don't necessarily just want to shrink the cancer because that may not make you live longer or better, but I want to take you from your cancering state to your health state.

Good diet, physical activity, trying to maintain as close to a normal body weight as possible in the area vaccines, hepatitis B vaccine and HPV vaccine actually does prevent some cancers. But you've seen death rates from cancer drop by 1% per year for the last ten years after going steadily up before that, but we have a lot of work to do.

Obesity, bad nutrition and lack of physical activity is like a three legged stool, and it is now the second leading cause of cancer. In the next 10-15 years, it could surpass tobacco as the leading cause of cancer. We have to start to do what they did in the Manhattan Project, is get people from various disciplines to work together as a team.

This notion of individual science should dead, it's all about team science now. We need to motivate teams to work together to hope they get an answer and a new way to treat this devastating disease. What is happening in the basic science of cancer is breathtaking. We really understand at the most detailed level what causes cells to grow out of control, the challenge is to take that information and change it as quickly as possible into new targeted therapeutic.

Finally we have mature technologies now genomic being the first. The hope is over the next decade we then use them in the actual management of more patients. So it's been on the learning phase for the last decade now than any technologies. Now hopefully the application phase. In the midst of these remarkable revolution of understanding, what makes a good cell go bad and become malignant on the basis of mutation today because we can read those app now.

What we need to do now is take that base fundamental understanding and do things differently. We need to try to figure out a new way to approach disease because this is not working. Unnecessary surgeries, unnecessary chemo therapy and the world of oncology. Some of the screening that's being done is actually our concern causing some of this necessary harm.

The problem with making therapeutics work is the pipeline is too long and the failure rate is too high. There's an 18% decrease in risk of death for Americans from 1991 to 2008. Breast cancer 30% reduction in risk of death, colon cancer 33% reduction. There's no doubt that colon cancer screening saves lives, yet less than half of adult men over the age of 50 have ever gotten colon cancer screening.

It just doesn't make sense. My job is to make people live better and longer. And even if they succumb to a disease and I helped them live a better and a quality life, I've done a good job, that's what makes me feel good, but at the same time it's difficult, but the hope is I can make a difference.