Scientist Offers Plan for Reducing Cancer

John Mendelsohn, president of the University of Texas M.D. Anderson Cancer Center, released a 10-point plan to reduce the incidence of cancer and prevent its recurrence at a Newsmaker program on Feb. 17.

He noted that nearly 40 percent of Americans will develop cancer during their lifetime. While cancer survival rates in the United States have doubled over the past 50 years and death rates have fallen, cancer still accounts for one in every five deaths among Americans, according to the National Institutes of Health.

Highlights of the plan are:

1. Cancer therapy research should focus on human genetics and the regulation of gene expression. Most cancers involve several abnormally functioning genes. Screening for genes and their products can be done with new techniques that dramatically reduce the time involved in determining the proper course of treatment. They include new diagnostic molecular imaging and immunotherapy.


2. Develop better tests to predict cancer risk and enable earlier detection. New predictive tests are based on abnormalities in blood, other bodily fluids or tissue samples. Such tests may predict the risk of cancer in individuals and detect cancer in its early stages long before any symptoms appear.


3. Practice preventive care beginning with a risk assessment and counseling of a person when no malignant disease is present. Risk factors include inherited or acquired genetic abnormalities and those related to lifestyle and the environment. Mendelsohn noted that the largest risk factor for cancer is tobacco smoking, which accounts for nearly one-third of all cancer deaths. He stressed that educating the public about the causes of cancer is a key step to prevent or lower the risk of disease. “Quit smoking, have regular health screenings, exercise and stay trim” to lower your cancer risk, he advised.


4. Make the needs of cancer survivors a top priority. Since many patients are surviving their cancers or living with them, helping them to manage all the consequences of their disease, such as pain or drug-related side effects is essential.


5. Train future researchers and cancer care providers. NIH and other funding sources must designate more of their budgets for young academic researchers to enable them to start their careers.


6. Increase federal funding. The National Cancer Institute budget nearly doubled between 1998 and 2002, but has declined for the past four years. Through budget cuts and inflation, the NCI budget has lost about 12 percent of its purchasing power. “We need stable and steady funding” in order to be able to plan and carry out research projects, Mendelsohn said.


7. Accelerate pace of clinical research. Greater participation in clinical trials will speed up drug development, in addition to providing patients with the best options if standard treatments fail. At the same time, the potential risks and benefits of clinical trials must be fully disclosed to patients involved and the trials must be carefully monitored.


8. Develop partnerships to shorten the time for drug and medical device development. “We need more collaboration between academia and industry, among academics and across disciplines,” Mendelsohn said.


9. Provide access to cancer care for everyone who lives in the United States. More than 47 million Americans are uninsured and many are underinsured for major illnesses like cancer. Mendelsohn said a solution will require give-and-take among all stakeholders.


10. Design a new system of payment that rewards outcomes and use of preventive services. “If we paid for performance and outcome, there would be an incentive to do things more efficiently. Instead we are paid for each procedure and this results in unnecessary testing to avoid lawsuits,” Mendelsohn said.

Mendelsohn also called for standardizing electronic medical records. He advocates making the data accessible nationwide so patient information is available to multiple providers at multiple sites. To the extent that data mining might compromise patient privacy, Mendelsohn said it is essential to find a balance between protecting patient information and obtaining medical data that could improve the overall quality of health care.

On the administration’s health care reform efforts, Mendelsohn supported the idea of a White House health care czar. He suggested that anyone chosen for the position should have an expertise in both health care and economics given the key role that he believes health care reform will play in the economic recovery.