Some thoughts on the president’s cancer “moon shot”

It has been a couple of weeks now since Vice President Biden started work on the cancer “moon shot” initiative that President Obama announced during the State of the Union speech to Congress on January 12.

Your sitemaster is a great believer in investment in medical research in general and cancer research in particular. Investment in such research creates jobs, often leads to the development of new and useful products and services, and can help to save and extend lives. In addition, the knowledge generated can often have implications way beyond the immediate medical research fields in which the investment is initially made.

On the other hand, cancer is complex. It is not one disease; at best it is several hundred slightly different diseases, and at worst it may be several tens of thousands if not millions. Actually curing even one form of cancer will rarely lead us to a situation in which we can immediately see how to cure a second one.

I write this not because I think the cancer “moon shot” is more hype than substance but because we need to be reasonable and sensible in setting our goals and our expectations.

At present, the proposed budget for the cancer “moon shot” is of the order of $1 billion to be spread over several years (so-called “multi-year spending”). About $750 million of that funding is earmarked to go the the National Institutes of Health (NIH). There is already $195 million going into the NIH this year. Then there will be some other monies for related agencies (e.g., the Food and Drug Administration).

But here are a couple of facts that are relevant:

  • The National Cancer Institute already has an annual budge of the order of $5 billion.
  • The approximate cost of President Kennedy’s successful attempt to put a man on the moon by the end of the 1960s was of the order of $20 to 25 billion in 1970s dollars.
  • If the $20+ billion dollars spent on the original moon shot is converted to 2016 dollars, then it would equate to something more like $125 to $150 billion today.

Thus the currently proposed budget for the cancer “moon shot” is about 1/125th of what was actually spent to put a man on the moon (or less).

The great unanswered question that needs to be clearly addressed is going to be: how do we use the proposed, additional $1 billion to make cancer research far more efficient than it has been to date? If we can’t do that first, then we will continue to fritter away much of the $5 billion each year that goes to the National Cancer Institute to provide grants for everything from the most basic research to sophisticated clinical trials.

As far as The “New” Prostate Cancer InfoLink is concerned, the best possible use of that $1 billion in “moon shot” monies would be to fund a single, highly efficient, and effective cancer information and data-sharing warehouse linked to a Watson-like data processing computer so that we could do away with all the siloed and currently unsharable information that exists on tens if not hundreds of thousands of different computers scattered across American and the rest of the world. This can be done through the use of data de-identification systems without placing anyone’s individual and personal data at risk, and it would help us massively in working toward things like standardized data registries for all patients with specific types of cancer (yes, prostate cancer specifically included).

3 Responses

  1. I am sure ole joe not wasting too much time on this.

  2. Assuming that by “old joe” you mean Joe Biden, he has actually been spending a lot of time on this over the past several weeks. The primary reason for the project was driven by his son’s death from a brain cancer.

  3. $1 billion over several years is nice, and I think it is a great idea to concentrate it to one purpose, like an enhanced national cancer registry. I’d also like to see a West Coast NCI Research Center to give greater access to clinical trials to people who may be too ill or inconvenienced to travel to Bethesda for diagnostics and treatments.

    On the other hand, the President just asked Congress for nearly $2 billion over 2 years for Zika virus research and preparedness. That, for a disease that seems to be symptomless and may cause birth defects in a small proportion of pregnancies. Compared to that, the cancer “moonshot” is not all that impressive.

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