Annual Progress Report from the National Cancer Institute

By Coping Magazine 27 Jul, 2023 CANCER CANCER NEWS

Dr. Monica Bertagnolli

Reflecting on Progress Toward Ending Cancer As We Know It:

It Takes All of Us

by Monica M. Bertagnolli, MD, director of the National Cancer Institute

It is my pleasure and honor to write the 29th annual progress report from the National Cancer Institute (NCI) for Coping^®, an invitation that has been extended to the NCI director annually – since 1994. This was right around the time I started my career as a surgical oncologist. I have witnessed firsthand important progress since that time: the cancer mortality rate has declined by a very impressive 30%; we understand tumor biology in ways that we never have before; effective therapies are available for previously untreatable cancers; and we have technologies that can find cancer before it becomes deadly. Still, there is much more work to be done. I am confident that the cancer community can build on the progress already made to help more people with cancer live the full and active lives they deserve and to reduce the chance of a cancer diagnosis whenever possible.

Why we do what we do

In light of the progress made in cancer research and care since the last NCI progress report was published, I am pleased to remind us all of important work specific to the community served by Coping: It is for the more than 18 million (and growing number of) survivors of cancer throughout the United States. We have access to technologies, knowledge, and approaches in cancer prevention, detection, treatment, and survivorship that we could not have even imagined just decades ago. It is critical to ensure that these advances reach the “last mile” – every person for whom that would mean a significant change in their survivorship experience, especially the medically underserved.

A personal story and tribute to research participants

I have served patients as an oncologist for over 35 years now. Less than a year ago, I found myself on the other side of the patient-physician relationship with my own cancer diagnosis. My experience has given me such an important additional perspective, that of a survivor. My cancer was found during a routine screening, and, thanks to early detection, my prognosis is excellent.

I am profoundly grateful to the incredibly brave and generous patients who volunteered to participate in cancer clinical trials, without whom we would not have any of the life-altering screening, diagnostic and treatment approaches that we have today. From the mammogram that detected my cancer, to the treatments I received, to the science to identify behaviors that can improve my quality of life as a survivor – every step in my journey so far as a cancer survivor was made possible by the collective efforts of the entire cancer research and care community, and by many courageous people affected by cancer who participated in research.

Some of you reading this are in the waiting room of a cancer center or hospital, preparing for the next step in your survivorship experience. I was there, too, and I hope you know that you are not alone and that all of us at the National Cancer Institute are doing everything we can through research to help more people with cancer live full and active lives and to help prevent cancer whenever possible.

A great deal of our focus at NCI is on those diagnosed with cancer who do not have access to the quality care and treatment they need and deserve and on those with cancers for which we lack effective treatment options. We have so much more progress to make.

Making cancer clinical trials more efficient, accessible, and inclusive

One area of critical importance is clinical trials. We have powerful clinical trials networks across the entire country that are bringing research into the communities where people live and are connecting patients with trial options they might otherwise not know of. Every person with cancer, at risk for cancer, or anyone else who wishes to participate in research, should have the opportunity to do so. It is the contributions of these participants that generate new findings required to improve approaches to all aspects of cancer, prevention, screening, diagnosis, treatment, and survivorship.

To this end, NCI has been taking important steps toward modernizing clinical trials. We need to make it easier for people to join studies, and we are doing so by testing new, more streamlined study designs, working with public and private partners and the research community to bring innovation to the way we evaluate new clinical approaches. NCI is dedicated to removing many of the barriers that prevent people from joining clinical trials and to improving the diversity of participants so that studies are more representative of the real-world patient population – those who would benefit from the results.

Eliminating inequities

Addressing health disparities is a core goal underlying all NCI activities. In partnership with the entire cancer research community, we are making important progress in enrolling people from diverse backgrounds in clinical trials through nationwide community-based clinical trials networks. To ensure that the results of research apply to all people, one program aims to include more people from underrepresented racial and ethnic minority populations through multilevel, culturally tailored outreach and education efforts. We also support many programs focused on bringing evidence-based information and resources about cancer prevention, screening, and treatment to racially and ethnically diverse communities and to people living in rural areas throughout the country. Such efforts are designed to bring the benefits of research to more people, and also to specifically address inequities responsible for some people experiencing higher rates of cancer and worse outcomes after a cancer diagnosis.

Data sharing

Another area where we are making great progress is data sharing. The NCI-led Childhood Cancer Data Initiative, or CCDI, is a great example of our work in this area. To supercharge research for our youngest cancer patients, CCDI is building a national-level platform that will enable sharing of clinical care and research data from every child, adolescent, and young adult diagnosed with cancer, regardless of where they receive their care. This unified effort can help us learn faster and on a much larger scale than any single institution can achieve on its own. For the first time, we have a data catalog in a singular place where anyone can search information on what data are available: the Childhood Cancer Data Catalog.

Efforts are also underway involving public and private partners working together to establish a standardized, shareable health record and to connect families with the knowledge and resources they need to access the best care and research opportunities for their child.

Working together

A reignited Cancer Moonshot was announced by President Biden last year, and he challenged us to reduce cancer mortality by 50% in the next 25 years and to improve the experience of survivors and their loved ones. To reach these critical goals will require action across many different aspects of society. Everyone has a role in accelerating progress toward ending cancer as we know it.

To this end, NCI has developed, in collaboration with partners across the cancer community, a National Cancer Plan with eight key goals, including several that everyone can contribute to (see sidebar).

We are already making important progress toward each of these goals. We know that we will make better progress by applying current best approaches to increase uptake of proven screening methods, reduce tobacco use, and increase access to more effective treatments like therapies that help a person’s immune system better fight cancer. Yet, if we merely continue what we already have in our arsenal to combat cancer, we will fall short of the Cancer Moonshot goal of a 50% reduction in the cancer mortality rate by 2047. We must ensure that progress is made for every cancer, including those that are rarest and hardest to treat. We will not have ended cancer as we know it until everyone benefits from advances in research and care.

To be successful, we need to intensify and combine efforts from across the entire continuum – from the bench to the bedside, translating discoveries about cancer biology made in the laboratory to patients at the hospital or clinic. Every effort matters.

With all of us doing our part, we can bring about the changes we wish to see for the benefit of everyone with cancer and those at risk for cancer – our families, friends, neighbors, colleagues – and the ones closest to them. I look forward to witnessing what we can achieve together in the next year.

To learn more about cancer and its treatment, visit the NCI website – www.cancer.gov. There you’ll find accurate, up-to-date medical information, as well as videos and print materials, on cancer. You can also talk to trained information specialists with the NCI Cancer Information Service in the United States, in English or Spanish, by calling 1-800-4-CANCER. Additionally, if you or someone you know needs more information about how to quit smoking tobacco products, NCI has a Smoking Quitline at 1-877-44U-QUIT. Helping people quit smoking and limiting exposure to secondhand smoke can save lives.

Since 1994, the National Cancer Institute has written an exclusive annual report for Coping.

This article was published in Coping^® with Cancer magazine, Fall 2023.