Greetings on this late-winter afternoon. My hope for the coming of spring has been sparked as I watch the first Phillies spring training game on TV. Thinking about spring makes me consider this dark winter, which will, as always, be followed by new growth and renewal. In this moment I derive inspiration from all that we have accomplished.
We are in the most glorious era of scientific discovery and its application to improved health in the history of humanity. While some would point to the practical benefits of sanitation, vaccines, antibiotics, anesthesia and the use of surgical sterile techniques, these profoundly impactful advances were in retrospect fairly low-tech solutions. Consider if you will the work of Edward Jenner, whose development of the smallpox vaccine in the late 18th century was based on keen observations and required no new technology development.
In the past 80 years, accelerated scientific discovery has transformed cancer outcomes. Just think of it: DNA and RNA were discovered, the entire human genome was decoded, the genetic basis of cancer was established, the building blocks of human immunity and the anti-cancer immune responses were deciphered. Advances in chemistry led first to commonly employed chemotherapy drugs and then to highly specific targeted therapies. Advances in protein engineering and immunology begat monoclonal antibody therapies and immune checkpoint antagonists. A better understanding of cancer causation, such as tobacco use, led to highly effective strategies to reduce those risks and save lives. Technological advancements enabled the development of CT scans, MRIs, PET imaging and advanced mammography techniques. Increasingly sophisticated laboratory methods make it possible to analyze people and their cancers, allowing clinicians to tailor therapies that are best for each patient. Improved understanding of how to communicate and collaborate with our patients and the communities we serve has provided the impetus to move toward care for everyone. Importantly, we have learned how to mitigate the symptoms too many cancer patients experience. All this in the course of a single average lifetime. It is nothing short of breathtaking.
These advances have led to important outcomes. When the National Cancer Act was signed in 1971, a newly diagnosed cancer patient had an approximately 50% survival probability. Now, that probability is about 70%, and with continued progress that number will only increase.
I was on a Zoom meeting with other cancer center directors on Friday when Acting NCI Director Doug Lowy noted that the advances just in the past 30 years have accelerated this progress. The NCI and the NIH have been pivotal in driving and supporting this progress against a collection of diseases that have long been among humankind’s greatest nemeses. Given the promise of extraordinary new discoveries such as AI to drive progress, we are poised to take another leap forward. This is no time to stop, no time to “take a pause.”
Yet that is what has happened in just one month. New directives have slowed or threatened to stop research and harm the NCI and NIH missions in a way that will not advance the common good. The federal government and pharmaceutical industries have long relied upon the academic sector as the primary drivers of discovery and implementation of those discoveries. The mechanisms in place have been stunningly effective. The return on investment in research has been enormous: In addition to the millions of lives that have been saved or improved, this research has generated billions in downstream economic activities and created countless jobs for highly skilled and unskilled workers. Undoubtedly, there are opportunities for improvement and even for greater efficiencies — there always are. Any thoughtful and knowledgeable person would acknowledge that. But detonating dynamite to annihilate the infrastructure of so much progress is not disruptive, it is destructive.
The cures we offer today are built by the research we did years, even decades ago. The students and early-career investigators who do the work of today cannot be easily replaced or discarded like dishrags. The loss of a generation of discoverers imperils the future health of our nation, of our world, and will make the world an unhealthier place for our children and grandchildren. They deserve better. What a terrible waste; what a dismal legacy.
What can we do? There is one thing about which I am certain: I will fight for the future. We all should. We find a way to continue the work, to keep the flame alive until we are able to fully resume our quest, which remains one of the noblest efforts in human history.
Make the world a better place this week. It’s never been more important. Spring is just around the corner.
Lou
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