Inside a "Cancer Moonshot" Meeting with VP Biden

5/10/2016

When Vice President Joe Biden visited Duke University this February for a roundtable discussion on cancer, he was flanked by clinicians, researchers, and advocates, and had an audience of dozens of high-profile figures. Biden spoke about the recently announced, $1 billion “cancer moonshot” initiative and asked panelists for their insights and perspectives.

One researcher at the table was Stephanie Wheeler, MPH, PhD, associate professor of health policy and management at the University of North Carolina Gillings School of Global Public Health. She explained to the vice president how cancer disparities – a main focus of her research in public health – are a challenge in cancer prevention and control.

Wheeler has been investigating health disparities since she started her career in sub-Saharan Africa, initially working with women who had HIV/AIDS. With funding from an American Cancer Society grant, she is currently investigating the reasons why, in minority communities, a number of breast cancer patients do not follow through with doctor-recommended endocrine or anti-estrogen therapy – a treatment that can help reduce the risk of breast cancer recurrence and breast cancer-related death.

“The vice president was interested in learning about the work we were all doing. He asked a lot of questions and listened very carefully,” Wheeler said. “He spoke earnestly about why cancer research is a priority and why it’s one of the greatest contributions our generation can make. It was very inspiring.”

Prevention Efforts Are Crucial

The cancer moonshot initiative has been widely praised and supported in the scientific community. However, many public health experts are concerned that the initiative does not focus enough on the role of public health and prevention. This week, deans of 70 US public health schools sent the vice president a letter expressing this view.

After stating their strong support of the goals to find cancer cures and reduce cancer mortality, they wrote “the initiative may be undervaluing the vital role that public health and prevention have played – and must continue to play – in reducing cancer incidence and mortality. Since the beginning of the ‘War on Cancer,’ the most notable cancer successes have been due to the power and efficacy of prevention.”

The letter urged the vice president to “pay careful attention to the balance between treatment and prevention-related investments.”

Leveraging Big Data

At the roundtable, Biden spoke of the importance of standardizing “big data” – which can include anything from datasets that describe molecules and genes, to datasets about patients’ health records. He asked the roundtable members for specific examples of ways to leverage big data for action: steps that can be taken for progress in prevention, treatments, and cures.

Wheeler explained how big data has been used to identify “hot spots” where colorectal cancer mortality is high and colorectal cancer screening is underused, which has created opportunities for researchers – including Wheeler – to develop and test screening interventions in these communities.

“The vice president appreciates that cancer is not simply one disease that can be addressed with a single cure. He understands multiple different strategies at multiple levels are going to be required,” Wheeler said. “Cancer is a multifaceted set of diseases operating at the cellular, community, and health systems levels. To combat it effectively will require multidisciplinary expertise and outside-the-box thinking.”

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