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29 January 2016

Obama’s plan to fight cancer: what role for prevention?

On 12 January Barack Obama announced the launch of a national plan to eradicate cancer. ‘Let’s make America the country that cures cancer once and for all,’ he declared to members of Congress who had assembled to hear his State of the Union Address.

Comparing this challenge to the programme to reach the Moon launched in the early 1960s, the US President described the plan as ‘a moonshot to cure cancer’.

Barack Obama has entrusted this mission to his vice-president, Joe Biden, whose son died recently of brain cancer.

Few details about the programme’s general overall thrust and coverage have so far been made available.

In a statement published following the Presidential speech, Mr. Biden refers to hopes linked to ‘several cutting-edge areas of research and care’, mentioning immunotherapy in particular.

According to the press, announcement of the new plan came just after the presentation by a group of pharmaceutical companies of their ‘Unified Front Against Cancer’. It is based on the initiative of Dr. Patrick Soon-Shiong, a scientist and entrepreneur who was behind the discovery of Abraxane, a drug used in the treatment of metastatic cancers of the breast, lung and pancreas. The American vice-president reportedly met Dr Soon-Shiong – 34th wealthiest American, according to Forbes – while his son was battling with cancer.

The aim of Dr. Soon-Shiong’s project is to conduct clinical tests based on associating drugs capable of stimulating the patient’s immune system to destroy cancerous cells.

On the basis of what little information has so far been released, the battle plan drawn up by the White House against cancer is essentially directed to curing rather than preventing the disease. The term ‘prevention’ is indeed nowhere to be found in the American vice-President’s statement.

And yet in 2009 a presidential panel of cancer experts highlighted the need for stricter regulation of chemical substances in a report that represented a move away from the approaches advocated and supported by the pharmaceuticals industry.

‘If we applied what we already know about cancer prevention, early detection, and treatment, we could prevent a substantial proportion of the nearly 600,000 cancer deaths in the US each year. These remarkable tools mean nothing if they sit unused, unavailable to those in need because of gaps in care caused by poverty and other factors,’ said Otis Brawley, Chief Medical and Scientific Officer of the American Cancer Society.

Dr Christopher Wild, director of the International Agency for Research on Cancer, has also criticised the lack of attention and resources accorded to prevention. In a recent article, he has stated that ‘40 to 50 percent of cancers could be prevented if the accumulated knowledge about causes could be translated into effective primary prevention’.

Dr Wild regrets that prevention represents less than 5 percent of the total funding for research into cancer, and believes that prevention campaigns should not be exclusively focussed on individual behaviour (smoking, diet, alcohol, etc.).

The scientific community estimates that between 5 and 8 per cent of cancer deaths are due to exposure to carcinogens in the workplace, amounting globally to between 410,000 and 656,000 deaths per year. Despite these dramatic figures, the battle against occupational cancers remains the poor relation of national and international campaigns against cancer.

In a recently released ETUI publication, the international occupational health expert Jukka Takala invites the European Union to spearhead a global campaign to eliminate occupational cancer.

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