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Sunday, January 17, 2016

Making Quality of Life Part of The Cancer Moonshot

by Christian Sinclair

During his last State of the Union address, President Obama placed Vice President Joe Biden in charge of finally curing cancer, which is being dubbed the 'Cancer Moonshot.'

Last year, Vice President Biden said that with a new moonshot, America can cure cancer. Last month, he worked with this Congress to give scientists at the National Institutes of Health the strongest resources that they’ve had in over a decade. So tonight, I’m announcing a new national effort to get it done. And because he’s gone to the mat for all of us on so many issues over the past 40 years, I’m putting Joe in charge of Mission Control. For the loved ones we’ve all lost, for the families that we can still save, let’s make America the country that cures cancer once and for all. Medical research is critical.
- President Obama, 2016 State of the Union
VP Biden first brought up the cure for cancer in a speech late last year when he was announcing his decision not to run for president. You may recall that his son, Beau Biden, died from brain cancer in May 2015. Reflecting on his family's experience, VP Biden discussed his renewed focus on the things he wanted to change.
I believe we need a moon shot in this country to cure cancer. It’s personal. But I know we can do this. The president and I have already been working hard on increasing funding for research and development because there are so many breakthroughs just on the horizon in science and medicine, the things that are just about to happen, and we can make them real, with an absolute national commitment to end cancer as we know it today. And I’m going to spend the next 15 months in this office pushing as hard as I can to accomplish this, because I know there are Democrats and Republicans on the Hill who share our passion—our passion to silence this deadly disease.
- VP Joe Biden
Now we could get into some of the deeper questions, like can cancer ever be cured given the predilection to mutating, the fact that cancer is not one disease it is many, and so on. But let's focus on the fact that many resources will be now laser focused on cancer research and treatment like never before. Now that palliative care has become a much more integrated part of modern oncology care (yet we still have a ways to go), how do we make sure that palliative care is at Mission Control with a seat at the table? Shall we start with understanding the Cancer Moonshot beyond the soundbites?

Photo by Evan Vucci for Associated Press
Part of the Cancer Moonshot, is related to the NIH's recent $2 billion funding increase, the largest in 12 years (Way to go government! Thank your legislator!).  Chances are much of that new research money is already getting earmarked for projects. To boot, the palliative care research infrastructure is still young. We have great organizations like the Palliative Care Research Cooperative Group (PCRC) and the National Palliative Care and Research Center (NPCRC) and a few institutions in the US with the bulk of palliative care researchers. But hopefully through these nascent PC research programs and organizations like the Patient-Centered Outcomes Research Institute (PCORI) we can get more quality of life research projects submitted and approved for grants.

Biden has already been meeting with cancer physician, researchers and philanthropists, and the thrust of the focus seems to be on cutting-edge research related to immunotherapy, genomics and clinical trials. Biden says the basic plan is to:

  1. Increase resources - both private and public - to fight cancer.
  2. Break down silos and bring all cancer fighters together - to work together, share information, and end cancer as we know it.
Not many palliative care clinicians I know would brand themselves as 'cancer fighters', so rebranding seems to be a unlikely option, but maybe we can be part of the second option, breaking down silos. We're good at communication, right? Let's partner with our oncologists and researchers so that we can help make palliative care a standard of care for all patients, at any age and any stage.

So if you are part of an academic medical center, extend your hand and offer to support and bring a quality-of-life focus to any cancer research. If your research experience is quite small, then consider making sure your organization is a part of PCRC, or talk with your professional organization like AAHPM, NHPCO, or HPNA and let them know this matters to you. And if you use social media, make sure you speak up for quality of life and palliative care inclusion whenever you hear about cancer research or the Cancer Moonshot.

Let's make sure quality-of-life is part of the Cancer Moonshot. Let's get palliative care at Mission Control.

Christian Sinclair, MD, FAAHPM is a palliative medicine doctor at the University of Kansas Medical Center in Kansas City, KS and the editor of Pallimed.

Ed - By the way if you are curious if it is moonshot or moon shot...I could not find any source which gave an adequate discriminating answer to either. In the speeches by the President and Vice-President it is written both ways. ¯\_(ツ)_/¯ 

Image Credit: Cancer Moonshot - Apollo 17 Image from Wikimedia Commons via Creative Commons, composite image created by Christian Sinclair, Attribution 4.0 International / Free Culture license
Image Credit: Biden at SOTU 16 via NY Daily News by Evan Vucci/AP (License purchased by Pallimed Foundation via AP)

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