Biden’s moonshot examined: Researchers say cancer cure is a long ways off

The White House touts prevention in its moonshot agenda. In 2022, the first year of the reignited moonshot, the FDA proposed rules to prohibit menthol cigarettes. Among other agenda items, the moonshot program plans to increase cancer screenings in at-risk communities and facilitate donations of sunscreen to schools and youth organizations.

But prevention is a trickier cancer-prevention mechanism than treatment. It could mean cleaning up Superfund sites or removing lead pipes to reduce environmental cancer risk. It often requires people to change their behavior — to drink less alcohol and exercise more or stop smoking — a more challenging mission at the population level than directing patients to take a pill or offering them a diagnostic test.

“It’s not necessarily clear how one spends money on prevention,” Welch acknowledged. “It’s much easier to sell a test or a drug. It’s a concrete thing. Prevention takes action on the part of individuals,” he said. “You gotta say, that’s harder.”

More funding wouldn’t necessarily solve the problem, according to Emanuel.

There’s a lot of money already in the system. It just needs to be redirected and allocated differently, Emanuel explained.

Who is spending that money also matters. The government sponsors roughly one-third of clinical cancer research, according to Emanuel. Industry accounts for the remaining two-thirds of funding. “It’s good that they’ve got a lot of drugs that they’re testing. What’s bad is having industry shape the clinical research agenda, because industry has a bias.”

Emanuel’s solution: stronger government leadership and more non-industry sponsors.

“The NCI [National Cancer Institute] is the biggest NIH institute,” Emanuel said. “It’s not exactly like they’re starving.”