An interview with Andrew C. von Eschenbach
Cancer—in all its forms—continues to take a huge toll on people across the world. In your opinion, where do we stand in the fight today?
This year, more than 1.4 million Americans will hear the words, "You have cancer." One out of every two men and one out of every three women during their lifetime will hear the words, "You have cancer." One American every minute is dying as a result of this disease. Now, we need fresh thinking about new goals—goals that remain focused not as a cure but as a long-term solution for controlling cancer.
In 1971—the same year that Lance Armstrong was born—the National Cancer Act was passed, and the country committed its resources to conquer cancer. That journey has led us to a truly transformational moment. The National Cancer Institute has committed itself to a goal, one based on our emerging understanding of cancer as a disease process. Our plan is to eliminate the suffering and death that result from this process that we understand as cancer, and we are committed to a goal of doing so as early as 2015.
In what ways do you see the fight against cancer changing so dramatically?
We have the ability within our grasp, based on the trajectory of progress, to expand our understanding of the fundamental mechanisms that give rise to our susceptibility to cancers, the early events of malignant transformation, the progression and the metastatic spread and the ultimate death that we see all around us in our friends and relatives.
We are now understanding the molecular mechanisms that control the process, and we are learning how to exploit those mechanisms to prevent, detect, eliminate or control the process.
Would you give us examples of how the NCI and its many researchers across the globe are proceeding in their work?
Genomics, proteomics and emerging technologies are enabling us to profile not only diseases but the persons who bear those diseases. We can, thus, understand the genetic and molecular differences, so that we can begin to personalize intervention strategies.
In our recent experience with lung cancer, we have seen the introduction of the drugs Iressa and Tarceva, which are targeted to affect an enzymatic pathway involved in the proliferation and growth of cancer cells. By understanding the genetic mutations that lead to that abnormal pathway, we can identify those patients who might benefit from that particular intervention.
Also, we are moving from an era in which imagery is no longer simply enabling us to see a lump on a chest X-ray or a mass on a CT scan, but enabling us to visualize—using molecular imaging—the biology of the disease in real time. For example, in gastrointestinal cancer, using the new drug Gleevec, you can use radioactive imaging agents to see in 24 or 48 hours whether you have changed the biochemistry of that tumor.
What we thought was impossible back in 1971 is a reality today. What we think is impossible today—a world in which no one would suffer or die from cancer—can become a reality if we make it happen together.