Will Biden’s moonshot be a turning point in the war on cancer?

President Biden on Wednesday announced the relaunch of his “cancer moonshot” program, an initiative that he insisted could “end cancer as we know it.”

Biden is not the first president to mobilize the federal government around the goal of defeating cancer. Richard Nixon declared “war on cancer” in 1971, and helped persuade Congress to pass the National Cancer Act, which poured billions of dollars into the search for a cure. Although major strides have been made over the past 50 years, cancer remains the No. 2 cause of death in the U.S., killing more than 600,000 Americans in 2020.

Cancer is a deeply personal issue for Biden. His son Beau died of brain cancer in 2015 at age 46. A year later, Biden launched his first all-out campaign against cancer, while serving as vice president. After leaving office, he and his wife, Jill, started a nonprofit, the Biden Cancer Initiative, to carry on that work. During the 2020 presidential campaign, he boldly proclaimed, “If I’m elected, we’re going to cure cancer.”

Recently, though, Biden has steered away from that lofty promise. While announcing the details of his new “moonshot,” he set the more modest — yet still ambitious — goal of halving the death rate from the disease in the next 25 years. His new plan also takes a broader approach to treating cancer than previous presidential efforts, which have primarily focused on finding a cure. In addition to calling for more research into promising new treatments, Biden’s updated strategy emphasizes early detection, improved prevention strategies, more equitable health care access and direct support for patients living with cancer.

Why there’s debate

Many medical experts have praised Biden’s updated approach for setting out both a more realistic set of goals and a thoughtful plan to get there. They say that, for all the talk of a cure for cancer, the idea of truly eradicating it has always been a fantasy — largely because cancer is in fact a class of diseases that includes hundreds of distinct illnesses. Moving on from that approach, they add, helps create a clearer path toward minimizing the burden of cancer, by both fueling new scientific advances and removing barriers that prevent people from taking advantage of the proven strategies that already exist.

Others are skeptical that Biden’s new approach will work. A number of cancer researchers argue that new treatment breakthroughs won’t happen without a major infusion of funding from the federal government, which is not included in Biden’s proposal. Others say that any strategy that fails to address the inequities and extraordinary costs of the American health care system is destined to come up short.

What’s next

One reason for optimism cited by Biden and many researchers is hope that breakthroughs with mRNA achieved in the development of coronavirus vaccines could also open the door to new ways of treating or preventing cancer. Dozens of trials testing new cancer vaccines are currently underway, but it’s too early to know how effective they might be.

Perspectives

Optimists

Advances in science and Biden’s new strategy really can end cancer as we know it

“We are on the brink of exponentially making cancer a disease of the past, and Biden has the opportunity to change the future of humanity by making cancer history.” — Leo Nissola, The Hill

Biden is wise to abandon the unrealistic hunt for a cure

“We’re not going to eradicate cancer. That isn’t going to happen. But we will manage it better. What we like to think is it will not be considered a fatal, lethal disease. It will become a chronic disease. So the attention on survivorship is really critical.” — Gloria Peterson, epidemiologist, to NBC News

Biden’s plan will address cancer from both a scientific and societal level

“Covid has amply demonstrated what Biden calls the value of a ‘whole-of-government’ response — one that harnesses the power of government to advance science and collaboration, while also tackling the broader structural context in which disease exists. For cancer, this means continuing to accelerate scientific progress while addressing equity, prevention, access and affordability for all kinds of patients who will confront this disease in their lives.” — Eugene Rusyn and Abbe R. Gluck, Washington Post

An emphasis on early detection will save countless lives

“Embracing multi-cancer early detection and setting up the system to improve access now will set the country up to fundamentally reimagine how we fight and hopefully one day eradicate the disease. The current pandemic brutally exposed how our lack of preparedness led to a public health crisis that many experts had warned was coming. We don’t have to repeat that same mistake with cancer.” — Rob Tufel, San Francisco Chronicle

Biden is the first president to recognize the importance of equity in fighting cancer

“The bulk of the data that have been painstakingly gathered over the past half-century were collected from white people — a bias that must be corrected.” — Editorial, Nature

Skeptics

Biden’s plan will come up short without billions in funding for research

“There is great value in a president giving the populace hope that science can lead to cures. But I would say without funding for a research component, you’re not going to get over the goalpost.” — Jill O’Donnell-Tormey, CEO of the Cancer Research Institute, to Stat

America’s broken health care system will hold back any major advances

“Many cancers, including certain types of breast or colon cancer, are already curable. But they need to be promptly diagnosed and treated. That can be a challenge when 27.4 million Americans don’t have health insurance.” — Shefali Luthra, Los Angeles Times

Government bureaucracy will only slow scientific progress

“The U.S. should focus on reducing the barriers that encumber access to these treatment technologies—and other promising remedies—for patients who don’t have time to spare.

… There are countless reasons to believe that the government has slowed cancer prevention with the intent of racing towards a cure. Like many problems, there is too much at stake with cancer to let politicians dictate the solution.” — Natalie Dowzicky, Reason

Biden is afraid to make the tough choices that would meaningfully reduce cancer rates

“Neither Biden nor previous cancer warriors have suggested comprehensive policies to prevent cancer by strengthening regulation of the carcinogenic practices of multiple industries. Making prevention the priority, or targeting industries that contribute to cancer, could jeopardize elite support for the war on cancer, a prerequisite for continued public and private funding for research, philanthropic contributions, and the favorable media coverage essential for the public’s support of any war.” — Nicholas Freudenberg, Stat