‘Moonshot’ Metaphor on Cancer Is a Failure to Communicate

If you actually wanted better faster results on treating Cancer you need a much better person than the VP. Just saying???

Why in the world would you want to decry an offering of 1 billion dollars?

Especially when the GOP is constantly hounding the Democrats for spending money way too freely. This should be viewed as the first in the many building blocks to follow.

As a writer you need to step outside your snow globe and take a look at the big picture. This is way too complicated an issue to take such a limited view. How about, "Terrific intention, but more is needed, am I'm hoping this will help kick-start the call for initiatives that must follow if this honorable attempt is to succeed."

What a terrific 'glass-half full' notion of the media you have given critics of the media.

Lets just say that miracle cures for cancer are possible. What is the real positive versus negative impact of these "cures" if they cost a fortune AND run up the cost of care ruinously otherwise?

We have to realize that any "miracle cure" found is going to cost so much that it will not be easy for most blokes to access without bankruptcy.

At the very least we should be looking at the cost-effectiveness of what we are going to unleash AND we should be double sure to disallow the exploitation for obscene profit by "non-profits" of the price increases for 340B cancer drugs.

We MUST get the cost of high value care under control; no excuses; no delays; no profiteering; no limited access to new discoveries based on cost of care versus income of the patient.

It is not generally appreciated that a single cell, even one as simple as a bacterium, is vastly more complex in its inner workings than anything man has built. The space shuttle is understandable by engineers, but the biochemistry of a cell is not understood yet by biochemists. The cure for cancer and a lot of other diseases is likely to come from a surprise discovery in basic research rather than a frontal assault on the disease.

A lot is known about preventing cancer, but that seems to go by the wayside in the search for a cure. We have not cured lung cancer, but we have cut the death rate drastically by making a concerted effort to get people to stop smoking. We know that processed meats increase the risk of a number of cancers, but most of the articles on the recent WHO announcement rushed to assure Americans that they could continue to eat "moderate" amounts of bacon. We didn't reduce lung cancer deaths by telling people to smoke "moderate" amounts of cigarettes. What we need is the bravery to go against the industries that manufacture cancer-causing foods and the courage to give those up. Perhaps we will be able to cure some of these cancers some day, but we know a lot about prevention right now. We just aren't willing to put it into practice.

I. Have worked ad a large cancer center for the past 14 years. After all the seminars an talks about a cure for cancer I have come to the conclusion that there will never be a true cure for cancer. The key to the cure will be prevention and early detection. Prevention to lower the risk, which will never be zero for any of us, and early detection before the cancer has had a chance to evolve the ability to mestastasize. That means developing techniques that can find a cancer that is only a few thousand cells in size and determine how aggressive that cancer may be or become. We are a long ways from being able to do that. Tyat is where the moonshot money needs to be directed.

Give me a break, and everyone else. This is meant to be a good thing! Let's let be one!

But can we afford the treatment? Cost of cancer drugs is astronomical, yielding huge profits. And yet most of the research on which drug development was based was paid for by the US taxpayer. There needs to be a de-escalation of greed among high ranking scientists and a fair sharing of the spoils. Which in my book would mean the US has some ownership or contol of patents based on US funded research. And I don't believe for a minute this would disincentivize anybody.

Any person who wants to try to begin to understand the variability of cancer, and possible ways of minimising the risk of different cancers, needs only to look outside the USA to see that many other cultures around the world have much higher and also much lower rates of the supposedly same cancers.

To take the longer view, however, requires much more understanding of the basics of epidemiology than we see usually demonstrated in the NYT. For example, it became evident to me recently that many commenters simply don't understand the concept of 'age-adjusted' death rates from cancer.

The oldest members of Okinawa, Sardinia and Ikaria have far lower rates of every sort of cancer than Americans. Not so for the younger generations who have widely adopted North American ways of eating and drinking, and the American love of watching adult sports rather than participating in them, or being physically active outdoors cultivating their gardens.

We need to spend a lot more money on the "War on Cancer"
NOT curing Cancer is costing our economy over $260 Billion Dollars a year and the cost in Human Suffering is Infinite.

If we were to allocate our national budget based on how many American lives each dollar would save or how many Americans each dollar would benefit we'd be be spending hundreds of times more money on Cancer Research.

Everybody dies eventually, but dying of Cancer is a horrible way to die.

We need to start taking the war on Cancer seriously.

Cancer doesn't just kill its victims, it tortures and maims them first.

There's no pain that compares to Cancer Pain.

If you don't think this is about you, you're wrong.

Everybody either dies of Cancer or loses someone they love or care about to it.

And its a horrible way to die.

I don't see a problem with calling a strengthened cancer initiative a "moonshot".

A few years ago my work was supported by a American Cancer Society grant, I was surprised to learn how ACS budget breaks down. I do basic research, but relatively little of the organization's budget was applied to this- much more goes to education and testing. Better education and increased testing are MUCH more effective ways to impact cancer survival in the short term. However, at fund raising events, all the talk is about the cure. This is because people don't donate for testing- they donate because a loved one died and they want a future where this doesn't happen. If Moonshot talk captures the imagination of those of us who have been or will be impacted by cancer (ie, all of us) awesome.

Let's put it another way- anyone who is complaining that a Cure Cancer Moonshot fails to acknowledge the complexities of cancer biology and the challenges in creating treatments probably is already in favor of an additional billion for cancer research.

Given the lack of attention to solving issues that are more immediate to all citizen voters than "the moonshot of curing cancer," it's not surprising that nearly nobody is paying attention to this latest "shiny object" distraction to come from the Obama administration.

This isn't an election issue in an election year that is about change. Part of the disinterest is about this program is that nobody thinks it will do anything, primarily as the Obama administration has made bold pronouncements about many things, yet handled them incompetently.

Better to ignore the politically motivated announcement than believe that it will accomplish anything.

There have been a number of articles criticizing Obama (and others) for invoking the "moonshot" analogy to cancer research. Although I understand there are key differences, I feel a significant point is being missed.
JFK's space program initiative in the 1960s inspired a generation of people to become invested in science and engineering (granted, a big aspect of that was a national security fear of the Soviets as well). However, the key point was that it changed the way this country thought about science and technology.
Unfortunately, and the science community deserves the primary blame, the importance of basic science research has not been communicated to the public. Personally, I think the parallel of curing diseases to a moon landing is not only appropriate, but necessary as a first step in the right direction -> US citizens understood why sending a man to the moon was important, they need to understand why funding basic research is essential to curing disease and solving global warming.
Especially in the US, where more and more people don't believe in vaccines, don't believe in global warming, and are scared of their food containing "DNA", we need to bring science research and education back to the forefront. Maybe this can be the beginning of a new outlook on science for this country.

I think that we should have a moonshot to find ways to stop earthquakes, volcanos, and hurricanes in the next 10 years. Overcoming forces of nature is far more difficult than carrying out a targeted, if complex, engineering feet. Cancer is a bit more like a force of nature than an engineering problem, although there are ways to make steady slow progress on some parts of it.

Surely the time has come to stop talking about a 'cure for cancer'. There is probably no such thing. It is a multi-factorial disease; it is not, like cardiovascular disease, a single entity. There are scores of different types of cancer. And unfortunately there are scores of competing organisations investigating cancer. Do they all co-operate? Very few. They compete for funds and facilities. If Mr Biden wants to achieve anything he should start pulling all these competing organisations together - especially the 'Not for Profits'. Too many undertakings are made about 'breakthroughs'. What a cliche. Lets have some honesty. More people are being diagnosed with cancer as the populations age; more people are dying with cancer - not of it. Lets have more investigations into quality of life; not just extending life at any cost.

What we need is a moon shot for Alzheimer's and other dementias... Right now, with regard to their prevention or cure, we're living in the world of the Wright brothers.

To the contrary it's the perfect metaphor - if you're pushing a "Mom and apple pie" issue. These issues are pushed by the party in power to put the other party in a bind. If they oppose, they're against "Mom and apple pie". Or "soft on communism", if you prefer.

The tragedy is that we have an administration that thinks it can pick up real vital issues and turn them into "heads we win, tails you lose" campaigns.

There is a tendency to make heroes out of those who put out the fire. Avoid letting the fire happen in the first place and no one knows or seems to care -- meh.

Big bucks in treating cancer with patented products. No profit in prevention.

Ask anyone who has had cancer, which would they prefer: better more effective treatments? or the knowledge and ability to not get cancer in the first place for everyone they love?

Yes, Yes to more basic research. But the public dollar should be spent identifying avoidable causes that might also lead to better treatments, not simply priming the pump for big pharma and oncologists to perpetuate their lock on morbid windfalls.

I am a cancer researcher, so of course I think more money and more attention to the problem is a good thing. I really think the specific metaphor doesn't matter that much (other than giving us Times readers something to argue about), but who can argue that more resources on this would not help? We are making incredible progress, and the more resources we put to the problem the faster we will be able to implement new therapies. This is a particularly nasty way to die, and if we can prevent it from happening to more people, that is progress in my book. And I don't care what you call it.

As someone who worked in cancer research for quite a number of years, and in biological research even longer I can say one thing about this: it's not the right metaphor. We don't fund basic science adequately in America to begin with. Most Americans don't understand how science works much less how their own bodies work. Health care is very expensive and time consuming the way it's done now. Grants, particularly government-sponsored grants are very hard to get. It was hard in the 80s because of cuts to funding. I don't see it being any easier. The government may do the basic research and pass some onto the pharmaceutical industry. They will charge hefty prices for any cure.

Why not focus on creating a health care system that works for Americans instead of going for a cure for cancer? Why not also focus on making health care affordable rather than having treatments that will be unaffordable developed and then advertised to the public? Why not fund basic research into how cells change from normal to cancerous, how the chemicals that industry is allowed to dump hurt all of us? Why not start spending money on improving life in America? People need jobs, affordable housing, access to good health care. We don't have that any more.

As a cancer researcher physician-scientist with 25 years of hands-on experience in this area, I can say that the moonshot is the wrong metaphor for curing cancer.

It is the difference between science vs. technology. Here is why:

We didn't have to discover new fundamental laws of physics such as Laws of Motion to go to the moon. All the science was there - already known. All we had to do was to translate this scientific knowledge into technology. So, going to the moon was a purely technological problem.

Biology is very different than Physics and we do not have full grasp of the science of cancer. We're just beginning to discover fundamental laws of Biology that govern cancer. So, what we're hoping for is to slowly change cancer from a scientific problem into a technological problem. This will happen with more basic scientific research, which happens best if many ideas compete in a free market of ideas. Not when the government chooses a winner and arbitrarily forces a centralized technology solution that lacks scientific merit.

Lastly, the correlation between money vs. outcome is more directly related in technology. The same is not true in science, you can't just give a billion dollars to people and say go discover gravity and expect guaranteed results. Sometimes, you will have to wait until a Newton or Einstein comes along.

Perhaps throwing more money and research at the disease of cancer would produce helpful results. However, the lies I encountered regarding what IS known during my own experience of breast cancer caused me to become a bit cynical about the whole cancer "industry". I wrote my experience into a story posted at

http://mammogramsanddcis.blogspot.com (mammograms and dcis)

First, we should be told what already HAS been discovered with the use of our money.

Katherine Langley

I think we would all be better served if our government stopped declaring war on things, situations and activities well outside the realm of Realms, frankly.

The realm of Realms. Nation-states. Governments with flags, leaders and armed militaries.

It's rank absurdity otherwise, with serious consequences. Take the "War on Drugs". It fills prisons at ruinous cost to taxpayers and destroys far too many lives. Waging war "on Terror" is a pointless exercise because terror is a tactic, an asymmetric method of warfare that predates the Stone Age. How do you defeat that asymmetry? The "War on Poverty" and "War on Illiteracy" target the Human Condition itself. Both have always been with us, and always will be. Then there's the "War on Obesity", the "War on Diabetes", the "War on Gun Violence" and the "War on Crime". Pointless, because they are ineradicable.

As is the "War on Ebola" and the "War on Lassa Fever" because each is a life force. Life will find a way.

"War" in these contexts isn't even a metaphor. It's an obfuscation. The enemy shares common denominators like invisibility and intractability -- equally true about another condition we traditionally call "cancer". Another metaphor. As already noted in the article cancer isn't a single disease but many, and many underlying disease processes; too many to count; most poorly understood; no two alike. It's more like a hydra. An invisible hydra.

Declare war on an invisible hydra? You might as well surrender on the spot.

As several commenters have pointed out, cancer is primarily a disease of old age. The rate rises exponentially after the age of sixty. Other chronic diseases, including rheumatoid arthritis, dementia, hearing loss, and macular degeneration kick in. Life follows the familiar pattern of growth and assimilation followed by decay and death.

General de Gaulle said that "old age is a shipwreck". The Renaissance physician, Sir Thomas Browne, said that "when I think of all the myriad ills man is heir to, I thank God that I can die but only once."

The moral seems obvious: The government should spend money on improving the psychological and physical health of children and young people; making sure that they receive good food, pure drinking water, dental care, medical care, and health and nutrition education. It should also focus efforts to understand and cure childhood maladies, such as leukemia, diabetes, suicide, and accidents.

The government's priorities are just the opposite, however, since legislators tend to be older men who are focused on staving off their own natural decay and demise.

The single biggest risk factor for cancer is aging. Can we really stop aging? We will die sooner or later and one way or the other. Even if cancer can be cured, there will always be something else. The current business model of research in this country is out of date. There are too many "struggling" research laboratories. More money is really not the solution. Market force, fair competition and economic benefit should all be considered in making funding decisions. Many labs should be closed in order to improve efficiency. From war on cancer to this new moonshot, accountability and cost effectiveness should be seriously evaluated. Business-as-usual just won't do it anymore. Tax payers dollars should be spent wisely.

The purpose of calling this a moonshot is to galvanize and focus people and priorities to beat cancer.

Is cancer complex and nuanced? Of course. Is a billion dollars a drop in the bucket of our total budget? Yup. Have we been trying to beat cancer for years? Yes.

Perhaps you can rest on your pedantic laurels while those active in trying to beat this disease agitate, galvanize, remind, and fight to beat cancer.

It's actually quite an apt metaphor. The space program that sent a man to the moon, although awe-inspiring at the time, is now regarded by many people as a grandiose, narcissistic show of superiority, and a colossal waste of money, which did nothing to improve anyone's lives. The current world of "cancer research" (and in fact much of life science and biotech in general) is the new space program. Look how advanced we are! Look how much money we're throwing around! Whether there will be any benefit to humanity is questionable.

We've been "at war" with cancer for over 40 years. Although there have been a few successes (eg treatment of childhood leukemia), incidence of many cancers continues to increase and cancers once associated with the elderly now strike younger and younger people. Clearly we're taking the wrong approach in this "war." But it's a big business, so why not throw more money at it and continue to make no progress?

Depends on how you spend it. Bigger isn't always better. DARPA has radically changed vaccine production from the chicken egg days with a relatively small budget, critical for rapidly emergent pandemics. But the Big Boys of Pharma aren't interested in the spare change of vaccine production when there are big bucks to be made with $100k treatments covered by Medicaid.

I believe that falling costs of genetic testing, targeted cancer viruses and other advances in cellular and molecular biology and refinement of clinical treatment will advance cancer treatment beyond the "cut and poison" era.

It's worth noting that the US is not alone in this research and that Big Pharma is not likely to lead the way, much as Big Oil did not develop fracking.

If cancer is primarily a symptom of programmed aging like cardiovascular disease and dementia, lets spend some of that reasearch money on the real root problem.

If the Cancer Moonshot settles for incremental funding increases to existing cancer research programs or drug development, then Margot's criticism will be entirely correct.

But while that is the easiest way to obligate funds in the federal government (disclosure: I once ran a federal agency, and set up $2B in recovery act funds), and is indeed the focus of the White House press release, that is not my understanding of the Moonshot strategy.

I believe that the section on Data Sharing will be the most consequential element of the Moonshot- using federal levers and funding to make it easier for individuals to donate their genetic and medical data, and for researchers to search and analyze them, uncovering associations and identifying targeted therapies and diagnostics.

In the digital age, a billion dollars is not a lot of drug development, but it sure could get us a whole lot of data sharing and information processing.

This is the second piece I've read about why calling it a moonshot is so irksome. What gives? Who looks a billion dollar gift horse in the mouth and complains about terminology? Sounds churlish.
If researchers want to highlight the meager amount spent on cancer research compared to the space program, there are better ways to do it than complaining about calling it a moonshot. Perhaps they could point out that their budget is less than what we spend to elect politicians who don't believe it is their job to do anything for us. Or perhaps they could point out that the revenue lost annually by abolishing the estate tax is more than twice their total budget.

If we want to talk about inapt analogies that actually matter, how about explaining that comparing health insurance to car insurance is inaccurate. Or how about explaining why healthcare as a product is not comparable to computer chips.

Federal help in all aspects of medical research is welcome. However, it must be combined with assurances that private industry (big pharma) will not be allowed to make obscene profits from that research.

The focus on curing cancer is a major distraction from the major problems facing our country.

Consider the five leaving causes of death in the U.S.: The first two are the same for men and women--cardiovascular disease and Alzheimer's disease. The third most common cause of death for men is lung cancer; for women it would be cerebrovascular disease. The fourth most likely cause of death for women is lung cancer, for men it's COPD (chronic bronchitis and emphysema). The fifth most common in men is cerebrovascular disease; for women it's COPD.

Eighty percent of lung cancers are caused by smoking--it is a largely preventable disease. If no one smoked, cancer wouldn't even be in the top five most common causes of death.

[Breast cancer is seventh most common for women; prostate cancer is 8th most common in men.]

Our country doesn't need a "moon shot" for cancer, it needs one for education, health care for all, income inequality, meaningful jobs paying a living wage.

Funding of basic medical research is always welcome and the uncontrolled division of cells is close to as basic as it gets. Hooray for this initiative!

Well done.

One billion for cancer research, a trillion for tax cuts for rich to buy more yachts and mansions, no biggie. But, hey, just keep voting Republican. What harm can that do?

Vapid posturing as a surrogate for actual accomplishments is the hallmark of the Obama White House

You are correct. The metaphor implies a simple solution of money and will power, which is kind of a false hope.

Cancer is more complex than shooting a rocket into the air.

The choice of "Moonshot" aside, the problem lies with the notion of CURE with its satisfying sense of closure. Why not stress, in addition to prevention strategies, the increasingly better ways of CONTROL - demonstrably putting cancer in the field of other chronic conditions?

Perhaps it is an dizzying array of treatment options because we fail to address cause while focusing on effect. If Cuba has really developed a vaccine for lung cancer, it calls into question our entire approach. Yes, it is cheaper to vaccinate than to treat but the latter is far more profitable and that may be the true source of the disconnect. Invest in cancer prevention, not treatment.

On the contrary, it's a successful communication from a political point of view, because it appeals to the vast numbers of stupid people who think that all the problem needs is to throw money at it.

Moonshot is the perfect name, however $1B won't even get us to the launchpad. We spent $45B to bailout Citigroup in 2008, yet spend 1/10 of that on a disease that kills 500,000 Americans annually and millions worldwide. President Obama missed a great opportunity in his 8 years to initiate a true moonshot effort -- like JFK, FDR (Great Depression), or LBJ (Great Society). BHO's legacy will be ObamaCare -- not a cure for cancer moonshot. Sorry, Mr. President, too little, too late. (http://bit.ly/1PJL4xq)

National Cancer Moonshot is a perfect name for this campaign. It's perfect because it gives cancer research an identity that is memorable and meaningful to Americans. Perhaps with this exposure it will encourage congress to adequately fund the NIH instead of slashing their budget as Paul Ryan has suggested on the past. My husband is a researcher at a leading cancer research institution here in Seattle. They just went the through a rebranding process costing millions of dollars in hopes of being more visable to the general public to generate more individual donations since their NIH grant requests are being denied. My husband's work on repairing tissue after heart attacks and graft vs host disease have both been halted due to lack of funding. The only grants being fully funded are those that are tied to homeland security such as radiation research. So I am grateful to President Obama for getting this research goal in front of Americans - hopefully they will pressure congress to increase funding to the NIH. Especially representatives like Jaime Herrera Beutler who voted to cut the NIH budget yet took her baby to John Hopkins for life saving treatment funded by the NIH, after getting their budget cut by $10 million.

The original moonshot was an engineering problem, with almost all of the science behind it settled. That's why the "moonshot" problem, inspiring as it was, could be solved in nine years.

Finding a cure for cancer is a basic research problem (actually, many, many basic research problems) where unpredictable results and undefined strategies for success abound. That's the difference between the moonshot and finding cures for the numerous cancers. And it is an enormous difference.

Um. This is a bizarre article that completely misses the point to make an absurd semantic argument. To just dispense with the semantic point, the use of the "moonshot" is not a budgetary thing then or now. It continues to mean that there is a goal that has been impossible so far, but is in our grasps if we make a great effort.

As to the importance of this new effort and the brilliance of using the term is that we finally have a vision of the possibility. Just like having finally gotten into orbit, a moon expedition was now an understandable and possible project. Similarly, we have finally gotten several glimpses of how to better attack the various cancers. As a caregiver that has seen this revolution first hand, the only question is why not push ahead as if this was a moon shot.

The only difference that is significant, besides the saving lives aspect, is that the effort to cure cancer is a project that most everyone can participate and that need not be concentrated in one budget item or organization. Actually this is more about coordination, education, getting more people into clinical trials (see: clinicaltrials.gov ) and multidisciplinary approaches.

This is a moonshot that we can all watch unfold. But the difference is that the visible indication of success is not flag planted on another globe, but billions of smiles of families and health care providers around the world,

Not only in cancer research/treatment is there a lack of communication but also in mental illness treatment. Schools measure a student's height and weight and check eye sight and blood pressure, but where is the mental health check for students! Starting in middle school, every student should be evaluated for mental health because many of these mental diseases including Schizophrenia, bipolar, start during adolescence when a new phase of synaptic pruning occurs in the brain. These diseases get worse through high school, college and graduate school. We need to get a good baseline in middle school and get early intervention started as soon as a mental health problem is identified. This can't happen if there is no mental health screening for the students! Drexel University is one of the first schools to have a mental health kiosk on campus where students can access their mental health status and get treatment if needed. However, this process needs to start in middle school! We also need a quick process to get students quickly to the right doctors to get the help they need. Currently, the mental health system is so difficult to navigate even with supportive family.