Director's Update: September 16, 2003
In July, I was privileged to be at the finish line to witness Lance Armstrong win the Tour de France, for the fifth consecutive time. Lance was quickly celebrated as one of the best cyclists the world has ever seen, but he immediately reflected on his victory over cancer. For both reasons, he has become an inspiration for a group of people growing in numbers and influence: cancer survivors.
In 1971, the year that Lance and the National Cancer Act were born--and even five years later when I was beginning to practice urologic oncology--the idea that a person with metastatic testicular cancer involving the lung and brain could survive five years was a dream. And the suggestion that he could also go on to win the Tour de France five straight times was pure fantasy. But Lance, diagnosed in 1996, began his cycling comeback in 1998 and won his first Tour de France in 1999. Both the dream and the fantasy became reality. Can we dream of a day when every cancer patient will be a survivor? Today, 61 percent of those diagnosed with cancer can expect to live at least five years.
I was privileged to be part of the era that ushered in combination chemotherapy and integrated surgery-radiation-chemotherapy regimens, advances that made cancer survival a reality for many people. Now, as director of the National Cancer Institute, I am privileged to stand at the brink of a new era, one in which survival becomes a reality not just for many but for all cancer patients. I have challenged myself and the entire cancer community to usher in that new era by eliminating the suffering and death associated with cancer by 2015. (See Dr. von Eschenbach's recent interview and Director's Update).
As we work toward that goal, we must prepare the way for more survivors. First, we must come to understand what it means to live with rather than to die from cancer. At NCI, for example, we are looking at ways to improve quality of life for survivors by focusing on palliative care (symptom relief) from the point of diagnosis, rather than primarily in the context of end-of-life care. NCI is working collaboratively with several organizations to integrate palliative care into health professional education. Also, in the past year, NCI has increased by 30 percent the number of grants that address post-treatment needs of cancer survivors and/or their families.
We are also studying long-term and late effects of cancer and cancer treatment, developing a better understanding of the behavioral and socio-cultural factors that influence patient outcomes, further exploring genetic risk factors and tailored treatment regimens, training researchers and disseminating research findings on survivorship, and identifying the special needs of pediatric-cancer survivors.
In developing our plans and programs, we seek and take guidance from such sources as the Institute of Medicine, whose recent reports have been a beacon to our survivorship research, and from the President's Cancer Panel, a three-member group created by Congress to appraise the National Cancer Program and report to the President. Current panel members, Dr. LaSalle Leffall, Dr. Margaret Kripke, and Lance Armstrong, have made survivorship their priority. As we get closer to the 2015 goal, survivorship will grow as an ever more important part of the National Cancer Program.
Andrew C. von Eschenbach, M.D.
Director, National Cancer Institute
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