The New "C"...Continuous Innovation

Ignoring this cycle of innovation in cancer research due to economic pressures carries the risk of unintended consequences.
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On April 5, 2009, three words changed my life -- and the lives of my wife and four children - forever: "You have cancer." Here is what I wrote in my blog: "It was a moment frozen in time as I gazed over the edge of my earthly life."

Those words resonate within me to this day.

Diagnosed with stage IV diffuse large B-cell non-Hodgkin's lymphoma, my life was turned upside down as I was abruptly catapulted into "cancer world" -- a world of doctor and hospital visits, medical tests and chemotherapy; a world of waiting and watching, worrying and praying.

The calm after the storm came eight months later, in December, when my oncologist informed me that I was in remission. While I remain cancer free to this day, one thing will never change: I am a cancer survivor, one of the 13.7 million Americans who have heard those same three words, "You have cancer," and still are alive to talk about it.

June 2 is National Cancer Survivors Day, a day when communities nationwide host events to honor those living with a history of cancer, as well as the healthcare providers, family and friends who have supported them. Look for the celebrations to get larger with each passing year, since there will be 18 million cancer survivors by 2020, according to the National Cancer Institute.

There can be life after cancer -- a good life. And that's something to celebrate.

We've come a long way since President Richard Nixon first declared the "war on cancer" in 1971, when the dreaded "C" word remained tantamount to a death sentence in most cases. Thanks to an unrelenting commitment on the part of many people, and a truly "war-like" investment of resources in recent decades, we now have a deeper understanding of the fundamental nature of cancer, including the fact that it is not one disease, but more than 200. Survival times for many cancers -- such as prostate, thyroid, testicular, melanoma and breast cancers -- continue to expand, and when diagnosed earlier on, some cancers can be controlled or even cured.

Unfortunately, there are no guarantees that this progress will continue, as economic pressures threaten the fuel that drives innovation against cancer -- including donations to cancer charities; government investment in basic research, and the willingness to pay for new cancer treatments.

I worry about this, not only as a cancer survivor, but also because I work in the pharmaceutical industry at Lilly. It takes significant investments to bring new cancer medicines to patients -- in a complex, global, closely regulated process that takes more than a decade, when it's successful at all -- and involves substantial financial risk.

At this moment, I am attending the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. Aptly themed Building Bridges to Conquer Cancer, ASCO brings together more than 25,000 of the brightest oncology minds from around the world to share research and forge new, creative collaborations that will one day lead to newer and better cancer treatments -- and eventually to cures.

"One day" is the operative term, because if there's anything we've learned from cancer research, it's that progress usually does not come in the form of dramatic developments but rather in the form of continuous innovation over time. For example, seemingly modest survival benefits of weeks or months build on each other over time, as the knowledge gained from one generation of treatment points the way to the next generation of more effective treatments.

Ignoring this cycle due to economic pressures carries the risk of unintended consequences. If regulators, health-technology assessment bodies, or healthcare payers in different places insist on seeing evidence of large-scale benefit up front as the requirement for giving patients access to new medicines, then there is a real danger that some new therapies may never see the light of day.

That's why understanding and appreciating continuous innovation is so important. The term captures the essence of our progress against many cancers -- progress that has improved the lives of millions of people now living with cancer.

For example, dramatic progress against breast cancer resulted from continuous innovation. Not too long ago, radical mastectomy -- the removal of the entire breast (and often the unaffected breast), underlying muscle and underarm lymph nodes -- was considered the only way to treat the disease. With continual scientific advances in screening, surgery, chemotherapy and radiation therapy over the last few decades, breast cancer is now often treated in a far less invasive manner in combination with other therapies, and with a focus on breast preservation. Simultaneously, according to the American Cancer Society, the five-year survival rate climbed from 63 percent in the early 1960s to over 95 percent today. It made that climb not in a single leap, but in individual, continuous steps.

The key policy question today is how to replicate and improve that model against other cancers: accelerating the steps, sustaining investments and placing the interests of individual patients above all.

My industry colleagues and I believe that the answers will be arrived at collaboratively. In my company, we've created a network called PACE, which stands for Patient Access to Cancer care Excellence. PACE aims to help build the understanding, confidence and cross-sector infrastructure for better collaboration on policy reform. We know that it will take much more than PACE to sustain continuous innovation against cancer, but we also believe that no one who cares about this challenge should stay on the sidelines.

Thanks to continuous innovation, I lived to see another ASCO, another Cancer Survivors Day and, on June 16, another Father's Day.

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