Dana-Farber Cancer Institute Joint Visiting Committee Symposium Dinner
November 17, 2010
Remarks as prepared for delivery
Thank you, Dr. Benz, for that kind introduction. And thank you for inviting me to join you tonight.
Something you may not know about Dr. Benz is that in addition to being a great leader and researcher, he has also been a great teacher. In fact, he was the one who taught our NIH Director and human genome pioneer Dr. Francis Collins how to make RNA back in 1983, which is kind of like being the one who taught Tom Brady how to throw a football.
So on behalf of our department, I want to thank Dr. Benz. And I also want to thank him and all of you for everything you do to make Dana-Farber such a special place.
For decades, Dana-Farber has been a crown jewel in our nation’s health care system. For patients, it is a symbol of hope. For researchers, it is a standard of excellence. For our country, it is a source of life-saving, job-creating discoveries.
And none of that would be possible without those of you who are here tonight. From Dr. Benz and the administration to the faculty to the donors and supporters who help Dana-Farber stay on the cutting edge of cancer research and treatment, I want to thank all of you for making these contributions possible.
Dana-Farber has also helped make Boston a world leader in health care, not to mention a fertile recruiting ground for our department. Many of our department’s senior leaders come from the Boston area, including our Centers for Medicare and Medicaid Services Administrator Dr. Don Berwick, our Assistant Secretary of Health Dr. Howard Koh, and our National Coordinator for Health Information Technology Dr. David Blumenthal.
So when I accepted this invitation, I had to promise Dr. Benz that I’m not going to take any researchers back with me. At least for now.
I’m glad to be talking with you tonight as you prepare for tomorrow’s discussions about the future of this center because I believe we are also at a critical moment for the future of cancer and our country.
Over the last hundred years, we’ve seen two trends converge.
First, there have been huge gains in length and quality of life. Since World War II, the death rate for coronary heart disease in this country has dropped more than 60 percent. The death rate for stroke has dropped 70 percent.
The result is that a child born today will live nearly three decades longer than a baby born in 1900. That’s one of the most extraordinary accomplishments in American history.
But as our lives have lengthened, new health threats have emerged. Cancers that often didn’t show up until after your 60th birthday used to be afterthoughts. Now, they are some of our deadliest killers.
Altogether, about 500,000 Americans will die of cancer this year, almost one every minute.
You know this trend better than anyone. It’s the reason fighting cancer must be a top priority if we want a healthier country.
But here at Dana-Farber, you are also helping to drive the second trend, which has the potential to counteract the first.
Over the last few decades, we’ve seen the start of a transformation in how we treat cancer from brute force treatments that don’t distinguish between healthy and cancerous cells to more effective, targeted therapies.
Thanks to new efforts like the Cancer Genome Atlas, we can look forward to the day when cancer treatments are tailored to the specific DNA changes in each patient’s tumor.
So the need for breakthroughs against cancer has never been greater. But neither has the opportunity to make those breakthroughs.
That’s why cancer has been a focus for President Obama and this Administration from his first days in office. In his first address to Congress, he called for quote, “a new effort to conquer a disease that has touched the life of nearly every American by seeking a cure for cancer in our time.”
Since then, we’ve pursued an aggressive agenda to beat back cancer across the country.
Our first area of focus has been prevention. Every day, more than 1,000 Americans die from smoking or second-hand smoke. And yet, every day, 1,000 Americans under age 18 become daily smokers.
To bring down the first number, we need to bring down the second.
To do that, we’ve undertaken a broad agenda to stop people from starting to smoke and help them stop. Last year, new legislation gave the FDA unprecedented new power to regulate tobacco and stopped some of the sleaziest tactics for marketing to kids. And last week we announced new graphic warning labels that will let consumers know exactly what they’re getting when they buy a pack of cigarettes.
We also know one of the most important factors in whether you survive cancer is how early you catch it.
For example, when breast cancer is caught early, the five-year survival rate is 98 percent. When it’s caught late, the survival rate can be as low as 23 percent.
Yet for too long, too many Americans didn’t get the screenings necessary to catch these cancers because they couldn’t afford them. Last month, I spoke with a woman named Lorene from Georgetown, South Carolina whose story is all too common.
Years ago, she felt a lump in her breast, but she didn’t have the insurance to afford to get it checked out. So she kept putting it off. By the time a nurse practitioner suggested that she get it checked out, it had grown into a stage IV breast cancer.
But now under the Affordable Care Act, many Americans will be able to get critical preventive screenings like mammograms and colonoscopies at no additional cost.
We’re also developing better screening techniques. For example, earlier this month, we learned that when current and former heavy smokers got annual low-dose helical CT scans, their risk of death from lung cancer fell by one fifth.
Coming up with an effective strategy to help people stop smoking or a better screening test may be less dramatic than developing a new, ground-breaking drug, but we can’t beat cancer without doing all of that.
So prevention is the first part of our anti-cancer agenda. But no matter how successful we are, people are still going to get sick. That’s why we’re also working to increase access to care.
For years, health insurance companies have had free reign to reject the applications of Americans with cancer, which meant that the people who needed coverage the most were often the ones who couldn’t get it.
And even if you had insurance and faithfully paid your premiums, insurers could take away your coverage just by finding an error in your paperwork.
Earlier this year for example, I met a woman named Kelly from Las Vegas who told the story of her sister, kindergarten teacher Christy Annett. In 1999, Christy was diagnosed with an acute leukemia, but it was treated successfully. All she had to do was get her blood drawn regularly to make sure the cancer hadn’t returned.
Then in 2007, she was diagnosed with a bone marrow disorder that often leads quickly to a return of leukemia. She needed a bone marrow transplant and thankfully, she had insurance. But her insurer rescinded her coverage, saying that the “blood draws” she had received were “treatment” that she hadn’t reported on her application.
Christy appealed, but her appeal was denied. She passed away in 2009, two weeks before her 31st birthday.
For too long, too many Americans like Christy were denied the life-saving care from places like Dana-Farber because of our broken health insurance system.
Under the new health care law, that’s starting to change.
Thanks to a new Patient’s Bill of Rights that went into effect in September, there will be no more lifetime dollar limits on benefits, which could leave a cancer patient without coverage right in the middle of a round of treatment.
Insurance companies will also no longer be allowed to cancel your coverage because of an unintentional error in your paperwork.
And there will be new coverage options for Americans with pre-existing medical conditions.
Earlier this year, I met another woman named Gail O’Brien from Keene, New Hampshire. In March, Gail was diagnosed with non-Hodgkin’s lymphoma. She didn’t have health insurance, and in the past, her story might have ended like Christy’s.
But under the Affordable Care Act, Gail was able to join a new Pre-Existing Condition Insurance Plan in July and is now receiving treatment and responding well.
And starting in 2014, she’ll be able to choose from a range of insurance options in a new Health Insurance Exchange, where plans will be forbidden from excluding anyone including cancer patients based on their health status.
As a result of these new reforms and others, more Americans with cancer than ever before will be able to take advantage of the incredible treatments that have been developed in the last couple decades.
But for too many Americans with cancer today, the treatments we have are insufficient. They are ineffective or offer only a few more months of comfort.
That’s why the third part of our cancer agenda is a renewed commitment to cancer research.
We’re fortunate to have a terrific team at NIH lead by Dr. Collins whose work sequencing the human genome is now the foundation of much of the most promising cancer research.
And we’re grateful that Dr. Harold Varmus, a Nobel Prize winning cancer researcher and former head of the NIH has returned to lead the National Cancer Institute.
President Obama believes strongly in the promise of biomedical research. As many of you know, one of the first laws he signed was the Recovery Act, which invested an additional $10.4 billion in the NIH over two years, including nearly $1.3 billion for cancer research. This was the single largest boost to biomedical research in American history and many of those funds went right here to Dana-Farber.
Those funds are also supporting the Cancer Genome Atlas, which is building a comprehensive database of the DNA changes associated with 20 major tumor types – another initiative in which Dana-Farber is playing a critical role.
Recent developments in lung cancer research show the promise of this approach.
The Dana Farber/Harvard Cancer Center played a key role in identifying several mutations associated with a common form of lung cancer. Now, we’ve identified two chemotherapy drugs work much better in lung cancer patients with one of those genetic signatures.
We have a long way to go down these promising research avenues. But we all know that in today’s budget climate, it will be difficult to secure additional funding – even for investments with the proven long-term impact of biomedical research.
That’s why it’s so important that we make the most of the funds we have.
And that means making sure no promising discovery languishes in the laboratory.
Today, as the researchers here know well, there is a long path between a scientific breakthrough and a new medicine, and there are many detours and obstacles along the way.
So over the last two years, this Administration has undertaken a broad effort to speed discoveries from microscope to market. As part of the Affordable Care Act, we are creating the Cures Acceleration Network in the NIH that will help academic investigators move their discoveries through the drug development pipeline.
And we’re building a stronger partnership between NIH and FDA. From early in development, basic researchers at NIH should be sharing information about emerging technologies with scientists at FDA to help them develop standards for safety and effectiveness. At the same time, the FDA can help guide NIH research by identifying critical safety or quality issues that can be addressed early in the development of new treatments.
If new cancer therapies do fail, we want it to be on the basis of science, not because it was too difficult to navigate the regulatory process.
To gain the upper hand on cancer going forward, we will have to continue to pursue all three parts of this agenda: more prevention, more access to care, more research breakthroughs.
And there are signs that we are making progress: In 2007, the number of cancer deaths in the US went down for the first time ever.
But the history of the fight against cancer has taught us that when we see a glimmer of light at the end of the tunnel, we need to accelerate, not ease up.
President Obama and this Administration are committed to doing everything we can to support the treatment and research efforts of centers like Dana-Farber. But we also need your help.
There is no doubt that that Dana-Farber will continue to provide advanced care and conduct path-breaking research. But here at Dana-Farber, you are also experts at rallying support for a worthy cause. You are the reason every child growing up in New England knows what the Jimmy Fund is long before they’ve ever heard of Jimmy Carter or Jimmy Buffet.
So tonight, I want to ask you to take the same energy, creativity, and passion that you bring to the work of this extraordinary Institute and use it to support the broader agenda that will be required to have a healthier America. It’s true that we will never defeat cancer without the next generation of treatments and cures. But we also cannot defeat it as long as four thousand teenagers smoke their first cigarette every day and millions of Americans continue to go without necessary care because they don’t have health coverage.
Many of you have seen the new “Biography of Cancer” that is on bookshelves now across the country. It’s not surprising that the author trained at Dana-Farber.
But this book is just the beginning of the story. If we can work together to put a new focus on prevention, give every American access to affordable care, and develop a new generation of targeted treatments, we can write the next part of the story in which cancer deaths continue to fall, and eventually, a final chapter.