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Since 1991, the National Breast Cancer Coalition — an influential disease lobbying organization — has promoted evidence-based medicine and focused its public policy advocacy on legislative priorities that encompass three primary goals: increased funding for breast cancer research, improved access to quality breast cancer care and clinical trials, and expanded influence of breast cancer advocates wherever and whenever breast cancer decisions are made.
Last month, the National Breast Cancer Coalition (NBCC) launched the Breast Cancer Deadline 2020 — a call to action for policymakers, researchers, breast cancer advocates and other stakeholders to end the disease by January 1st, 2020.
In what some might call an unrealistic goal, the NBCC has drawn a line in the sand. Clearly, however, the NBCC has had it with the status quo, declaring that more of the same will not end breast cancer :
More than 40 years and billions of dollars have not ended breast cancer. It has, however, created a robust cancer industry that thrives on raising awareness and producing drugs, screening devices and genetic tests. It has also created an academic system that generates hundreds of thousands of articles about breast cancer and builds careers for thousands. Although there is no doubt individual researchers sincerely want to end breast cancer, every system is perfectly designed to achieve the results it gets. The current system is perfectly designed to be lucrative, cautious and incremental.
Breast cancer research takes place within many disciplines, including laboratory science, clinical research, epidemiology, social sciences, and health services research. Generally, research organizations do strive for excellence and prioritize in order to make significant progress in their work. However, there are conflicting agendas that can hinder progress. Pursuit of fame and profit can take the emphasis away from achieving genuine advances for women. Emphasis on research for its own sake limits the avenues for application. Reluctance to include patient and advocate perspectives in research means that issues critical to those living with breast cancer and at risk are neglected, which results in less productive or useful research.
Breast cancer research over the decades has produced elegant science and thousands of important research papers, but little that has had a big impact on patients or those at risk. It is possible for researchers to gain significant acclaim for their work, and to be judged highly successful by the scientific world’s measurement, without having helped a single patient. The system rewards safe ideas and discourages innovative ones that might lead to the big breakthroughs in prevention and treatment. The infrastructure of breast cancer research is to keep things moving along as they have been and to reward people for doing safe, low-impact work. These obstacles are not scientific challenges but rather organizational and systematic dysfunctions. These are problems with solutions.
The NBCC is doing more than just setting a deadline. They have outlined an action plan to get there.
The NBCC has hosted catalyst meetings for more than a decade, bringing together a unique combinations of expert perspectives, including advocates, policy makers, physicists, geneticists, healthcare providers, economists, mathematicians and epidemiologists. The NBCC is now expanding its catalyst meetings to address important questions that are often overlooked but could have a dramatic impact on ending breast cancer; the NBCC will assist in the development of collaborations to design and implement strategies to answer them. The first initiative is the development of a preventive breast cancer vaccine.
A breast cancer vaccine
Cancer vaccines are designed to strengthen the body’s natural defenses by stimulating the immune system to recognize and attack existing cancer cells. There is a model for the NBCC’s approach: human papilloma virus (HPV). Key to this strategy and the challenge for researchers will be the identification of molecular mechanisms shared among the various breast cancer subtypes that cause the disease. A breast cancer vaccine may be closer than you think. A report in Nature Medicine earlier this year reported an experimental vaccine that prevented breast cancer in mouse models .
Dr. Kathy Miller from Sound Medicine — a weekly talk radio show produced by the Indiana University School of Medicine and WFYI Public Radio — recently interviewed the researcher who led the study, immunologist Dr. Vincent Tuohy. You can listen to the interview at Sound Medicine.
The National Breast Cancer Coalition (NBCC) is determined to end breast cancer and is committed to the challenges necessary to overcome whatever barriers are in the way. What do you think? Check out BreastCancerDeadline2020.org and choose your side.
- Breast Cancer Deadline: Why Now? National Breast Cancer Coalition whitepaper. 2010 Sep 20.
- Jaini et al. An autoimmune-mediated strategy for prophylactic breast cancer vaccination. Nat Med. 2010 Jul;16(7):799-803. Epub 2010 May 30.