Cancer is Political

Cancer is Political

Why? Well, first of all, people die from cancer. It’s the second leading cause of death in the US.

Second, it can happen to anyone. Cancer is extremely common. If they live a normal lifespan, half of women and a third of men will get it. And if you’re thinking it can’t happen to you, well—neither did the last few thousand of my patients.

Yes, we can tempt fate and increase our risk by bad lifestyle choices: alcohol, tobacco, and obesity are big risk factors. But a great many cases happen because of genetics or just bad luck. Doesn’t matter who you are, or how you vote.

Though it’s more common as we age, it can strike at any age. And it starts getting more frequent just as people enter the last decade of their working lives.

Third, it’s expensive. Though two of the most common types, breast and colon cancer, for instance, are very curable, the treatment may take 6-12 months, often interrupts work, and comes with significant out-of-pocket expenses even for those with insurance. A cancer diagnosis in the United States causes 60% of patients to have to deplete their savings, and increases the risk of bankruptcy 2 1/2 times.

So…

  • Common
  • Expensive
  • Life & Death

That’s political dynamite.

Cancer’s been overtly political since President Nixon signed the National Cancer Act in 1971, setting in motion a half-century of public investment in cancer care.

Green Bay Oncology was founded five years after that. And we’ve seen first-hand what our citizens have gotten in return for that investment. 

At a recent round table of our doctors (some retired and some still practicing), we compared life expectancies for several different cancer types from the 70s to now. Let’s consider the examples of stage 4 melanoma, kidney cancer, and colon cancer—we see they’re still uniformly fatal, but patients survive them much longer.

DISEASE1970sNOW
Colon Cancer< 6 months2-4 years
Melanoma< 6 months2-5 years
Kidney Cancer< 6 months2-4 years
Myeloid Leukemia2 yearsNormal lifespan
Promyelocytic Leukemia< 2 weeksNormal lifespan
Myeloma1 year8-10 years
Source: Green Bay Oncology Physicians’ Roundtable, 8/2022

But several former death sentences can now be substantially delayed or cured altogether. 

Next, let’s compare the patient experience of one of the most common types—breast cancer—from then until now. We can see how we’ve learned to treat it with less surgery, less side effects, and less hospitalization.

EXPERIENCE1970sNOW
Mastectomy> 90%< 30%
Receiving chemotherapy> 75%< 25%
Duration of chemo6 months2-3 months
Vomiting after chemo> 75% < 20%
Hair loss after chemo> 50%< 20%
Hospitalization after chemo> 50%< 10%
Source: Green Bay Oncology Physicians’ Roundtable, 8/2022

That’s a lot of lives, workdays, and wages saved.

Almost all of this progress has been the result of publicly-funded research that started back in the 1970s. It takes a long time. We know this because besides our clinical work, Green Bay Oncology devotes significant time and resources to help test new treatments through clinical trials. Our doctors, like the people of Wisconsin, are “get involved” kind of people, and that’s why our practice is able to achieve a 17% clinical trial enrollment rate—far above the national average of 2%. This research is happening right here in our hometown.

But not all of the benefits I just described are accessible to all the people of Wisconsin. Rural people, for instance, many of whom live fifty miles or more from cancer clinics, find the frequent travel a significant burden. It’s expensive and time consuming, at a time when they already don’t feel their best. Because cancer patients in rural Wisconsin have to spend more money traveling for care, they tend to forego screening and delay diagnosis. These delays cause rural cancer patients to be sicker, with more advanced disease when they finally do walk in the door—with worse survival rates as a result.

Sources: WI Office of Rural Health JCO Oncology Practice, Levit et Al, 7/6/2022 Health Services Research, Holmes et Al, 4/2006

Green Bay Oncology is well aware of this because we’ve driven to the moon and back—quite literally the distance from the earth to the moon, and back—taking cancer care closer to rural residents, so they can have a fair share of what they’ve already paid for with their tax dollars.

What Green Bay Oncology, in partnership with the American Cancer Society Cancer Action Network asks of our lawmakers is this:

  • First, acknowledge the scope of the problem and the breadth of the people affected.
  • Second, stay invested in the long game. From the frequent advertisements for new immunotherapy drugs you see on TV, you might get the impression that immunotherapy is a new idea, but I can tell you…immunotherapy for cancer was a hot topic all the way back when I was an undergraduate in the 1980s. All of today’s progress is a result of decades of basic science research – most of which was publicly funded. So mistrust anyone who promises quick results on the cheap.
  • Third, don’t lose patience with the complexity of the problem. Yes, there are fantastic opportunities for private capital and public investment to work together, and yes—there’s a role for research and regulatory reform. But there’s no single, simple solution. We need public funds to support endeavors with little profit potential, and we need oversight and accountability anytime one group of people are tasked with spending other people’s money. The key is balance, and balance is complex—not simple. Sensible, incremental change and progress gets the results. Slow and steady. That requires patience and persistence. Mistrust anyone shilling simple solutions.
  • Fourth, let us help lawmakers identify and promote the most impactful reforms, and help craft a winning message to garner public support for the effort. The American Cancer Society Cancer Action Network and Green Bay Oncology understand that we only succeed together—lawmakers and healthcare leaders.
  • Fifth, keep the door open for rural people, who cannot bridge the gap without expanded access to care.

Only working together—clinicians, activists, and lawmakers—can we keep cancer treatment within reach of all the people of Wisconsin—rural, urban, or suburban. Much has been gained since the 1970s, and the people of Wisconsin have helped pay for that progress with their taxes. They rightly own a share of the returns.

Cancer Lobby Day

Cancer Lobby Day

If you’ve attended any local cancer event in the last twelve years—we’ve probably met.

My passion is connecting our community with their cancer doctors. This led me to serve on The American Cancer Society Wisconsin Leadership Board and to become an Ambassador Constituent Team Lead with The American Cancer Society Cancer Action Network.

While in DC for Cancer Lobby Day, we asked three important things of our Wisconsin lawmakers. Here’s why it’s important and how it will impact cancer care in our hometown.

  1. Support increased funding for cancer research & prevention programs.
    • The medical science can only advance as fast as people are willing to participate in trials. And Wisconsinites participate in cancer research at a 17-20% rate, consistenly outpacing the national average of only 2-4%. Our citizens know the currently available treatments are only good enough for yesterday—not tomorrow. They stand ready and able to carry the nation’s progress in cancer treatment forward.
  2. Co-sponsor the DIVERSE Trials Act
    • This would increase diversity in clinical trials and make it easier for all people with cancer to participate by reducing financial barriers to enrollment. 
    • This legislation allows trial sponsors to reimburse patients for non-medical costs associated with their trial participation, including parking, food, or lodging. It provides the necessary technology to facilitate remote participation. It also requires the Department of Health and Human Services to create guidance on the use of decentralized trials to increase diversity.
  3. Co-sponsor the Medicare Screening Coverage Act
    • This would create a pathway to allow Medicare to cover multi-cancer screening tests once they have been approved by the FDA. 
    • It’s widely accepted that public investment in cancer prevention and screening is good and necessary. But there’s another reason: the worsening shortage of U.S. oncologists. The Journal of Clinical Oncology estimated a shortfall of 3,800 cancer physicians in 2020. And we’re already experiencing the pinch, right here in rural Wisconsin. We must reduce the number of advanced cancer cases, and develop better, less burdensome treatments to relieve the strain on our health system. Because sooner or later cancer comes for all of us, or those we love.

The week ended with a Lights of Hope walk to remind everyone why we continue to come to DC year-after-year. Over 60,000 candlelit bags lined the pond at the Washington Monument and were dedicated to someone impacted by cancer.

For more ways to be involved, check out: ACS-Cancer Action Network

Cancer Action Network – Wisconsin Team