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July 4, 2021

Letter to Director, National Cancer Institute,

natpernickshealthblog.wordpress.com/2021/07/04/letter-to-director-national-cancer-institute/

4 July 2021

Hi Dr. Sharpless,

I read your April 2021 talk to the American Association for Cancer Research (AACR), see

http://www.natpernick.com/AACRSharplessApril2021.pdf, and am distributing it to my

network.

In my view, reducing the high number of US cancer deaths is primarily a management

problem to be solved by creating a strategic plan that identifies necessary management and

medical / scientific tasks:

1. Our goal should be to reduce annual US cancer deaths from 600,000 currently to 100,000

by 2030, as discussed in our strategic plan,

http://www.natpernick.com/StrategicPlanCuringCancer.html. Although your goal of

reducing age-adjusted cancer death rates in half is rational, this is too abstract to resonate

with the hundreds of millions of Americans who must feel compelled to act.

2. I believe that we can substantially increase survival for aggressive pancreatic, lung,

colorectal and breast cancers by using large combinations of partially effective therapies

targeting different malignant attributes. For each cancer histological type, we should identify

20-30 important malignant attributes and then identify or develop therapies with at least

partial effectiveness for each attribute, see

http://natpernick.com/Pancreatic%20Cancer%20Treatment%20Targets.html. Then, our

oncologists and pharmacologists can find combinations of 8-10 of these therapies that will be

substantially effective, http://www.natpernick.com/CombinationsOfTherapy.html. This

proposal is based on complexity science – the behavior of the whole is greater than the

behavior of the sum of the parts. We should also reduce the number of clinical studies using

only single agents (after initial trials establish their efficacy) – we know that single agents

typically cannot be successful because they cannot adequately damage the weblike nature

of the malignant process.

3. To determine the malignant attributes of each cancer histological type, we need to identify

systemic network disturbances that nurture the cancer, such as microenvironmental factors,

inflammation, unicellular-type programming, dysfunctional immune systems and hormones.

We also have to better understand cancer cell stability (“cancer attractors”,

https://pubmed.ncbi.nlm.nih.gov/19595782) and how to disrupt it with therapies that move

tumor cells into less hazardous networks, https://pubmed.ncbi.nlm.nih.gov/31921665.

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4. We need to investigate and reduce cancer deaths occurring within 30-60 days of

diagnosis. These deaths, when due to infections, treatment side effects or disruption to vital

physiologic networks, are often preventable,

http://www.natpernick.com/CuringCancerPart9.html. Some of these cases may be

analogous to diabetic ketoacidosis – with proper management, the life threatening episode

can be resolved and the underlying disease can then be managed.

5. Long term, we can reduce cancer deaths by 30-40% through prevention and improved

screening. We must reduce tobacco use to 5% or less of the population, improve the

American diet to be predominantly plant based, reduce excess weight from 60% to perhaps

10% of the population and ensure that all Americans get adequate medical care including

regular examinations to promote prevention and detect early disease.

My training is in mathematics, computer science, pathology and law,

http://www.natpernick.com/, but my management experience is in creating a free online

textbook in 2001, now used by most pathologists in the English speaking world,

https://www.pathologyoutlines.com/ and creating (last month) a worldwide directory of

pathologists, https://www.pathologyoutlines.com/directory.

Please contact me or have one of your staff contact me regarding the next steps we can take

together.

Nat Pernick, M.D.

Curing Cancer Network:

* Strategic Plan – http://www.natpernick.com/StrategicPlanCuringCancer.html

* American Code Against Cancer –

http://www.natpernick.com/AmericanCodeAgainstCancer.html

* Blog – https://natpernickshealthblog.wordpress.com/

* Newsletter – https://lp.constantcontactpages.com/su/onz6IND

* Grants – https://www.pathologyoutlines.com/grants.html