27 August 2021
This essay summarizes the latest version of our Strategic plan to substantially reduce cancer
deaths, click here.
* First, it is important to have an ambitious plan that itemizes what needs to be done and
what needs to be better understood. Our plan might fail. But it is important to “dare greatly”
(“The Man in the Arena”, 1910, retrieved 27Aug21) and attempt to achieve our actual
goals, even if we do not know precisely how to do so.
* Second, reducing the high number of US cancer deaths is a management problem that
requires that we optimize each step of cancer’s clinical pathway (prevention, early detection,
treatment and failure to respond to treatment). It is not primarily a problem of finding a “silver
bullet” or “magic pill”.
* Third, we should study and reduce cancer deaths that occur shortly after diagnosis. These
may be preventable if due to (a) overzealous treatment that does not adequately balance
treatment side effects, (b) predictable infections or (c) damage to essential physiologic
networks that can be normalized.
* Fourth, we speculate that for each cancer type, even the most aggressive, there exists a
combination of perhaps 8-10 therapies that individually may be only partially effective but
together can be substantially effective. Effective combinations not only target the cancer cells
but their surrounding microenvironment; systemic networks involving inflammation, the
immune system and possibly hormones; germline variations in DNA and known patient risk
factors for this disease.
* Finally, we outline important therapeutic strategies, including: