The ‘war on cancer’ continues
Masonic Cancer Center director Douglas Yee, M.D., reflects on progress so far, work left to do, and how the U will contribute
It’s been 50 years since President Richard Nixon signed the National Cancer Act and declared a “war on cancer.” This year also marks the 30th anniversary of what’s now known as the Masonic Cancer Center, University of Minnesota.
We asked Masonic Cancer Center director and M Health Fairview oncologist Douglas Yee, M.D., who holds the John H. Kersey Chair in Cancer Research, to weigh in on progress so far and work left to do.
So, are we winning the war yet?
Fewer Americans are losing their lives to this disease every year, so in that regard, yes, we’re winning. But the war is not over, and we are continuing to “know our enemy” through research.
The main challenge is that cancer is not a single disease, even within a certain organ. My specialty is breast cancer, for example, and there are at least five well-recognized subtypes—and probably more like 10 or 12 subtypes in all. So we’ve learned that a single strategy cannot be expected to prevent or a cure each of those independent subtypes.
How do you begin to tackle such a complex disease, or group of diseases?
Developing technology is extraordinarily important. When the National Institutes of Health put its weight behind sequencing the human genome in the 1990s, the development of that technology became applicable to improving outcomes and treatments in cancer. Computing technology is really important, too. I think things will get better as we get faster.
Technologies are evolving very rapidly. The therapies I use in clinic on a daily basis were not known when I started my career. They exist because of research and technology advances.
What do you see as the Masonic Cancer Center’s role in eliminating cancer?
Our center is built on the expertise of our world-renowned bone marrow transplant program. Bone marrow transplant was the original cell therapy. Cellular therapies have only become more relevant in the last 30 years. The idea that cells derived from bone marrow can actually enhance or be used as treatments for several types of cancers is pretty exciting. (See below.) But we also know that these cellular therapies need to be easily generated and be available to many patients, and we are leading in making “off-the-shelf” cellular therapies.
We also have made progress in expanding knowledge about how to prevent cancer. We have a smoke-free Minnesota in indoor public spaces because of science generated at the Masonic Cancer Center, which showed that people who are exposed to secondhand smoke had the same carcinogens in their bodies as if they were actually smoking.
I think the idea that the Masonic Cancer Center exists to do complex clinical trials, while at the same time informing public health measures, is our greatest strength.
What advances are coming in the next 10 years?
No one has a crystal ball, but I would like to see better discussion of individualized risk for cancer. President Biden is pushing for us to share deidentified data available through electronic medical records, which will help us better understand how factors like physical activity, weight, and diabetes—and someday genetic makeup—will be used to determine an individual’s risk of developing cancer. And we’re also going to better understand how the microbes that live in and on our body both determine our risk for cancer and interact with cancer treatments.
I also think we will have a deeper understanding of disparities in cancer outcomes. Not all Americans have the same outcomes, in a large part based on ancestry, where you live (urban or rural), and socioeconomic status.
We need to understand these factors in order to change public policy and improve cancer outcomes for everyone.