When we finally develop broad and enduring treatments for many leading forms of cancer, historians may recall President Barack Obama’s stirring call for a “moonshot to cure cancer” in his final state of the Union Address as a major turning point in the long war against the “emperor of all maladies.”
While the president’s language rang with Kennedyesque inspiration, Vice President Joe Biden’s more prosaic speech three days later may have truly laid the groundwork for victory against a disease that claims the lives of almost 600,000 Americans each year.
In an address at Penn Medicine’s Abramson Cancer Center in Philadelphia, Biden implicitly recognized the challenges faced by researchers who study cancer – not a single disease but a complex set of perhaps 200 diseases known by a single name. Specifically, he urged everyone fighting cancer to “break down silos and bring all the cancer fighters together – to work together, share information and end cancer as we know it.”
In a word, Biden called for collaboration – for everyone in the fight to see themselves as members of a single army battling a common enemy.
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His call is more than a demand that independent researchers and corporations balance their healthy quest for prestige and profits with an awareness that proprietary information can be an impediment to discovery. It recognizes how much science and medicine have changed during the last few decades, creating an urgent need for reform in how we accelerate disease-targeted research progress based on an expansive new understanding of collaboration.
Despite romantic notions of lone genius inventors and eureka moments, the increasingly complex and resource-intensive nature of scientific and medical research has fostered both specialization and teamwork. The field once known simply as biology, for example, has splintered into an array of micro-disciplines.
Ironically as the questions asked grew more focused – creating silos of information – the scope of inquiry became far wider. Especially during the last half of the 20th century, medical research extended beyond those seeking to unravel the mysteries of the human body. Today, engineers, mathematicians, statisticians, chemists, physicists and computer scientists work on problems that run the spectrum from basic biomedical discovery to the development of treatments for disease, including cancer. And this trend is expanding even further as we learn more about how our most devastating diseases are subject to the complex influences of our social and physical environment – requiring that we look to social, public health, economic and environmental research to address critical human health issues.
These twin trends – convergence and collaboration – will shape our fight against cancer as well as other health problems, including obesity and diabetes. Indeed, they are also informing fields outside of medicine. The new master plan for the Research Triangle Park explicitly seeks to encourage collaboration as do the cutting-edge “innovation districts” that have sprouted from Boston to Barcelona.
One vibrant example can be found where I work, the University of Michigan.
In 2011, we created the Institute for Healthcare Policy and Innovation to bring together health services researchers in a variety of fields to evaluate how health care works and how it can be improved.
Today, more than 460 researchers – including public health specialists and physicians, lawyers and pharmacists, social scientists and nurses, engineers and economists – are working together to mine the massive data found in medical records and make discoveries that can improve the quality, safety, equity and affordability of health care services.
We have also launched similar efforts in biology-driven disciplines – focusing on studies of microorganisms that live in our bodies, probing the role of botched protein production in many diseases and understanding cancer’s devious biology.
In the spirit of Biden’s call, we must all work to share information and encourage collaboration in order to pool and exploit the vast knowledge about cancer and other diseases that have remained hidden away in silos.
Just as Apollo 11 astronauts reached their destination, I believe that our moonshot to cure cancer, and to address other major health issues confronting our nation, will ultimately succeed not only because of the powerful tools and knowledge we have at our disposal, but also because of our much better sense of how collaboration can help us use and develop them to conquer this ancient foe.
Marschall S. Runge, former executive dean of the UNC School of Medicine, is executive vice president for Medical Affairs and dean of the Medical School for the University of Michigan.