27 August 2021 - Updates to Strategic Plan to Substantially Reduce Cancer Deaths

This essay summarizes the latest version of our Strategic plan to substantially reduce cancer
deaths, http://www.natpernick.com/StrategicPlanCuringCancer.html  .

* 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”,
see https://en.wikipedia.org/wiki/Citizenship_in_a_Republic, 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:

– Treatment should focus on managing the malignancy to reduce death and disability, not
eliminating every possible cancer cell.

– Consider achieving “marginal gains” at all steps of the disease process, which may
increase possible treatment options and reduce a sense of futility.

– Therapy should be patient centered to the extent possible because patients may have
markedly different therapeutic preferences.

– Aggressively enroll patients into clinical trials so physicians can learn and improve over
time.

You can help:

* Follow our Curing Cancer Blog at https://natpernickshealthblog.wordpress.com/

* Sign up for our Curing Cancer Network monthly newsletter by clicking at
https://lp.constantcontactpages.com/su/onz6IND .

* Become an example to others of anti-cancer behavior. Read our American Code against
Cancer at http://www.natpernick.com/AmericanCodeAgainstCancer.html, decide what
steps you can take to reduce your cancer risk and spread the word through your social
networks.

 

 

 

 

10 August 2021: Letter to President Biden

 

Let me know if you have comments for future letters or you have suggested contacts.

Thanks

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10 August 2021

Dear President Biden,

I am a pathologist who developed PathologyOutlines.com, a free online pathology textbook used regularly by pathologists worldwide.

Consistent with your goal of ending cancer as we know it, I have developed a strategic plan to substantially reduce cancer deaths from the current level of 600,000 per year to 100,000 per year, see http://www.natpernick.com/StrategicPlanCuringCancer.html.

Who do you know, in or outside government, who is willing to “think outside the box”, and focus on this long term goal and what we need to do to get there?

Unfortunately, most cancer physicians and scientists are focused on short term thinking - promoting their career and not ruffling too many feathers. They don’t want to take risks that may fail. In addition, too many scientists are wedded to reductionist thinking and focus on naive concepts such as “the cure” or “a world without cancer”. However, cancer is the result of intersecting webs of disturbed physiologic networks - we typically will need to cut many strands of the web to destroy its function - a few drugs will usually be inadequate to do that. We also need more ambitious prevention goals such as markedly reducing tobacco use and obesity and making dramatic changes to our diet if we want to substantially reduce cancer deaths.

Our work is moving forward with the help of a growing network of interested people, but the more people in our network, the better. I would appreciate your help, or that of your staff, in advancing this cause by identifying interested people to work with us.

We don’t need your money, but we do need your connections!

Please review and advise.

6 August 2021: Updates to Strategic Plan

We have updated our Strategic Plan to substantially reduce cancer deaths, see http://www.natpernick.com/StrategicPlanCuringCancer.html .

There are three main changes. First, we propose that success in substantially reducing cancer deaths is essentially a management task, not a technological one. Second, we have broken down treatment related goals into specific tasks that can be assigned to individuals or groups. Third, the overall plan was “tightened up” and is shorter.

We have created a table listing malignant attributes associated with pancreatic adenocarcinoma, the most common type of pancreatic cancer, see http://natpernick.com/Pancreatic%20Cancer%20Treatment%20Targets.html. We need to further refine this table by adding more attributes, by identifying more treatments that are at least partially effective against these attributes and by contacting individuals who might be interested in pursuing clinical studies testing therapies against these attributes.

We plan to create similar tables for lung and liver cancer, the other major aggressive malignancies. For colorectal, breast and prostate cancer, we have to separate out the specific types that are the major causes of cancer death since most cases have favorable survival. We plan to hire a research assistant to assist with these tasks.

We have met with public health experts at the State and County level to discuss reducing the cancer risk factors listed in the American Code against Cancer, see http://www.natpernick.com/AmericanCodeAgainstCancer.html. Although public health agencies are currently overwhelmed by the COVID-19 pandemic, we plan to work with them to discuss how to achieve the ambitious behavioral changes necessary to markedly reduce cancer deaths. We may also sponsor high school science fairs or essay contests related to cancer.

You can help:

* Follow our Curing Cancer Blog at https://natpernickshealthblog.wordpress.com/ .

* Sign up for our Curing Cancer Network monthly newsletter by clicking at https://lp.constantcontactpages.com/su/onz6IND .

* Become an example to others of anti-cancer behavior. Read our American Code against Cancer at http://www.natpernick.com/AmericanCodeAgainstCancer.html, decide what steps you can take to reduce your cancer risk and spread the word through your social networks.

* Tell any medical researchers you know about our current grants at https://www.pathologyoutlines.com/grants.html .

* Contact me with your thoughts and suggestions at Nat@PathologyOutlines.com

28 July 2021: Random Chronic Stress Is a Major Cause of Pancreatic Cancer - abstract

Pancreatic cancer is a major cause of US cancer death. It has risk factors that are preventable, such as cigarette smoking, excess weight, type 2 diabetes, excessive alcohol use and diabetes (Pernick, How Pancreatic Cancer Arises Based on Complexity Theory, 2021). It also has risk factors that are not, such as having blood groups A, B or AB (i.e. not O). This abstract discusses random chronic stress or bad luck, another major cause of pancreatic cancer that is not preventable (Curing Cancer Blog – Part 7 – Random Chronic Stress), which is also a major cause of lung cancer in nonsmokers (Pernick, How Lung Cancer Arises, Based on Complexity Theory, 2021).

 

This subject was discussed in the abstract below, which was not accepted at a recent conference. Although disappointing, the advantage of this rejection is that I can publish it without any restrictions. The full paper is at http://www.natpernick.com/PancreaticcancerFeb2021.html. I welcome your comments to Nat@PathologyOutlines.com.

To continue, see: Random Chronic Stress Is a Major Cause of Pancreatic Cancer - abstract (link), Blog, PDF.

 

How can you help?
 
1. Follow our Curing Cancer Blog at
https://natpernickshealthblog.wordpress.com/ .
2. Sign up for our Curing Cancer Network monthly newsletter by clicking at
https://lp.constantcontactpages.com/su/onz6IND .
3. Become an example to others of anti-cancer behavior. Read our American Code against
Cancer at http://www.natpernick.com/AmericanCodeAgainstCancer.html,
decide what steps you can take to reduce your cancer risk and spread the word through
your social networks.
4. Tell any medical researchers you know about our current grants at
https://www.pathologyoutlines.com/grants.html.
5. Contact me at Nat@PathologyOutlines.com with your suggestions or thoughts on
how you can help.
 

 

 

26 July 2021: Letter to President Joe Biden (July 2021)

 

I emailed this letter earlier this month – to date, there has been no response:

Dear President Biden,

Please identify who I should talk to concerning your goal of “ending cancer as we know it”. To be successful, we need better management, beginning with a strategic plan similar to the one I have developed, see http://www.natpernick.com/StrategicPlanCuringCancer.html.

We need a challenging goal, such as reducing US cancer deaths from the current level of 600,000 per year to 100,000 per year.

We need to identify the knowledge gaps and focus on research to fill them.

We need to abandon outdated concepts, such as talking about “the cure” or “a world without cancer”. We need to stop considering single drugs adequate for treatment. We need to recognize that cancer is within all older adults and that our goal should be to hold it in check, not to eliminate every cancer cell.

We need to study and target systemic networks that nurture malignancy and develop treatments to push cancer cells into networks that are less hazardous.

We need ambitious goals for behavioral changes, such as reducing tobacco use to 5% of the population, excess weight to 10% of the population and ensuring that all Americans get regular medical examinations to detect early disease and to promote prevention.

We need to manage cancer, both within a single patient and in our American society. Focusing solely on technology as the answer is a mistake.

Please review and advise.

Nat Pernick, M.D.

19 July 2021: Video on Strategic plan to substantially reduce cancer deaths

This 3 minute video outlines our strategic plan to substantially reduce cancer deaths.

Strategic plan to substantially reduce cancer deaths

Video summary:

We need a strategic plan to substantially reduce cancer deaths.

• To focus our efforts, identify gaps in knowledge.

• Goal is to reduce annual cancer deaths from current 600K to 100K by 2030.

• It might fail – that may be why others have not attempted this, but I think we can make important progress towards this goal.

Two main aspects – prevention, combinations of treatment.

• Prevention: American Code Against Cancer – not controversial, find ways to better promote these activities (see http://www.natpernick.com/AmericanCod… ).

• Combinations of Treatment: New thesis – If we have 20+ partially effective therapies for a specific type of cancer, then some some subset, in combination, should be substantially effective, see: http://www.natpernick.com/Combination...

• Behavior of whole is greater than sum of behavior of parts.

• Target: primary tumor, also microenvironment, systemic networks.

• Compiling a list, see http://natpernick.com/Pancreatic%20Ca…

• Then start clinical trials, or other means of testing (animal models, cell cultures, computer simulations).

What do you think?

Email me your comments to Nat@PathologyOutlines.com

Links for more information:

Strategic plan (cancer papers are towards the end): http://www.natpernick.com/StrategicPl…

American Code Against Cancer: http://www.natpernick.com/AmericanCod…

Curing Cancer Network newsletter: https://lp.constantcontactpages.com/s...

5 July 2021: Letter to President Biden

 Dear President Biden,

Please identify who I should talk to concerning your goal of “ending cancer as we know it”. To be successful, we need better management, beginning with a strategic plan similar to the one I have developed, see http://www.natpernick.com/StrategicPlanCuringCancer.html.

We need a challenging goal, such as reducing US cancer deaths from the current level of 600,000 per year to 100,000 per year.

We need to identify the knowledge gaps and focus on research to fill them.

We need to abandon outdated concepts, such as talking about “the cure” or “a world without cancer”. We need to stop considering single drugs adequate for treatment. We need to recognize that cancer is within all older adults and that our goal should be to hold it in check, not to eliminate every cancer cell.

We need to study and target systemic networks that nurture malignancy and develop treatments to push cancer cells into networks that are less hazardous.

We need ambitious goals for behavioral changes, such as reducing tobacco use to 5% of the population, excess weight to 10% of the population and ensuring that all Americans get regular medical examinations to detect early disease and to promote prevention.

We need to manage cancer, both within a single patient and in our American society. Focusing solely on technology as the answer is a mistake.

Please review and advise.