Rekubit Exchange:Biden set his 'moonshot' on cancer. Meet the doctor trying to get us there

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"Shoot for the moon. Even if you miss, you'll land among the stars."

When it comes to curing cancer, President Joe Biden is shifting that sentiment into full throttle. And one person is taking up the challenge.

Who is she? Dr. Monica Bertagnolli, the director of the National Cancer Institute.

• Bertagnolli started in the position last October and is one of the leaders tasked with overseeing Biden's "moonshot" effort to reduce cancer rates and deaths in the United States.
• She has also served as a professor of surgery in the field of surgical oncology at Harvard Medical School; a surgeon at Brigham and Women's Hospital; and a member of the Gastrointestinal Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute.
• Bertagnolli's work recently became much more personal; she was diagnosed with early stage breast cancer late last year.

What's the big deal? Since serving as vice president, Biden has touted a plan he calls his "cancer moonshot." The plan aims to cut the cancer death rate in the United States by at least 50% over the next 25 years.

• During last week's State of the Union address, Biden expressed his commitment to revamp those efforts, by making more cancers treatable, and providing more support for patients and families.
• According to the CDC, cancer was the second leading cause of death in the United States in 2020.
• At the same time, some of the most innovative cancer treatments come at a very high price. And a 2022 survey by the Kaiser Family Foundation found about two-thirds of adults with health care debt who've had cancer themselves or in their family have cut spending on food, clothing, or other household basics.
• Some cancer researchers have urged caution against bold claims in light of renewed focus on the moonshot initiative, tempering expectations of curing cancer.
• Bertagnolli is on board with the ambitious moonshot goal, though says it won't be easy. She says it will require a lot of collaboration, as well as more clinical trials.

What are people saying?

Biden, in his State of the Union address earlier this month:

"It's personal for so many of us.

For the lives we can save and for the lives we have lost, let this be a truly American moment that rallies the country and the world together and proves that we can do big things.

Let's end cancer as we know it and cure some cancers once and for all."

Bertagnolli, on how getting people to stop smoking has impacted cancer rates:

"That has dramatically reduced mortality and incidence of cancer, if you talk about sheer numbers. That really has been amazing. For the rest, there have been some truly dramatic new treatments like immunotherapy ... [and] some other new targeted therapies have been very exciting for particularly the diseases like melanoma and lung cancer in some of the tissues of of the blood. But those are really very powerful for individual, smaller groups of patients. Where the thing that truly has made a huge difference in terms of absolute numbers, the single biggest thing has been having people stop smoking."

Bertagnolli, when asked about the personal financial costs of cancer treatments to patients:

"We're a research institute. We're focused on research. So what we can do is we can determine what's the best treatment, what's the most effective treatment that can hopefully minimize health care cost to doing that treatment. We can also help identify what's the best way to deliver care in the community so that it's very efficient. But then I think this is part of what President Biden is talking about. We're not going to solve the problem without the rest of the government and the rest of society stepping up to solve problems like this one."

So, what now?

• Biden is urging Congress to reauthorize the National Cancer Act, which established the National Cancer Institute.
• Bertagnolli says that any decrease in funding for the National Cancer Institute's research would mean it wouldn't be able to achieve the goals it has set, adding: "Funding has to support the entire range of work that's required to end cancer as we know it, which is from prevention, to early detection, all the way through treatment and and survivorship." 
• Bertagnolli says she is doing well since her own cancer diagnosis and is undergoing treatment. She is also participating in a clinical trial.

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