"It's not going to be easy." So says Dr. Lee Hartwell, the director of the Fred Hutchinson Cancer Center and chairman of the scientific advisory board at the Canary Foundation, re: the goal of ending cancer. But that doesn't mean he doesn't have a strategy for getting there. I'm at Stanford, sitting in on the annual Canary Found. Symposium, a gathering of about 100 stellarÂ researchers and scientists who are all focused on the early detection of disease (thus the name "canary"). The guiding principle is simple: If we can detect disease early (specifically cancer, from the Canary's POV), we can save thousands of lives. Canary founder Don Listwin is a maverick Silicon Valley veteran who offers the goal in one graphic that looks something like this:
That's my rough redo on his slide based on a quick glance, so don't those numbers as anything accurate. But the take-away is obvious: Intervene early, and you have a good chance of survival. Intervene late, and survival rates are slim to none.
The "not easy" things Dr. Hartwell is talking about start with proteomics, the search for protein biomarkers that signal early (or even pre-stage) disease, but they quickly multiply. The challeneges are vast: What are the proteins we need to look for? How do we find these proteins (and more specifically, how do we find them cheaply, easliy, and without an invasive procedure)? Having detected the biomarker, how do you locate the cancer in the body? And having found it, how do you treat it? Do you surgically remove it? Or do you simply leave it alone (if it's a non-fatal cancer)?
Each of these questions requires a vast deployment of science, innovation, and luck to answer. And each answer must not only be answered, but systematized, to create a viable, FDA-approved aresenal of diagnostics and treatments. As Anna Barker from the National Cancer Institute puts it, this is most definitely "big science" - the sort of goal that takes great coordination, great patience, and great amounts of money. But the upside is huge. She describes a medical model where we get our genome sequenced at birth, along with an assortment of other baseline marking. Then as we grow we follow specific behaviors and practice preventive techniques suitable to our profile. And as we move into adulthood and age, we undergo routine screening for those conditions we might be susceptible to, and if necessary undergo early treatments. At each stage, we're improving our odds for longer life.
It sounds easy. But it's not going to be.