“ Knowing what’s right doesn’t
mean much unless you do
what’s right. ”
THEODORE ROOSEVELT
American Association for Cancer Research IX
As the number of cancer diagnoses increases, so, too, will
the economic toll of the disease. Cancer is already among
the most costly diseases to the United States. ;e most
recent NIH estimates indicated that the overall economic
costs of cancer to the United States in 2009 were $216.6
billion. When these costs are compared with the NIH and
NCI budgets for ;scal year 2014, which are just $30 billion
and $4.9 billion, respectively, it underscores the inadequacy
in federal funding for cancer research that exists today.
Developing Cancer
Cancer arises when the orderly processes that control the
multiplication and life span of normal cells go awry. ;e
resultant changes in cell behavior are predominantly a
result of alterations, or mutations, in the genetic material
of the cells. ;e speci;c mutation, and the order and speed
at which mutations accumulate, coupled with a person’s
genetic makeup and lifestyle factors such as tobacco use,
diet, and physical activity, in;uence the rate at which cancer
develops and progresses.
Although genetic mutations that lead to malfunctions
in a cell underpin cancer initiation and development in
most cases, interactions between cancer cells and their
environment—known as the tumor microenvironment—as
well as interactions with systemic factors, in;uence the
development and progression of the disease. ;us, if we
are to advance our mission to prevent and cure all cancers,
we must develop a more comprehensive, whole-patient
understanding of cancer.
;e dedicated work of researchers throughout the biomedical
research enterprise has expanded and continues to expand
our knowledge of cancer. As our knowledge has grown so has
our ability to exploit it to improve health care. Most of the
new approaches to cancer treatment more precisely attack
cancers than do traditional therapies, providing patients with
not just longer but also higher-quality lives.
Healthy Living Can Prevent Cancer
From Developing, Progressing, or
Recurring
Many of the greatest reductions in the morbidity and mortality
of cancer are a result of advances in cancer prevention that
have come about as we have learned more about the factors
that increase a person’s risk of developing cancer.
Many factors that increase the risk of developing cancer
are related to lifestyle, and it is estimated that more than
50 percent of the 585,720 cancer deaths expected to occur
in the United States in 2014 will be related to preventable
causes. Most notable among these causes are tobacco use,
obesity, lack of physical activity, exposure to ultraviolet
light from the sun or tanning devices, and failure to use or
comply with interventions that treat or prevent infection
with cancer-associated pathogens. As a result, adopting
a healthy approach to living that eliminates or reduces
these risks, where possible, could signi;cantly decrease the
number of people diagnosed with certain types of cancer.
Importantly, healthy approaches to living can also reduce
cancer recurrence and improve outcomes following a
cancer diagnosis. However, a great deal more research
and resources are needed to understand how best to help
individuals change their lifestyle.
Cancer screening is another important part of a healthy
lifestyle because ;nding a cancer early, before it has spread
to other parts of the body, increases the likelihood that
treatment can be curative. Given that each individual has
unique risks for developing each type of cancer, everyone
should consult with his or her physicians to develop a
personalized cancer-screening plan that takes into account
evidence-based recommendations; the individual’s own
