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Fighting Cancer Is Everyone's Obligation

Lance Armstrong

From The Lance Armstrong Foundation, Austin, TX

Corresponding author: Lance Armstrong, The Lance Armstrong Foundation, 1221 S MoPac Expressway, Suite 320, Austin, TX 78746; e-mail: www.livestrong.org

INTRODUCTION

In the midst of undergoing chemotherapy in the fall of 1996, my oncologist, Craig Nichols, talked to me about "the obligation of the cured," Although this was before I even knew my own fate, I was already developing a feeling of responsibility as a survivor. I asked my closest friends—Bill Stapleton, Bart Knaggs, John Korioth, and Gary Seghi—to join me for lunch to discuss an idea I had. I wanted to create a foundation to support cancer survivors and needed their help.

If someone had pulled me aside that day at lunch and said, "Hey pal, one day, this foundation idea you’re spitballing will help provide billions of dollars for the fight against cancer," I would have laughed. Knowing what we have achieved together in the last decade, I am more hopeful and optimistic than ever that, as a nation, we can renew our commitment to fighting this disease and empowering survivors to live life on their own terms. And I believe the time for a national call to action in the war against cancer is now.

BACKGROUND

The facts of this disease are staggering. Cancer is the single largest killer on Earth, taking seven million lives a year—a mortality rate higher than that of AIDS, tuberculosis, and malaria combined. Here in the United States, 565,000 Americans will die of cancer in 2008—more than 1,500 people per day. This year, 1,400,000 Americans will hear the words, "You have cancer." Cancer is already the leading cause of death for Americans younger than age 85 years, but it is certain to become the leading cause of death for all Americans in the next decade as the so-called baby boomer generation ages.

In May, I testified on Capitol Hill before the Senate Health, Education, Labor and Pensions (HELP) Committee at the invitation of Senator Edward M. Kennedy (D-MA). The hearing, entitled Cancer: Challenges and Opportunities in the 21st Century, focused on the nation's approach to the war on cancer and the need to inject new resources and strategies into fighting the disease. I was encouraged by the attention being paid to the disease and the sense of renewed commitment to fighting this killer.

However, just as Senator Kennedy is leading the creation of this bipartisan legislation, news has come that this champion for health care and tireless warrior in the battle against cancer is himself facing the disease. His courage and dedicated service to the 12 million Americans who also live with cancer embody the LIVESTRONG philosophy, and I am fortunate that the mission of the Lance Armstrong Foundation (LAF) is shared by a man who has devoted so much of his life to his country. I believe the best way we can support the senator is to renew our dedication to the fight against cancer with greater resources and increased national attention.

FOUNDATION-SPONSORED SUMMIT

This summer, the LAF is hoping to make cancer the target of national attention and give voters the opportunity to hear directly from our presidential candidates about their plans to combat this disease. In this critical election year, the LAF is hosting our premier policy event, the LIVESTRONG Summit, in an important swing state. One thousand delegates from all 50 states and around the world will gather July 24 through 27 at the Ohio State University campus in Columbus to gain the knowledge and power they need to demand that cancer be made a national priority once more.

Throughout the Summit, delegates will attend sessions designed to strengthen their skills as grassroots activists for the fight and to hear pointers from some of our leading health and cancer experts, including Richard Carmona, MD, former US Surgeon General; Harold Freeman, MD, of the Ralph Lauren Cancer Center; and Stefanie Spielman, cancer advocate and wife of National Football League linebacker, Chris Spielman.

One of the thousand delegates we are honored to welcome is Bob Kiesendahl of Hawley, PA, a cancer survivor. Bob was diagnosed with chronic myelogenous leukemia 9 years ago at age 28 years. He was athletic, had no prior history of serious illness, and had been married for just 3 months. He thought he was invincible, but his world quickly changed. He was told his only chance for survival was a bone marrow transplantation. Bob was fortunate to find a good match through the National Bone Marrow Registry. During his treatments at the Fred Hutchinson Cancer Research Center in Seattle, WA, and throughout his recovery, he focused on ways he could give back and help others in the fight. During the last few years, Bob has organized fundraising efforts that have brought in more than $350,000 for the fight against cancer. "I realize I am fortunate to have survived and I want to do all that I can to make a difference," he said. It is dedication like Bob's that we are hoping will galvanize action throughout America.

In addition, never has action been more necessary. Nearly 47 million Americans lack health insurance, and about 16 million more are underinsured. Study after study has shown that those who lack insurance or are underinsured have higher cancer mortality rates than those who have insurance and therefore have better access to care. Health care coverage and financial concerns should not dictate who lives, who dies, and who suffers unnecessarily. And yet all too often, it does. We do not take full advantage of what we already know about delivering high-quality cancer care.

Providing access to quality cancer care and improving quality of life are intertwined. In 1971, there were three million cancer survivors in the United States. At that time, cancer was largely a death sentence. Today there are 12 million Americans living with the disease. Addressing the needs of this growing population is critical.

LOOKING TOWARD THE FUTURE

Managing cancer involves activities that aim to prevent or cure cancer, increase survival, and enhance quality of life for those who develop the disease. We must deliver the knowledge we have gained through research into strategies and services to the general public. We can have a measurable impact if we just apply what we know. We have the tools to detect many of the more common cancers earlier, when they are most treatable.

Investing more money in cancer research is necessary but not sufficient. We must also use strategies that improve the incentives for scientists, restructure the enterprise to encourage collaborative team science, and support best practices and common sense in clinical trials and the translation of discoveries into practice.

We need a broad-based national cancer plan that aligns our research priorities with those for cancer prevention, early detection, treatment, and survivorship. Ultimately, we need strong leadership that responds to the needs of the American public, is backed with the resources to achieve these goals, and has the authority to facilitate communication and collaboration across diverse federal agencies that are engaged in cancer research, prevention, and care.

Cancer affects every single person in America and we need every single person doing something about it. The Lance Armstrong Foundation is asking everyone to join its united front against cancer and help make beating this disease a national priority.

AUTHOR'S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The author(s) indicated no potential conflicts of interest.

EDITORS’ NOTE

In this issue of the Journal, we introduce a new series, Perspectives in Oncology. The purpose of this section is to publish commentary from an array of authors on topics beyond those typically covered in the Journal. For our first piece, we are pleased to publish a contribution by Lance Armstrong. Mr Armstrong needs no lengthy introduction. He is known as much worldwide for his seven consecutive Tour de France victories as he is for his courageous and successful fight against cancer and his dedication to survivorship issues. Within the text, our copy editors were concerned about the general understanding of the word spitballing in the quotation. We felt it important to keep this wonderful neologism for its descriptive qualities. The word spitball first appeared more than 150 years ago, and is defined as a piece of paper that is chewed, rolled into a ball, and thrown, typically against a wall or ceiling. Some stick and some do not. In the context of the quotation, "spitballing" refers to the decision-making process whereby many ideas are thrown out, to see which ones will stick.

NOTES

Mr. Armstrong, a seven-time winner of the Tour de France, is founder and chairman of the Lance Armstrong Foundation and a cancer survivor. Visit www.livestrong.org.

Author's disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Submitted June 10, 2008; accepted June 10, 2008.

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