There's a worrisome problem with Obama's 'moonshot for cancer' plan

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Biden Launches Cancer 'Moonshot' Initiative
Vice President Joe Biden is scheduled to host a roundtable in Davos on 'Cancer Moonshot - A Call to Action', with international physicians, researchers, and government officials on Tuesday.

In his final State of the Union address last week, President Obama suggested that Vice President Biden would lead what he called a "moonshot to cure cancer."

It's a noble goal. But it's also over-optimistic. And that's important to keep in mind when we're designing treatments for a disease which claims an estimated 8 million lives around the world each year.

Cancer is different from many genetic diseases, such as sickle cell or Huntington's, in that it is not linked with a few specific, identifiable genes. Instead it is the result of a whole bunch of mutations, tens of hundreds of tiny twists and pinches in our genes. These mutations are constantly changing and evolving, becoming increasingly resistant to our drugs. And genetics, of course, is not the only cause of cancer — environmental and behavioral factors matter.

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Still, we've managed to curb the incidence of many types of cancer in the past few decades, either through behavioral changes (after 50 years of anti-tobacco campaigns in the US, for example, rates of lung cancer have plummeted) or vaccines (we can prevent new cases of human papillomavirus, which causes most cervical cancer, and Hepatitis B, which causes most cases of liver cancer). President Obama's Precision Medicine Initiative aims to build on these efforts and treat existing cancers more efficiently.

There are even some types of cancer we can cure with surgery (in the case of some skin cancers) or a combination of several drugs and treatments (such as with some cases of Hodgkin's lymphoma or leukemia).

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There's a worrisome problem with Obama's 'moonshot for cancer' plan
WASHINGTON, DC - JANUARY 12: U.S. President Barack Obama waves after delivering the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Mark Wilson/Getty Images)
US President Barack Obama delivers his State of the Union address before a Joint Session of Congress at the US Capitol in Washington, DC, on January 12, 2016. AFP PHOTO / NICHOLAS KAMM / AFP / NICHOLAS KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: U.S. President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. Also pictured are Vice President Joe Biden (Top L) and U.S. Speaker of the House Rep. Paul Ryan (R-WI) (Top R). (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - JANUARY 12: U.S. Secretary of Defense Ashton Carter greets members of congress before US President Barack Obama arrives to deliver the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Mark Wilson/Getty Images)
US President Barack Obama speaks during the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
US President Barack Obama delivers his State of the Union address before a Joint Session of Congress at the US Capitol in Washington, DC, on January 12, 2016. AFP PHOTO / NICHOLAS KAMM / AFP / NICHOLAS KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: (L-R) Gov. Dannel P. Malloy of Connecticut, first lady Michelle Obama, Naveed Shah of Springfield, VA., and wife of U.S. Vice President Joe Biden, Dr. Jill Biden give applause as US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 12: President Barack Obama delivers his State of the Union address before a joint session of Congress on Capitol Hill January 12, 2016 in Washington, D.C. In his final State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Evan Vucci - Pool/Getty Images)
US President Barack Obama speaks during the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
US President Barack Obama (front) looks on as US Vice President Joe Biden gestures during the State of the Union Address in a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: US Secretary of State John Kerry (R), along with United States Secretary of the Treasury Jack Lew (2nd R), U.S. Secretary of Defense Ashton Carter (3rd R), and U.S. Attorney General Loretta Lynch (4th R) gives applause as US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - JANUARY 12: Members of congress including Democratic presidential candidate and U.S. Sen. Bernie Sanders (I-VT) (C) applause as US President Barack Obama delivers the State of the Union speech in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 12: U.S. President Barack Obama (L) shakes hands with U.S. Speaker of the House Rep. Paul Ryan (R) before delivering the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. Also pictured are Vice President Joe Biden (L) and U.S. Speaker of the House Rep. Paul Ryan (R-WI). (Photo by Chip Somodevilla/Getty Images)
UNITED STATES - JANUARY 12 - President Barack Obama speaks during his final State of the Union to a joint session of Congress in the House Chamber on Capitol Hill in Washington, Tuesday, Jan. 12, 2016. (Photo By Al Drago/CQ Roll Call)
US President Barack Obama (C) speaks during the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
US President Barack Obama reads from the text of his State of the Union address before a Joint Session of Congress at the US Capitol in Washington, DC, on January 12, 2016. This is Obama's final State of the Union address, perhaps the last opportunity of his presidency to sway a national audience and frame the 2016 election. AFP PHOTO/NICHOLAS KAMM / AFP / NICHOLAS KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: Sen. Elizabeth Warren (D-MA) speaks with members of congress before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Mark Wilson/Getty Images)
US President Barack Obama speaks during the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: Little Sisters of the Poor (C) arrive before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 12: Gov. Dannel P. Malloy of Connecticut (Center-L) and first lady Michelle Obama, talk before US President Barack Obama arrives before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
US President Barack Obama speaks during the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
US President Barack Obama delivers his State of the Union address before a Joint Session of Congress at the US Capitol in Washington, DC, on January 12, 2016. This is Obama's final State of the Union address, perhaps the last opportunity of his presidency to sway a national audience and frame the 2016 election. AFP PHOTO/NICHOLAS KAMM / AFP / NICHOLAS KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: U.S. President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. Also pictured are Vice President Joe Biden (L) and U.S. Speaker of the House Rep. Paul Ryan (R-WI). (Photo by Alex Wong/Getty Images)
WASHINGTON, DC - JANUARY 12: U.S. President Barack Obama (C) delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. Also pictured are Vice President Joe Biden (L) and U.S. Speaker of the House Rep. Paul Ryan (R-WI). (Photo by Chip Somodevilla/Getty Images)
House Speaker Paul Ryan (R), R-WI, and US Vice President Joe Biden (L) shake hands with US President Barack Obama before the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address Tuesday, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: US Vice President Joe Biden gestures before the arrival of US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - JANUARY 12: US Secretary of State John Kerry arrives before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Mark Wilson/Getty Images)
US First Lady Michelle Obama (C) waves before the arrival of US President Barack Obama before the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Barack Obama will give his final State of the Union address, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
Satya Nadella (C), CEO of Microsoft, gestures as he waits for US President Barack Obama to deliver the State of the Union at the US Capitol in Washington, DC, on January 12, 2016. Obama gives his final State of the Union address, perhaps the last opportunity of his presidency to sway a national audience and frame the 2016 election. AFP PHOTO/NICHOLAS KAMM / AFP / NICHOLAS KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
Democratic presidential candidate Bernie Sanders (L) of Vermont arrives prior to US President Barack Obama's State of the Union address before a Joint Session of Congress at the US Capitol in Washington, DC, on January 12, 2016. This is Obama's final State of the Union address, perhaps the last opportunity of his presidency to sway a national audience and frame the 2016 election. AFP PHOTO/NICHOLAS KAMM / AFP / NICHOLAS KAMM (Photo credit should read NICHOLAS KAMM/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: Republican presidential candidate Sen. Marco Rubio (R-FL) arrives before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
Kim Davis, the Rowan County clerk in Kentucky, arrives before US President Barack Obama delivers the State of the Union Address during a Joint Session of Congress at the US Capitol in Washington, DC, January 12, 2016. Kim Davis, a born-again Christian, was jailed briefly in September 2015 for contempt of court after refusing to issue marriage licenses due to her opposition to gay marriage, which the Supreme Court legalized across the United States in June. Barack Obama will give his final State of the Union address, perhaps the last big opportunity of his presidency to sway a national audience and frame the 2016 election race. AFP PHOTO / SAUL LOEB / AFP / SAUL LOEB (Photo credit should read SAUL LOEB/AFP/Getty Images)
WASHINGTON, DC - JANUARY 12: Democratic presidential candidate and U.S. Sen. Bernie Sanders (I-VT) arrives before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - JANUARY 12: Ahmad Alkhalaf, 9, arrives before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 12: Republican presidential candidate Sen. Marco Rubio (R-FL), shakes hands with Senator John McCain (R-AZ) as Sen. Kirsten Gillibrand (D-NY) looks on before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 12: Republican presidential candidate Sen. Marco Rubio (R-FL) gives a thumbs up to members of congress before US President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Photo by Chip Somodevilla/Getty Images)
WASHINGTON, DC - JANUARY 12: Members of congress listen to US President Barack Obama deliver the State of the Union speech in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. In his last State of the Union, President Obama reflected on the past seven years in office and spoke on topics including climate change, gun control, immigration and income inequality. (Photo by Mark Wilson/Getty Images)
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But there are still many types we can't.

"There will be a sizable portion of cancers we can't get rid of," Harold Varmus, director of the National Cancer Institute, said at a talk last year at Columbia University. "We're not going to eliminate cancer as a disease."

Why?

To say each cancer tumor is unique would be an understatement. "Virtually every tumor looks different from every other tumor," Varmus said. That makes designing drugs to beat them difficult. Many new treatments work only for a tiny subsection of patients, those with a specific subtype of one particular kind of cancer. These are exciting developments, but they don't begin to move the needle on treating — not to mention curing — cancer as a whole.

Plus, among the various genes involved in cancer, some are what Varmus calls "drivers," meaning they have an active role in spreading the disease throughout the body, while others are merely "passengers," meaning they make only neutral changes to the genome.

Think of trying to design a net for a species of sea creature that constantly changes its size and shape (and also sometimes decides to live on land instead of in water).

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No matter how advanced your net, some monsters will still be uncatchable.

As if that weren't enough, some of the drugs used by doctors in recent decades can actually encourage the cancer to develop resistance to them. When cancer cells detect the presence of these "targeted drugs," they do everything they can to survive, often mutating into forms that can't be defeated by the drugs.

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This doesn't mean doctors and scientists are not making progress. They are. Still, cancer as a whole will probably never completely disappear — and that's a reality of which we should be aware.

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There's a worrisome problem with Obama's 'moonshot for cancer' plan
GOOD MORNING AMERICA - Former GMA anchor Joan Lunden revealed that she is battling breast cancer on 'Good Morning America,' 6/24/14, airing on the ABC Television Network. (Photo by Lou Rocco/ABC via Getty Images)
GOOD MORNING AMERICA - Sandra Lee talks about being cancer free, on GOOD MORNING AMERICA, 9/22/15, airing on the ABC Television Network. (Photo by Ida Mae AStute/ABC via Getty Images)
NEW YORK - MARCH 21: (FILE PHOTO) Actor Robert De Niro attends a news conference March 21, 2002 in New York City. According to a spokesman, De Niro, 60, was diagnosed with prostate cancer, but is expected to make a full recovery. (Photo by Mario Tama/Getty Images)
THE TONIGHT SHOW WITH JAY LENO -- Episode 1233 -- Pictured: (l-r) Musical guest Carly Simon performs on September 26, 1997 -- (Photo by: Margaret Norton/NBC/NBCU Photo Bank via Getty Images)
BALDWIN, NY - OCTOBER 07: Actress Fran Drescher attends the Fourth Annual Breast Cancer Summit Honoring Fran Drescher at The Coral House on October 7, 2014 in Baldwin, New York. (Photo by Mike Pont/Getty Images)
Cynthia Nixon during T. Schreiber Studio and the Leukemia and Lymphoma Society Honor Cynthia Nixon - Arrivals at 3 West Club in New York City, New York, United States. (Photo by Lawrence Lucier/FilmMagic)
LAS VEGAS - NOVEMBER 15: Rod Stewart performs at the Mandalay Bay Events Center for 'Rock for the Cure' at the Mandalay Bay Resort & Casino on November 15, 2007 in Las Vegas, Nevada. (Photo by Jacob Andrzejczak/Getty Images)
MELBOURNE, AUSTRALIA - SEPTEMBER 28: Olivia Newton-John speaks to the media as she supports the Cancer & Wellness Centre by preparing to leading the way on a charitable walk at The Centre Ivanhoe on September 28, 2014 in Melbourne, Australia. The walk aims to raise funds for the wellness and supportive care programs provided to patients. (Photo by Robert Prezioso/Getty Images)
Edie Falco attends Super Saturday 13 to Benefit Ovarian Cancer Research Fund hosted by InStyle Magazine at Nova's Ark Project on July 31, 2010 in Water Mill, New York.
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