Moon shot cliches are becoming shopworn

biden moonshot

credit: @darth on Twitter

By my count there are at least three active health “moon shots” underway: one devoted to curing Alzheimer’s disease and two devoted to cancer cures, including the latest cancer moon shot announced by President Obama (to be spearheaded by Vice President Joe Biden) during his State of the Union speech January 12.

Other groups and institutions are attaching the moon shot analogy to their initiatives, including those pushing the 21st Century Cures Act, which has passed the House in July despite concerns that it will erode patient safeguards. We’ve written about each of the current moon shots and if you peruse the archives (or look at the list at the bottom of this post), you’ll find that publisher Gary Schwitzer has been critiquing moon shot stories for years.

But did you know America has been making cancer moon shots and declaring “war on cancer” since at least the 1970s? In 1971 then-president Richard Nixon declared a “war on cancer” through the National Cancer Act. It was predicted then that investments in medical research and technology would cure cancer “within six years.”

When John Bailar, MD, PhD, and currently professor emeritus of epidemiology at the University of Chicago, critiqued Nixon’s war on cancer initiative in the New England Journal of Medicine in 1986, and again in 1997, it caused quite a row when he called the initiative a failure.

But we’re still fighting that war and many of Bailar’s comments still hold. The National Cancer Institute’s then-director Andrew von Eschenbach also made a moon shot pitch in 2003 with a deadline of 2015.  He said the NIH’s goal then was to “eliminate suffering and death” caused by cancer by 2015. In the intervening years President Clinton declared war on cancer. President George W. Bush also had a cancer initiative.

Between 1971 and 2014, the National Cancer Institute spent $90 billion on cancer research and treatment and about 260 U.S. nonprofits devoted to cancer research spend an additional combined $2.2 billion on research each year, according to a 2014 investigation published by Chicago Health.

Many medical experts are underwhelmed by the “moon shot” slogan which is becoming a little shop-worn by now.

“I can’t stand it,” says H. Gilbert Welch MD, MPH, Professor of Medicine, Dartmouth Institute for Health Policy & Clinical Practice, Hanover, NH, and author of Less Medicine, More Health: 7 Assumptions That Drive Too Much Health Care. “It underestimates the task and overestimates our ability to fix it. Enabling a few selected healthy individuals to get to the moon is a much more bounded challenge than is curing millions of older individuals with heterogeneous forms of a chronic disease.”

“All our health problems can’t be fixed by technology,” says Welch. “We are making progress against cancer but it’s been slow and steady. We should acknowledge our progress. But the idea we’re going to make it disappear — that’s ludicrous.”

For some, the problem is that politicians approach curing cancer as if it’s an engineering project.

“Moon shot has two definitions,” University of Minnesota bioethicist Steven Miles, MD, wrote us in an email. “1. An improbable effort (cold fusion) and 2. that improbable efforts are simply a failure of will. This false analogy to JFK’s moon shot lies at the heart of the Biden cancer cure program.”

On January 13, as NIH director Francis Collins tweeted that the NIH stands “ready and committed” to the cancer moon shot, J.P. Morgan’s annual health conference sported a related slogan and live tweeted the event under the hashtag #CancerMoonshot2020. Other groups large and small orbiting in the cancer sphere such as were happy to endorse the moon shot.

As journalists we can’t seem to put the brakes on our use of cliches. (Mea culpa.) Maybe it’s time more reporters stop amplifying slogans like “moon shots” and “war on cancer” and do a better job of explaining the many skirmishes rather than an all-in surge.

Now that a couple days have passed since the State of the Union speech, some news media are taking a more nuanced and more historical look at efforts parallel to the Obama-Biden cure initiative.

STAT: Moonshot to cure cancer? We’ve heard that before. Many times.

New York Times: ‘Moonshot’ to Cure Cancer, to Be Led by Biden, Relies on Outmoded View of Disease “Commitments by powerful Washington figures to cure cancer seem to come along about every decade,” wrote the Times.

MedPage Today: War on Cancer Redux: Biden Leading Troops

More blogs on health moon shots:

Can $2 billion a year cure Alzheimer’s? – January 6, 2016
Biden resurrects false promise of cancer “Moonshot – October 21, 2015
Fred Hutch president predicts cancer cure in 10 years; critics have heard it all before – July 27, 2015
Things CNN didn’t report about the MD Anderson “cancer cure close” story – September 26, 2012
CNN proclaims “BREAKING news: cure for cancer close” – September 25, 2012

Kathlyn Stone is an associate editor with and frequent blog contributor. 

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