Q&A: Cancer Prevention and the Duncan Institute
CancerWise - December 2008
Finding new ways to prevent cancer is essential. The recent establishment of the Dan Duncan Family Institute for Cancer Prevention and Risk Assessment at
M. D. Anderson will bring together resources, research and experts to address prevention on several levels, including consideration of cancer’s effects on medically underserved and minority populations.
Answering questions about the institute and the future of cancer prevention is Ernest Hawk, M.D., M.P.H., vice president for prevention and head of M. D. Anderson’s Division of Cancer Prevention and Population Sciences.
Why is cancer prevention important?
Understanding a disease is the key to its future, and we already know cancer prevention works. We have hard data demonstrating that prevention is possible now for many types of cancer, including breast, cervix and colon.
Prevention efforts in cardiovascular diseases showed that a focus on prevention, as well as treatment, can make incredible improvements in the health of our population. By identifying key mechanisms of cardiovascular diseases and addressing them through preventive strategies, we’ve seen more than a 50% reduction in deaths from these diseases in the past 50 years.
How will these funds be used?
We plan to enhance faculty recruitment, bolster resources and fuel emerging areas of study. We want to maintain flexibility so we can respond quickly to scientific advances no matter where they come from, for instance new technologies or new opportunities.
The allocations we’ve envisioned fall into six programs, which fit together in a discovery-to-development-to-delivery cycle of investigation:
Integrative genetic epidemiology
This area of study looks at how cancer results from genetic changes.
M. D. Anderson is involved in several projects, predominantly tobacco-related, to study genetic changes in cancers of the bladder, lung and esophagus. We want to expand this type of investigation to other cancers and other genetic changes.
Personalized risk prediction
We will work to move beyond traditional methods of screening tests and family history to predict a person’s risk of getting a particular cancer. By marrying these methods to new types of data, including genetic assessments or molecular changes in precancerous tissues, we hope to individualize risk prediction and provide personalized prevention.
The beginnings of cancer
A lot of people are looking at advanced cancers, but we want to look at the genesis, or beginning, of cancer. We will focus on precancerous lesions to identify differences in those tissues that can lead to better tools to predict risk, target prevention efforts, and assess outcomes earlier and more reliably.
Communication technologies are not used as effectively as they might be to facilitate two-way communication about cancer between researchers/health care providers and study participants or the public. Using personal devices like cell phones and personal data assistants (PDAs), we want to communicate more closely with study participants and get more information about study results to the public more effectively and quickly.
Community implementation and dissemination
We already know a lot about what is effective in preventing cancer, but those messages don’t get to the public as well or as often as they should. This project will explore how to interact with the community more effectively, especially with regard to the disadvantaged or “unreached” segments of our population, to encourage their participation in research and to disseminate what we know more effectively. We’ll look at cultural, language, financial, socioeconomic and geographical barriers to communication.
The Mexican-American population has a lower rate of cancer mortality than the general population and other minority groups. Nobody understands why: Is it culture, diet, lifestyle, genetic makeup? It’s relevant because of this population segment’s rapid growth, and because it gives us important insights into cancer’s causes and how we might prevent it in other people and groups.
To look at this phenomenon, we’ve launched a large-scale study of 50,000 Mexican-Americans. So far about 15,000 people have enrolled.
What can I do to help?
Everything we know about cancer was learned because people participated in research. You can influence the future by taking part in research today. From observational studies to clinical trials, there are plenty of opportunities for you to make a difference and help researchers get the information they need to prevent cancer.
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