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Entertainment Summit West - Ed Maibach Transcript

Ed Maibach: Associate Director, National Cancer Institute

ED MAIBACH: I am an Associate Director at the National Cancer Institute. For those of you who don't know the National Cancer Institute, we are your cancer institute. NCI is a unit of the National Institutes Of Health, which is part of the U.S. Department of Health & Human Services, which as you may know is an agency of the federal government. We exist by virtue of the fact that Americans feel strongly that our Nation must fund medical research.
Why do the American people feel this way? We understand that the United States has an unparalleled university system, a large and uniquely qualified corps of biomedical researchers, and the financial wherewithal to invest generously in medical research.

Several years ago, before I became an NIH employee, I conducted research on behalf of NCI to determine what Americans knew and felt about the investments they were making in cancer research. I asked people quite directly: Should our Nation be doing this…investing in cancer research on behalf of all Americans? What I heard back from people around the country was incredibly gratifying. They said, in effect, “of course we should.” They went even further, however. They told me that we – the people of the United States -- should fund cancer research not just for the benefit of the American people, but rather for the benefit of all people, everywhere. In short, they told me that we must because we can. Medical research is a deeply held value of the American people, and I find that to be a touching and beautiful thing.

To be part of our Nation’s cancer research enterprise is a real honor for me. The progress in cancer research -- at NCI and among our partners in the National Cancer Program at medical schools and universities throughout the country -- is simply staggering. With each passing month we discover more and more about how to prevent cancer, how to detect it early when it is most effectively treated, and how to treat it so that peoples’ cancer will not kill them nor cause them undue suffering. My role at NCI is to help move these extraordinary discoveries out of the laboratory and into the lives of the people who can benefit from them. In effect, I'm using marketing skills to accelerate the rate at which all Americans – and secondarily, all people everywhere -- enjoy the dividends of our Nation’s cancer research program. Please accept my thanks for your part in helping to advance our national cancer research program.

I'm here today primarily to share three important thoughts with you. The first of these is that what was once a dream -- the dream that we can defeat cancer -- is rapidly becoming a reality. That day is not yet here, but with each passing month we are getting much closer. And with each passing day, the pace of our progress is accelerating.

The second thought is that when it comes to cancer -- and this is almost certainly true not only of cancer, but of any serious or life threatening disease -- knowledge truly is power. The more you know about your options – options to prevent the disease, to detect it at the earliest possible moment, and, should you ever face a cancer diagnosis, to treat it successfully -- the more your odds of good health improve.

My third and final thought pertains to the role entertainment media are playing in conveying important information about cancer and other diseases. People learn through stories, and entertainment media is one of the dominant sources of stories in American culture today. The stories currently being told about cancer in entertainment media are compelling, and for the most part, they have much value for their viewers. Indeed, I offer my compliments to all of you who are telling stories about cancer in the entertainment media; your work has tremendous value in helping people protect themselves and their families from cancer. But I believe there's even more we can do to tell compelling and useful stories about cancer; stories that will help people understand their options – and will help them exercise those options – so that cancer need not ever bring tragedy into their homes.

Cancer experts’ knowledge of the disease has evolved rapidly in the past several decades, but I’m concerned that the American people are thinking about cancer in ways that are out-dated and are not serving them well. I'm currently working with a team of leading risk communication researchers at Carnegie Mellon University to determine how people think about cancer. Our hypothesis is that many people are thinking about cancer in ways that undermine their understanding of -- and ability to take -- simple concrete actions that can help them prevent cancer, detect it at the earliest possible moment, and should they ever face a cancer diagnosis, exercise their treatment options effectively.

I wish to share just two of our preliminary findings. Most people think of cancer as a horrible, painful, deadly disease; a disease that is seen as equivalent to a death sentence. People also tend to think about cancer as a contaminant – something foreign to our bodies -- that must be removed, completely removed, at the earliest possible moment, lest it will rapidly lead to the worst possible outcome. While these two thoughts are not without some element of truth, I am concerned that they may be leading many people to erroneous conclusions. For example, the belief that cancer is nearly always fatal can lead to the erroneous conclusion: “Why bother to be screened for cancer; it’s a death sentence.” And thinking about cancer as a contaminant can lead to needless mastectomies (versus lumpectomies): “If I do have cancer, I want my doctors to do everything possible to get it ALL out of me, as fast as possible.” Once we better understand how peoples’ thought processes are supporting or undermining their ability to protect themselves from cancer, this will create important new opportunities for us to suggest alternative ways of thinking about cancer – ways of thinking that are based in today’s science-based understanding of the cancer disease process – so that people can more effectively protect themselves and their family members from the disease.

There are many important stories that are just waiting to be told about cancer as a disease process. For example, there is much that we can do to prevent cancer. Each of us have underlying susceptibilities to cancer; a portion of that susceptibility is genetic, a portion is related to things we have been exposed to in our environment, and a large portion is related to our lifestyles. The means of determining our risk are improving each year. Genetic tests, for example, will soon revolutionize what we know about our risk of cancer. The important opportunity for story telling, however, is to make certain that people harness this knowledge to take protective actions, rather than develop a fatalistic attitude and fail to take action. Bringing to life how people respond to such information can be dramatic, and compelling, and ultimately very useful.

A second story waiting to be told concerns the value of early detection. Today, early detection tests for breast cancer, cervical cancer, and colon cancer are among the most important options we have for ensuring that we don’t die from these common and very serious forms of cancer. While most women are receiving early detection tests for breast and cervical cancer – although some still aren’t – most people who should be are not being screened for colon cancer. This sad and unacceptable situation can be reversed when people understand the value of these tests. Let’s tell those stories.

Early detection will become even more important in the near future. We're in this remarkable period of time -- the nexus of the genetic revolution and the technological revolution – which will soon provide us with incredible new early detection tests for many more forms of cancer than we are currently able to detect early. Today we have early detection tests for only a very few forms of cancer. But three years from now, five years from now it's going to be a completely different story. There are already tests being evaluated on an experimental basis based on a drop of blood – identifying the proteins that have been thrown off by the cancer cells -- that can allow us to detect the presence of cancer in its earliest stage when it is easiest to treat completely and to the best possible outcome. Let’s tell these stories too.
Two years ago, my boss, the Director of the National Cancer Institute, Andy von Eschenbach, issued a challenge to the cancer community. He challenged us to focus our efforts such that by the year 2015, no American will even again suffer or die from cancer. This will not be easy, and Andy knows that, but it very well may be possible, and he therefore feels that we must strive to achieve the goal. Consider this: Our partners at the American Cancer Society have conducted analyses that prove that if we in the cancer community can put into practice what we already know to be of value – in terms of prevention, early detection, and medical treatment -- we would get half way to Dr. von Eschenbach’s goal. In other words, we can reduce the burden of cancer by 50 percent just by applying what we already know.

To apply what we know, however, we’re going to have to tell stories, useful stories, compelling stories. This is how we are going to help the American people better understand their options, and how to take advantage of them. The author Robert Coover said: “We need myths to get by. We need story; otherwise the tremendous randomness of experience overwhelms us. Story is what penetrates.”

Professor Michael Cody and some of his colleagues and students at the Annenberg School at USC, in partnership with the Annenberg School’s Hollywood, Health & Society Initiative, conducted an analysis of top-rated prime time shows during last year’s television season. Nine of these shows ran major story lines about cancer, and of those nine, six shows conveyed information that we at NCI believe has significant value in helping viewers better understand cancer. I think that's pretty remarkable; that’s equivalent to a batting average of .666. My hope is that this is only a beginning…there are many more compelling stories about cancer waiting to be told. As Neil Behr said this morning, balancing entertainment and education can be a tough act. But if you think about the challenge as he does – thinking first about telling a great story and then ensuring that you've got good information as the foundation of the story -- it can create great entertainment and it can help people.

Allow me to close by recognizing the Hollywood Health & Society Initiative at USC -- headed by Vicki Beck and staffed by Jennie Green and Mandy Shaivitz -- as they serve as NCI’s liaison to the entertainment community. They're available to work with any member of the entertainment community, and can offer access to leading experts on any given cancer topic. Please feel free to contact them if you wish to develop compelling stories about cancer.

I thank you all.

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