A Case for Earlier Cancer Detection Strategies with Dr. Bert Vogelstein

Our guest on the show today, Dr. Bert Vogelstein, is a vehement advocate of the proverb, ‘prevention is better than cure’. The history of cancer research shows that the focus has largely been on finding the silver bullet of therapy and management, while surprisingly little attention has been paid to primary and secondary prevention. Primary prevention is intervening, or acting to prevent the onset of disease, so the disease never occurs. Secondary prevention is based on detecting the disease at a stage when it can still be managed and thereby preventing serious consequences such as death.

Why haven’t we focused more on earlier cancer detection? The reasons for this include the misconceptions and skepticism around the efficiency of clinical testing and prevention measures as well as concerns about over-diagnoses and over-treatment. Such reservations have, unfortunately, claimed the lives of too many and prevented them from getting the necessary treatments before it was too late. In this episode, we are privileged to be joined by Dr. Vogelstein, one of the leading experts and most-cited scientists in the field of oncology. His pioneering work on tumor biology laid the groundwork for our understanding of cancer evolution, earlier cancer detection, and precision therapy. He is currently appointed as a professor of oncology and pathology, as well as Director of the Ludwig Center for Cancer Genetics and Therapeutics at the Kimmel Comprehensive Cancer Center within the Johns Hopkins University School of Medicine. In addition to unpacking the advantages and disadvantages of different approaches to cancer treatment, he also talks about the process of developing the CancerSEEK test and the challenges they have had to overcome.

Key Points From This Episode:

• How the medical world has fared in addressing cancer mortality.
• The need for more resources and funding to be devoted to earlier cancer detection.
• Vogelstein explains the difference between primary and secondary prevention in the context of COVID-19.
• Why those who resist early-detection approaches need to change their thinking
• Vogelstein makes a case for how we know that cancer is currently under-diagnosed.
• New ways to think about the evidence and efficiency around cancer testing in clinical practice.
• Understanding that action is required despite the lack of conclusive evidence and complete information.
• An overview of the history of cancer treatment and how the focus shifted from targeted therapies to diagnostics.
• Hear about the development of CancerSEEK
• Vogelstein talks about how a physician might become accustomed to seeing tissue of origin on a test report.
• A prediction about the percentage of cancers that will be detected by screening in the next few years.