Several months ago, I attended a town hall meeting of the President's Cancer Panel, where I had the good fortune to meet a brave little boy named Dakoda. He had recently been diagnosed with an inoperable brain tumor. Due to start chemotherapy later that night, he came to the meeting with his father, mother, and younger sister. His father, in a voice trembling with emotion, described the challenges of his son's illness and emphasized the progress he was making in his treatment. He also talked about the family's commitment to defeating Dakoda's cancer and encouraged those of us at the meeting that day to rededicate our efforts to develop new and more effective cancer therapies. Dakoda's story embodies universal themes of courage, commitment, and inspiration. Such stories - of the suffering that patients and their families endure on a daily basis because of this disease - remind us of the great value of cancer research and reinforce our determination to achieve our goal of eliminating the suffering and death due to cancer.

In 1971 - with the passage of the National Cancer Act - we committed our national will and resources to eliminating cancer. A cure for this complex set of diseases has proven far more elusive than anticipated thirty-three years ago. Yet our persistence and patience have led to increasingly significant dividends. There are now nearly ten million cancer survivors in the United States compared to three million in 1971. Death rates from the four most common cancers - lung, breast, prostate, and colorectal - continue to decline. Over the past decade, Americans have experienced a 7 percent decline in mortality from cancer and hundreds of thousands of lives have been saved. As this document illustrates, we are making extraordinary progress in cancer research. This progress has opened new avenues to even greater opportunities that will enable us to reach our goal of eliminating the suffering and death due to cancer.

To achieve this goal, we must continue to nurture the investment in infrastructure and intellectual capital that we began over three decades ago. The passage of the National Cancer Act challenged our Nation in 1971 and motivated many of our Nation's best and brightest to devote their professional lives to the study of cancer in all its formidable complexity. Only during the past decade have we amassed sufficient understanding of cancer's genetic, molecular, and cellular puzzle to elucidate the mechanisms responsible for its initiation and progression. We are now engaged in the development of extraordinary interventions directed at the specific processes governed by those mechanisms. We have at last entered into an exponential phase of progress in which scientific research, fueled by previously unimagined technologies, permits us to envision a future when people can live with, and not die from, cancer. While we may not cure cancer in the short term, we will develop the knowledge and tools to preempt its progression and thereby, effectively reduce its burden on our society. Using this strategy, we can and will prevent, detect, eliminate, and control individual cancers, and we must work together to accomplish this by 2015.

In this professional judgment budget, we at the National Cancer Institute highlight our vision for progress on the road ahead. The National Cancer Act of 1971 started us on this journey - and we must build on that momentum to persevere, to rapidly accelerate our pace, and to reach new heights of progress. Dakoda and his family, like all the families of America, are depending on the National Cancer Institute - and the entire cancer research community - to eliminate the suffering and death due to cancer by 2015. We will not fail!

Andrew C. von Eschenbach, M.D.
Director
National Cancer Institute
October 2003