The Moonshot Initiative [Interview][Transcript]

Dr-David-Cosgrove-cancer_Moonshot_InitiativeGuest: Dr. David Cosgrove
Presenter: Neal Howard
Guest Bio: Dr. Cosgrove is a medical oncologist with Compass Oncology, a practice in The US Oncology Network. He specializes in general adult oncology with advanced subspecialty expertise in breast and gastrointestinal (GI) cancers. He serves on The US Oncology Research Network’s national GI Research Committee and as a principal investigator for many studies.

Segment overview: Dr. David Cosgrove, MD, discusses the new cancer “Moonshot” initiative led by Vice President Biden.

Transcription

Health Professional Radio – Moonshot Initiative

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, thank you for joining us today. Our guest in studio today is Dr. David Cosgrove, a Medical Oncologist with Compass Oncology, a practice in the US Oncology Network. He specializes in general adult oncology with sub-specialty expertise in breast and gastrointestinal cancers and he’s a very strong advocate for bring leading edged therapies to us patients through clinical trials and he’s here today to talk with us about the Moon Shot Initiative led by Vice President Joe Biden. It’s important to take a look at aspects of cancer prevention that are in our control. Good afternoon Dr. Cosgrove.

David Cosgrove: Good afternoon Neal.

N: The Moon Shot Initiative and explain why it’s important that people know about this and implement it into their cancer prevention lifestyles?

C: Yes. So this is an exciting time within cancer research with the announcement of this Moon Shot initiative and I think the genesis of it is trying to coordinate our efforts at a national level to really move cancer forward and turn it from this devastating disease that we have today and to more of a chronic condition that we can manage and doesn’t take the lives of so many American citizens. I think it’s interesting in that the initiative unlike a lot of previous initiatives focused on cancer care incorporate some major early detection and prevention module and really trying to utilize some…recent technologies and genomics and proteomics to try to identify cancer at a much earlier stage than we do at the moment and thereby making the treatment path easier. Obviously we also have development of more standard therapies including a large immuno-therapy program within the Moon Shot but I’m hopeful that this coordinated effort can lead to major strides forward as a community.

N: How closely related if at all related is the Vice President’s initiative related to the First Lady’s initiative on healthy eating?

C: Yeah, I’m not sure they’re purposely related but there are clearly gonna be links in the prevention strategy of the Moon Shot program and in the healthy eating initiative and that the First Lady brought forward a number of years ago. I think her initiative is focused across health care, not necessarily focused just on cancer but it will have a major, major impact on cancer. If we can successfully integrate some of those general ideas.

N: You are involved in research and in recent years there’s been this huge push to help people stop smoking or using tobacco with other nicotine based products. Is it the nicotine that we should be worried about or is it the smoke or the combination of the two or simply just smoking just, we know smoking’s a bad idea but it’s seems that this vapor craze is getting people even more hooked on the vapor taken, it’s almost six in one hand half in the other if you’re not a smoker. Could you explain how cutting out smoking altogether should be our main focus when it comes to some of the things that in our control?

C: Yeah, absolutely. I think if we look back over the last 50 years it’s been very, very clear that tobacco exposure and cigarette smoking in particular has a huge negative influence on health and very especially in a number of different cancer types. And I think the nicotine component of cigarettes is certainly one of the things that leads to the addictive nature of cigarette smoking. Although there’s probably a lot worse components within cigarettes in terms of carcinogenesis than the nicotine. I think our goal ultimately should be to eliminate tobacco exposure as much as we can and whether there are alternatives that can suit certain lifestyle requirements or need and avoid some of these health benefits, I think that remains to be seen. I’m not sure about the e-cigarette craze is quite fits that bill because I do agree with you that it still promotes this kind of addictive behavior but I think we’ll wait and see.

N: As far as diet is concerned, sugar is a huge factor when it comes to cancer. It seems that there’s refined sugar in everything that we consume. How do you see, you can’t completely eliminate sugar not at this point, I just don’t see that as happening but what are your thoughts on gradually turning to a diet that promotes or prevents cancer?

C: Yeah. So I think diet is a huge influence on cancer as well as other diseases, it has been a bit more difficult to study because it’s obviously there’s so many layers to what a person’s diet actually entail and in terms of the sugar feeds cancer phenomenon, I agree that has been a nice public health…to hold onto. I think we as oncologists, we feel that any refined product that has carbohydrate that doesn’t have to be pure sugar but that is what leads to the increased inflammatory potential, increased insulin production that is associated with a number of different tumor types. So I think moving away from these highly processed foods and highly processed sugars to more complex sugars such as fruits, vegetables, things like that which while they still have sugar and carbohydrates they’re bind in a more complex form that are bodies are more traditionally designed to deal with and not cause that degree of inflammation. So I think it’s very difficult as you said to avoid these food types in our new western diet but that has to be a big focus and it will be within this Moon Shot initiative and also obviously in the First Lady’s Healthy Eating initiative.

C: Physical activity is another factor, can increasing one’s physical activity say I don’t know maybe 50% kind of offset some of the poor diet effects while we’re trying to improve our diet or can you cast out poor diet with vigorous and effective exercise?

C: Yeah, I think all of these things are linked. It’s very hard to … the very specific risk factor, I think when we look at the data on cancer prevention, some of the bigger studies have come from Europe and they kind of lump these things together with…activity, obesity, poor dietary compliance as a general negative versus maintenance of good activity, following a diet high in fruits and vegetables and whole grains, avoidance of obesity as a general positive. So it’s not clear that one will necessarily offset the other but there is research to say that being physically active even if you still have problems of obesity and your diet hasn’t changed much, will make a difference both in terms of cancer risk and in other heath conditions, so I think taking steps along that road of lifestyle modification every step is a good one, even if we don’t achieve every single dotting of I and crossing the T you’re gonna make a big difference in overall health.

N: Does the Moon Shot initiative taking to consideration not only the possibility of genetics playing a part but just the way a person is raised, their environment, their lifestyle other than food or exercise, the area of the country that they’re in? Are those taken into consideration in this initiative?

C: Yeah, I think when we think of cancer genomics which is a big component of this Moon Shot initiative, cancer genomics are a combination of the inherited genes that we have from our parents and then the influence on those genes of our lifestyle as we grow older and so there are certainly influences even though we consider cancer a genetic disease and the changes in the genes that lead to cancer are often driven by these lifestyle factors, some of which we can control like we talked about and some of which may be not necessarily within our control due to where we live and other issues within our communities. So this Moon Shot will certainly shine a light on that and try to of identify pockets that we have to focus on and but yeah the combination of genetics and then the changes in those genes because of lifestyle and because of behavior that’s gonna be a key component in prevention and early detection moving forward.

N: Now where can our listeners go online to find more information about Compass Oncology and your research as well?

C: Yeah, so I just said Compass Oncology we’re a group practice in the pacific north west, Oregon and Washington and we’re part of this larger US Oncology Network and so USON as a major research and community cancer player in the country and you can find that online and our group has our have our own website and patient resources at compassoncology.com.

N: Great, thank you so much. You’ve been listening to Health Professional Radio, I’m your host Neal Howard. And we’ve been in studio this afternoon talking with Dr. David Cosgrove a Medical Oncologist with Compass Oncology, a practice in the US Oncology Network specializing in adult oncology with advance specialty expertise in breast and gastrointestinal cancers and we’ve been in studio talking about some of the preventive measures when it comes to cancer and also the Moon Shot initiative that has been spearheaded by our Vice President. It’s been great having you here with us today doctor.

C: It’s great to be here Neal, thank you.

N: Thank you. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to this podcast on iTunes.

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