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The War on Cancer: Fifty Plus Years, Limited Gains - Cancer's Root Drivers - A New Framework for Prevention and Management
By Richard Z. Cheng, M.D., Ph.D., Editor-in-Chief More than fifty years after the United States declared a "War on Cancer," the results remain sobering. Since the 1971 National Cancer Act, cancer research funding has skyrocketed - increasing by more than 1200% - and hundreds of billions have been spent [1]. Yet the real-world results have been marginal [2]. While overall cancer survival has improved mainly due to earlier detection and reduced smoking, five-year survival for many common cancers has barely changed. New drug approvals often extend life by only a few weeks or months, at enormous financial cost. Mortality from pancreatic, liver, and lung cancers remains largely unchanged. Today, this already fragile system faces further disruption. Proposed Trump administration budget cuts-widely discussed in The New York Times (Sept 14, 2025) and even warned against by The Lancet Oncology [3]-threaten to shrink cancer research funding further. But the deeper problem is not simply how much money is spent. It is what we are funding: decades of investment in the mutation-centric, pharmaceutical model that has failed to deliver lasting progress. A New Perspective on Cancer OriginsMy new paper, recently posted on Preprints.org ( freely available here ), goes beyond debating cancer theory. Instead of focusing narrowly on genetic mutations or other intermediary mechanisms, it identifies ten categories of root drivers that set the stage for cancer and many other chronic diseases. This framework highlights practical opportunities for prevention, early intervention, and integrative care. Readers interested in applying these concepts in clinical or public health settings can explore the full open-access paper ๐ here, which includes practical references and supporting data. The Ten Root Drivers of Cancer and Chronic Disease
The identification of these ten categories of root drivers sets the framework for clinical management and public health policies that can and should be tailored individually. It also provides a foundation for clinical trials that prioritize patient improvement as the ultimate endpoint-rather than the drug-focused studies that dominate current cancer research. Toward Practical Solutions: Clinical and Policy FrameworkThis framework does more than catalog risk factors. It proposes a roadmap for both clinical management and public health policy, offering strategies for prevention, early intervention, and integrative care.
Media Narratives vs. Root-Cause RealityJust this week, The New York Times Magazine (Sep. 14, 2025) portrayed the Trump administration as threatening to dismantle cancer research at what it called "one of the most productive moments" in oncology. Even The Lancet Oncology warned that U.S. cancer research might "never recover" from proposed funding cuts [3]. Yet these narratives overlook a deeper truth. Despite decades of massive funding, the mutation-centric model has yielded only limited gains. What remains missing from both political debate and academic discourse is recognition of the upstream forces - metabolic stress, toxin overload, nutrient deficiencies, immune dysregulation - that drive cancer in the first place. Media and policy discussions defend the status quo while neglecting the approaches most likely to prevent cancer. Strong Early InterestThe response to this new framework has been remarkable. Within its first week online, the preprint received ~700 downloads - far exceeding the reach of most new scientific papers. This strong response underscores a growing demand for fresh approaches that move beyond the mutation model. Readers who would like to explore the complete framework, with references and supporting data, can access the full paper freely here. Ironically, while this framework is attracting strong early interest from readers, it highlights a broader problem: mainstream journals often block paradigm-challenging work at the editorial desk before it even reaches peer review. This kind of gatekeeping reflects a systemic resistance to new frameworks - even when the scientific and public interest in such approaches is clear. Readers can examine ๐ the full paper and decide for themselves. What Comes NextThis is only the beginning. The next phase of work will focus on translating this framework into actionable strategies: targeted nutritional interventions, toxin reduction protocols, immune support, hormonal balance, stress management, and more. These efforts must also be tested in adaptive, patient-centered clinical trials that prioritize real health outcomes over narrow endpoints. Colleagues and readers interested in collaborative research, clinical trial design, or policy dialogue around this framework are warmly invited to connect. Together, we can move cancer care and chronic disease management toward upstream prevention and truly patient-centered solutions. ๐ Cheng, R. Z. From Mutation to Metabolism: Root Cause Analysis of Cancer's Initiating Drivers. Preprints 2025, 2025090903. About the AuthorRichard Z. Cheng, M.D., Ph.D. - Editor-in-Chief, Orthomolecular Medicine News Service Dr. Cheng is a U.S.-based, NIH-trained, board-certified physician specializing in integrative cancer therapy, orthomolecular medicine, functional & anti-aging medicine. He maintains active practices in both the United States and China. A Fellow of the American Academy of Anti-Aging Medicine and a Hall of Fame inductee of the International Society for Orthomolecular Medicine, Dr. Cheng is a leading advocate for nutrition-based, root-cause health strategies. He also serves as an expert reviewer for the South Carolina Board of Medical Examiners, and co-founded both the China Low Carb Medicine Alliance and the Society of International Metabolic Oncology. Dr. Cheng offers online Integrative Orthomolecular Medicine consultation services.
References:1. Brawley, O.W.; Goldberg, P. The 50 Years' War: The History and Outcomes of the National Cancer Act of 1971. Cancer 2021, 127, 4534-4540, doi: 10.1002/cncr.34040. 2. Cheng, R.Z. From Mutation to Metabolism: Root Cause Analysis of Cancer's Initiating Drivers 2025. https://www.preprints.org/manuscript/202509.0903/v1 3. Kirby, T. US Cancer Research Might Never Recover from Proposed Trump Funding Cuts. Lancet Oncol 2025, S1470-2045(25)00414-0, doi: 10.1016/S1470-2045(25)00414-0. Orthomolecular MedicineOrthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org Find a DoctorTo locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource. Editorial Review Board:
Jennifer L. Aliano, M.S., L.Ac., C.C.N. (USA)
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