We have entered a decisive era for U.S. cancer care. Seventy percent of people now live at least five years after a cancer diagnosis, an unprecedented milestone founded on decades of scientific research. Yet these gains are not shared equally among communities, and the cost of care is rising exponentially.
We must confront some fundamental truths. This year’s American Cancer Society “Cancer Facts & Figures” report shows record survival. But while survival is up, so are cancer rates: Incidence continues to climb for common cancers including breast, prostate and liver. And in many communities, we’re seeing later-stage diagnoses, lower survival and higher financial burden.
As both survival and incidence climb, the need for timely access to advanced cancer care grows sharper. Currently, only a fraction of patients receive care at National Cancer Institute-designated comprehensive cancer centers, where leading-edge therapies and clinical trials often appear years before they reach community hospitals. That gap reveals both the promise of modern cancer care and the challenges that we must still overcome.
The financial pressures are equally significant. Cancer-attributable costs in the U.S. are projected to exceed $245 billion by 2030. Lifetime treatment for a single patient can reach hundreds of thousands of dollars, straining families, employers and payers.
A different path is possible. It depends on a change that cuts across policy debates, payment models and institutional rivalries: a deeper, more durable commitment to collaboration. Hospitals, research centers, employers, insurers, biopharma, policymakers and communities must treat collaboration as a core practice, not a side project.
City of Hope offers examples. Through initiatives like our AccessHope, NCI-designated cancer centers have come together to extend subspecialty expertise to employers nationwide, helping community physicians match patients to the right care at the right time, close to home. This model connects front-line clinicians with subspecialty experts, reduces variation, prevents avoidable costs and reaches millions of people. The results speak for themselves: Of the 20,000 cases AccessHope experts have reviewed since the program started, subspecialists recommended improvements in treatment plans 93% of the time, with local oncologists accepting their advice for more than two-thirds of patients.
The Stephenson Global Pancreatic Cancer Research Institute and the Stephenson Prize have also deepened our collaborative approach. A historic $150 million gift to City of Hope created a global institute focused on one of the deadliest cancers. It established a $1 million annual Stephenson Prize and millions in annual scholar grants to recognize breakthroughs in pancreatic cancer research, treatment and cures. The prize is open to investigators and teams worldwide, bringing experts together across institutions and borders to share data, accelerate discovery and advance promising science. In just the first year, more than 180 applications from leading cancer centers and research institutions around the world applied, with more than $6 million in total being awarded.
This is our organization’s long-standing belief made tangible: Cancer is the competition, not other health systems. When the world’s top scientists and clinicians come together under initiatives such as the Stephenson Prize, they are not competing for market share; they are competing against a disease that still carries one of the lowest survival rates in oncology. Philanthropy — a vital partnership with committed people — becomes the catalyst for shared progress rather than a fund for institutional isolation.
There are other encouraging signals. New public–private partnerships are working to speed the translation of discoveries into front-line care, from immunotherapies and targeted agents to novel diagnostics and supportive care models. Employers and health plans are testing benefit designs that encourage referrals to high-quality cancer centers to ensure the right care at the right time. Philanthropy is helping expand clinical trials, survivorship services and navigation resources to meet the growing needs of people living years after treatment.
Leaders in cancer care face real headwinds. In these times, policy uncertainty around reimbursement and threats to site-neutral payments and programs such as 340B could understandably trigger caution and retrenchment. The instinct to defend market share, protect the familiar and delay new partnerships is real, but it is misaligned with what patients now require.
Cancer does not recognize organizational boundaries. In confronting this disease, we need to be unbounded in our commitment and imagination. Collaboration, designed with rigor, backed by data and accountable for results, is no longer an accessory for our field. In an era defined by more cases, more survivors, higher costs and higher stakes, this change is one healthcare leaders can no longer postpone.
Robert Stone is CEO of City of Hope, one of the largest cancer research and treatment organizations in the U.S. Recognized as one of the most influential figures in U.S. healthcare, Mr. Stone played a key role in transforming City of Hope into a national cancer research and treatment network. Under his leadership, the organization expanded into five major metropolitan areas, serving over 160,000 patients annually. This expansion significantly improves access to advanced treatments, clinical trials and critical programs like bone marrow transplants and CAR T therapy. Known for its groundbreaking biomedical innovations, City of Hope is also the birthplace of biotech that has had a life-changing impact on millions worldwide.
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