Francis Collins: Ten years from now, anybody who develops cancer will have that cancer very intensively examined, complete DNA sequence, analysis of what genes are on or off, what proteins are being produced, and then a decision will be made of the increasingly long menu of targeted therapies that are both specific and not very toxic, what’s the right choice for that person to have the best possible outcome, and it will probably not be a single drug, because we know single drugs for other things, like HIV, can give you a response, but you want a cure.

It’ll probably be a combination, and the success rate might also depend upon an immune therapy being part of that mix, and it should be very high. But more than that, ten years from now our screening for cancer will have changed dramatically. We will find cancers at a much earlier stage when they’re better treated, and many of us think that will happen again because of DNA studies.

Turns out cancer cells are kind of clunky, and they actually spill their DNA into the blood circulation at a low level, and so all of the things we do now to survey for cancer using imaging and various protein markers may very well go by the boards, and it will be a DNA test that maybe we’ll each have once a year that looks for little hints of cancer cell DNA floating around that would be a sign you’d better find out what’s here, and then we’ll have it early enough to have a much better chance of treating that kind of — early detection is going to be transformed in the next ten years.