DIRECTORS CORNER

Good news, bad news by Dr. John L. Marshall

A moment of reflection on Dr. Marshall's recent trip to New Zealand

GI cancer doctors and nurses are busy…actually, we are VERY busy. Busier than we have ever been. In January, a main topic of discussion among global leaders was how busy we all are, how there aren’t enough of us to see all the patients, and how there is little sign of this getting any better. Then came the numbers – the 2026 ACS cancer statistics were published.

On the good side, we are curing more people with GI cancers. Our treatments have improved survival, screening helps, and more survivors are in follow-up, teaching us important lessons about living! One of the most important cancer drivers in GI cancers, KRAS, is being successfully targeted by several new therapies with anticipated approvals for pancreatic cancer this year. Our use of immune therapy is improving dramatically, enabling us to cure patients without surgery. Our improvements in multi-disciplinary care are having a major impact on survival and quality of life. More patients will be cured, more patients will live longer – meeting our main Ruesch Center mission!

Now for the bad side. For as yet unexplained reasons, more and more Americans are getting GI cancers. And I am sure you are aware, also for unexplained reasons, more and more young people are getting diagnosed with GI cancers. We all have our theories on this – mine is that we have somehow changed our microbiome, our personal soil, in some negative way, leading to these cancers. Others don’t agree. But we are unified in our need to figure this out, and figure it out fast!

I have recently been reflecting on Charles Darwin and his observation that natural selection/evolution must be true. He did not understand exactly how it happened; he simply realized that it did. It was a controversial position because much of his “audience” believed in creation. It took over 100 years for us to actually show how DNA works, how mutations occur, and how this can lead to the evolution of species. Today, we are observing that young people are getting GI and other cancers, and just like Darwin, we cannot say exactly why. Just like those before us, it falls on us to understand why this is happening and do what we can to reverse it. It is this that drives us at the Ruesch Center. We hope you will join us in our efforts!