If peak cancer years are two or more decades in your future, I'd argue that the best thing you can do today is donate to research programs that are likely to change the economic landscape of cancer research. You should also not get fat, not smoke, and all the other things that require no money, but research is much more transformative. You want the future to be no cancer, not less cancer.

Why economic transformation in cancer research? The cancer research community suffers from a high level strategy problem: the majority of treatments are only applicable to a small number of cancer types, out of the hundreds of known types, and the majority of new technology platforms under development will be just as expensive to adapt to a different type of cancer as to build in the first place. A much more efficient approach is needed, as there are only so many researchers and only so much funding in the world.

This is much on my mind because I'm helping to raise funds for one such project right now. It involves taking on the less well-supported but still necessary part of building a universal cancer treatment platform, one that can target all cancers. This could be built for about the same cost as one of today's highly specific single-cancer treatments. Obviously that is an immensely better path forward.

The approach is to block telomere lengthening: all cancers must lengthen their telomeres in order to grow, and abuse a small number of target mechanisms in order to do so. These mechanisms, telomerase and alternative lengthening of telomeres (ALT), are very fundamental to cellular biochemistry. If they are turned off, it is expected that there is no way for a cancer to evolve around that dead end. Many of today's cancer therapies, in addition to being very specific, also leave room for a cancer cells to evolve a different way of conducting business that renders them immune.

A number of research groups are working on sabotage of telomerase, but next to no-one is working on ALT. It is known that telomerase cancers can turn into ALT cancers, so it is probably the case that both doors have to be slammed shut to have a truly effective universal cancer therapy. So I'm helping a fundraiser to use an ALT assay to scan the standard drug candidate library for compounds that act to suppress ALT, something that should greatly advance that part of the field, both by identifying more lines of investigation, and by finding potential therapies for ALT cancers. Since ALT doesn't happen in normal cells, completely suppressing ALT should be a pretty safe treatment if an approach with limited side-effects can be identified. The telomerase blocking will need more work on compensating or targeting for other effects, since stem cells require it. But that is still a lot less work than producing one therapy per cancer type.