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Cancer Care, the FDA, and What Comes Next
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Released: February 23, 2026

John Marshall
John Marshall, MD
Catch Up On All Episodes of Oncology Unscripted

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Cancer Care, the FDA, and What Comes Next

 

John Marshall, MD: John Marshall, Oncology Unscripted.

 

A lot has been going on in the world of cancer care. There’s a lot of sort of gossip and buzz out there. I think one of the areas I’ve been getting in the crosshairs a lot lately is regulatory approvals. What’s actually going on at the FDA? Who’s working there? Who’s not working there? Staffing changes, new guidelines, new rules for what gets approved, what doesn’t get approved.

 

The speed at which things get approved—the structures that have been built and that we count on to ensure safety and efficacy for our patients and each other—is really unstable, unsettled at the moment. And if you don’t know, in April of 2025, there have been about 3,500 FDA jobs that were eliminated.

 

Those are people who were doing important work in trying to move the bar, to increase access, to accelerate access to novel therapies for our patients, just at a time when we need it more than ever. Leadership turnover—we’re going to talk a lot about this—there’s been a whole lot of turnover at the top, a hiring freeze, so we’re not backfilling any of this, and they are planning a big reorganization around all of this. And so, all of us in this industry, in this business, are concerned about what’s going on.

 

This Sunday’s Washington Post—I’m not sure it’s a newspaper I want to keep getting, but I still do get the paper copy. I go up the drive and pick it up and bring it down, rain or shine. It’s been very cold lately to go up and get it. But this Sunday, when I opened the business section, it was talking about key economic drivers in the United States and around the world. What are the key pillars? And guess what one of them was? One of them was healthcare.

 

And when I think about healthcare as an economic driver, what we mean by that is people are being hired, money’s being distributed. It helps the economy in general because then people have money, et cetera. Note that it’s all built on kind of a false economy, right? So the money that we are collecting down there at the hospital, the patient actually doesn’t have that kind of money. It’s coming from an insurance company. The insurance company got it either from the government or from the patient’s job or from some other resource.

 

And so, it’s sort of this fake economy that the Washington Post says is one of our key, yet unstable, economic drivers—and that’s on us as well. So, turnover at the FDA, an unstable situation there—that’s certainly the med buzz. The importance of healthcare to the overall economic health in the United States and around the world—you put those two things together, we could be in for some trouble ahead.

 

But we need to get on top of this. We need to talk about it. We need to make it better than it was before. And if we do that, we will, in fact, move forward toward curing more patients with cancer. John Marshall, Oncology Unscripted

 

This transcript has been edited for clarity.