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Groundhog Day, The Ice Palace, and $25 Trillion Cancer Costs
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Released: February 23, 2026

John Marshall
John Marshall, MD

         

 
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Groundhog Day, The Ice Palace, and $25 Trillion Cancer Costs

 

John Marshall, MD: John Marshall, Oncology Unscripted, Groundhog Day. That means this is that movie that just—the day just keeps happening over and over and over again until we get it right. Do you ever feel like that, whether it's in your clinic or in your commute or in your day job? Here in Washington, DC, the snow is so hard. They're calling it snowcrete, and we're not clear we’re ever gonna get dug out of it.

 

You know, it really is fitting to have Washington, DC, frozen solid like a rock because there's a whole lot of talk about ice, that's for sure. DC probably should be shut down, that's for sure. But we are trying to keep going, and we are trying to take care of one another.

 

I wanna start by looking at a paper that hit my social media feed from Nature, of all places, and it was really a paper that looked at the cost of cancer care going forward. Over the next 30 years, the estimate that we would spend on cancer as a world, the number was gonna be about $25 trillion looking ahead. And you think about, oh my goodness, and then you think about most patients in the world don't even have access to cancer care. So how much of that $25 trillion is, in fact, expanding markets versus how much of that is more and more consumables for the cancer patient, more expensive therapies, et cetera? I'm not really sure, but we need to watch ahead because we are a big market out there, team.

 

At the same time, we just got the American Cancer Society numbers that basically—this is just us, remember—said that over 2 million new cancers are being diagnosed in the year ahead. That's about 5,800 per day, and about 600,000 of those people will die of their cancer. Now, to be blunt, that sounds terrible, but that's actually better.

 

In fact, if you look over time, cancer mortality has fallen by over 30%, and so more and more people being diagnosed with cancer are subsequently cured of their cancer. But as you know, there are also some scary trends in increasing incidence of cancer that they project in this American Cancer Society summary paper from the last year and in the predictions for the year ahead.

 

You know, breast cancer, prostate cancer, young-onset colon cancer, melanomas in women, et cetera. There are rises being seen in incidence. We are doing better at diagnosis, and we are doing better at curing. We are spending more and more money as we go ahead, and how are we gonna get through all of this?

 

And so then here again, in the Ice Palace of Washington, DC, cancer research has been under threat. There have been drastic cuts, slowdowns, unfunded grants, things that the government said, we're not funding that anymore. We're gonna put a hold on that. That's even at the level of NCI-designated comprehensive cancer centers and many other aspects of cancer care.

 

And that threat, along with the sort of threat of health insurance not being maintained—the issues around the Affordable Care Act—is that really been funded or not? We're not quite sure where that stands, to be honest, right now, today on Groundhog Day. So there's a lot of threat to our industry and our business going forward.

 

But just in the last 24 hours, they did sign downtown in the Ice Palace—they did sign the ongoing bill through September, which at least maintains the National Cancer Institute funding at its current level. In some areas, it might actually be higher, but don't let anybody know down there because they'll cut it.

 

So every day I wake up, it's Groundhog Day, and every day I wake up to a new set of parameters that we have to live with, and worries and things we have to plan for. And at a time when more and more patients are expecting more of us, more and more innovation is coming to the table that's going to allow us to have a bigger and bigger impact on cancer.

 

And, of course, this house of cards may all fall. So stay tuned. Keep a watch here on Oncology Unscripted for the next day, next chapter in our world of Groundhog Day, the Ice Palace, cancer care in the world today. John Marshall, Oncology Unscripted.

 

This transcript has been edited for clarity.