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Crisis, Misinformation, and the Future of Cancer Care: A Candid Conversation with Dr Eric Winer
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Released: November 18, 2025

John Marshall
John Marshall, MD
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Crisis, Misinformation, and the Future of Cancer Care: A Candid Conversation with Dr Eric Winer

 

John Marshall, MD:
Hey, everybody out there—John Marshall for Oncology Unscripted.

 

And I am a lucky guy to be able to talk with such an amazing contributor to our world of cancer: Dr Eric Winer. And I’m going to embarrass him for a minute. Not only are we Dukies—by the way, go Devils—but we all know he has, as everyone on this call knows, really led so much of the innovation and progress in solid tumors—specifically breast cancer. Transformed things up at Harvard first, now back to his home base of Yale, where he oversees an incredible group of people and a program. And I am just—first—honored that he said yes when I asked him for a quick interview on the world today. So, Dr Winer—Eric—thank you for joining us.

 

Eric Winer, MD:
Oh, pleasure to be here—and I was honored to be asked.

 

John Marshall, MD:
You are so cool. Thanks a lot.

 

I mean, what I wanted to talk with you about is the impact—the acute impact—that we are having in general around cancer research and around cancer care, since this academic versus executive branch battle that’s been going on around grant funding, around cancer care, but now more acutely with the government shutdown, we have NCI trials. You know, patients are losing insurance and this sort of thing. And I know what it feels like here in Washington, but I thought—you, having a pretty broad vision around things in the country and maybe on a global scale—might have some reflections on this.

 

So, maybe just wax poetic a second about what the last several months have been like, and how the last month has made that even more.

 

Eric Winer, MD:
Sure. So, the last several months have not been easy, for sure. In truth, there are not that many grants that have not been refunded at our center at Yale. There are some—and there are people who lost some funding—and we’ve done our best to backfill whenever possible.

 

I think there’s a lot of anxiety. There’s a lot of anxiety, particularly among young people—young people trying to make careers in the lab, trying to make careers in clinical research—and that’s been pretty tough on everyone. And at Yale, we are one of those institutions—which I guess I should say we’re lucky to have such a large endowment—but we are one of the 8% endowment earnings tax institutions. So that is hundreds of millions of dollars a year to the university that we will be losing. And so, there have been many conversations about how it is that we’re going to manage to keep doing everything that we want to do. This is not just at the School of Medicine or in the cancer center—this is the university at large.

 

With, you know, with that kind of hit, I think the last few weeks have even been harder. Today there was, of course, supposed to be a Cancer Director’s meeting at the NCI. And the reason we are in our offices all day is because that was cancelled because of the shutdown.

 

John Marshall, MD:
Tell me the impact of that.

 

I mean, you guys get a lot done. I know when Lou Weiner goes up to those meetings, he comes back with a lot of fresh ideas, new collaborations, progress.

 

Tell me what a missed meeting—I mean, somebody said, “Well, we meet too often anyway.” What’s your take on that?

 

Eric Winer, MD:
Well, I think missing a meeting—you know, one meeting—isn’t such a big deal. I mean, in truth, was I perfectly happy to stay at home in Connecticut rather than go to Washington today? Sure. On the other hand, I think these meetings serve a real purpose.

 

It allows us to talk to one another. It allows us to hear what’s going on at the NCI, and how the Cancer Center Support Grants potentially are going to change. It’s a way of collaborating. So, I think it’s serious, and it’s concerning.

 

I guess my biggest worry with the government shutdown is all the people who aren’t getting paychecks. All the people diagnosed with cancer, who are living with cancer, who are struggling to find food to put on the table. You know, there were multiple stories this week—just watching the various news outlets—about government employees going to food banks. And some of those people have cancer. And it’s very hard.

 

I think that all the anxiety that we feel in academia at the moment—particularly related to medical research—I think now, suddenly, the whole country is feeling, with the government shutdown. And it’s hard to be under multiple stressors at the same time.

 

John Marshall, MD:
With cancer being one of them—particularly, think about our patients.

 

So, my wife accuses me of a lot of hyperbole—and she’s probably right—but I think we’re about one in three, one in five of my patients here in Washington, where one of the couple has either lost their job, is on furlough, or it’s questionable. And they’re often the one the insurance is with, right? And so, we’re trying to make plans for next scans or next cycles. And hospitals are on their heels a bit too about: will these be maintained? Will people keep up their premiums?

 

And so, I’m assuming you all are feeling it there in Connecticut as well, right?

 

Eric Winer, MD:
I mean, we don’t have as many government employees—federal government employees—as you do in DC. But, you know, I think it’s this pervasive sense of angst that so many people have that just makes it so much harder.

 

You know, my patients come in—and I see patients one day a week and totally enjoy it—but I have to say that the anxiety level is up for everybody. And I think that’s hard.

 

And it’s very hard when you’re going through difficult treatment and a difficult diagnosis, and you may be facing a diagnosis that is going to shorten your life expectancy—and to deal with everything else is pretty tough.

 

John Marshall, MD:
You’ve had a career in drug development, and I know you have a very good sense of global cancer research and global cancer care. There was just another colon cancer study that popped positive—using an IO plus an oral VEGF—that beat regorafenib by a nose. And I think about very expensive therapies—trial done all around the world—for a U.S. market, primarily.

 

And I sometimes wonder if our patients understand—or our federal government understands—just what a privilege it is to practice medicine here. Because we do have access to all the innovations. We’re the first to have access to them. We can provide them for our patients. Yes, it costs a lot of money—but it is a privilege. And we’re sort of the leading point on breakthroughs and applying those breakthroughs to our patients.

 

Do you think... you know, the administration before the Biden administration wanted this to happen. Certainly, RFK Jr. wants this to happen—some sort of leveling out of the playing field, of both the investment and the cost of cancer care.

 

Are you starting to see some of that?

 

Eric Winer, MD:
I don’t know that I’ve seen a lot of it.

 

I will—just to sort of shift a little bit—what I worry about is that the access that many people have to new treatments and drugs is not remotely distributed fairly or evenly in our country. And not all insurance is the same. Lots of people don’t have insurance. As there are threats to Obamacare and cutbacks in Medicaid and reductions in subsidies. You know, what the average family is going to pay in some states—where they've received subsidies—for their healthcare is huge. I mean, I think I read that a family of four living in Maine, when they lose their subsidy—a family of four making $130,000—is going to have to pay another $28,000 a year. They can’t do that.

 

That’s going to mean that people go without healthcare. And that’s going to lead to even greater inequities in the delivery of cancer care than we already know exist. You live in Washington, where the mortality for Black women with breast cancer is dramatically higher than for White women. And we know—if you look across the whole country—that if you’re a 20-year-old Black woman, a Black American woman, that you face twice the chance of dying from breast cancer as a 20-year-old White American woman before the age of 50. So, this is huge.

 

I will be the first to say: I believe in universal coverage. I think healthcare is a right, not a privilege. And it kills me that we’re getting further and further from that.

 

John Marshall, MD:
Further away. I couldn’t agree more about that.

 

And we spend—think how much we invest in our institutions, ourselves, and just the infrastructure and staff—to manage the complexity that you just described. And if we had a simpler system, we would reduce the cost of delivery just by that.

 

Eric Winer, MD:
Well, and it’s not even just about the dollars.

 

As treatments get more complicated, and they require more in the way of family involvement—if we have people who are struggling to get by, how are they going to have family members who can help them get through their cancer treatment?

 

You know, it’s interesting. We have a very large organization in New Haven called Sisters’ Journey, which is essentially a group of largely Black or African American women with breast cancer. And they are very effective advocates. They raise money. They try to help one another. And in talking to them, they realize that the care that many of their members have received over the years is just not the same—for a whole range of reasons—as the care that more affluent, and typically White, people receive.

 

John Marshall, MD:
Let me take you back and sort of—as we wrap up—to something you brought up at the beginning, and that’s younger people. You know, we are in the gray-hair part of our careers, but we’re still, you know, we’re out there doing our thing. But we’re OK. We’ll be OK individually.

 

But when you start thinking about somebody who’s 30, 40—early career—whether it’s medical or research or both. I think about my kids, who are in their early thirties. You know, what they’re going to have to deal with going forward about building careers—and the importance of that foundational science that really they provide us as we move the bar in research.

 

Maybe just share any further reflections you have. How vulnerable are these folks? Is it really angst that they should be worried about, or is it just angst because it’s unstable?

 

Eric Winer, MD:
Well, look. In the U.S. alone, we still have almost 2 million people diagnosed with cancer every year, and over 600,000 people who die from cancer. We need a lot of research still. We need research, and we need people who deliver the care. It’s just absolutely critical.

 

And you and I aren’t going to be those people with the breakthrough ideas. You need young people. And when a person who is 30 or 35 or 40—who’s finishing a PhD or an MD or an MD/PhD—looks at the likelihood that they’re going to get funded on their next R01, you know, with a chance of 4%. And maybe, if they’re a new investigator, it’ll be 7%. It’s hard to maintain enthusiasm. And yet, we desperately need those people to keep going into cancer research, or else we’re truly going to have a brain drain. Maybe not tomorrow. Maybe not next year. But in five years—we will.

 

And so, the damage that’s potentially done through these cuts in funding—and it’s not as if funding was so very generous ever—but at least there was a hope that people would get funded. But with the kinds of pay lines that exist at the moment, if I were a young person, it would be hard to maintain enthusiasm. And I’d be thinking about doing other things. I hope they don’t, but I fear they will.

 

John Marshall, MD:
Let me go one last place—and this is really what sometimes hurts me the most or makes me the most upset—and that’s the misinformation that’s being put out.

 

You know, as a GI oncologist, to see the word leucovorin on the front page of The Washington Post was shocking to me. Because, you know, we were going to cure a different problem with folic acid—fancy folic acid. And you see so much of it.

 

And so many of our patients are clearly reading this, because they’re coming into clinic and asking about it. So, I feel that I’m spending a much greater amount of my time just resetting reality—of what we know as science today and medicine today.

 

What’s your thoughts on that? Do you have any reaction to that?

 

Eric Winer, MD:
Well, I think, of course, misinformation is incredibly dangerous. And it’s hard for people who aren’t medical professionals to keep track of all the medical facts. I mean, medicine is complicated. But if at times people are hearing things that are just blatantly incorrect—and particularly when those comments come from people who they may respect—then it’s really challenging. I think we have to do our best to educate society about what we know and what we don’t know, and what steps people can take to improve their health and their family’s health. And when there are false statements made—it’s hugely damaging.

 

John Marshall, MD:
Thank you. Thank you for that feedback and thank you for your time.

 

I know it is Breast Cancer Awareness Month. You may or may not know that I’m sort of grumpy about that as a GI oncologist. So, if you want one of our stickers, here’s a “Love Your Butt” sticker—for, you know, the colon cancer people that are out there.

 

But let me again thank you so much, Dr Winer, for giving us your time and your knowledge and your experiences as we all navigate these challenging times.

 

We really, really appreciate your time.

 

Eric Winer, MD:
You bet. Take care.

 

John Marshall, MD:
John Marshall for Oncology Unscripted.

 

Thank you all very much.