Michael Sapienza, Colorectal Cancer and Fundraising

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2024/12/26

Michael Sapienza is the CEO of the Colorectal Cancer Alliance, a leading nonprofit dedicated to eradicating colorectal cancer through prevention, patient support, and research funding. A former professional musician, Sapienza was inspired to shift careers after losing his mother to the disease in 2009. He has since become an influential advocate for cancer awareness and research. Under his leadership, the Alliance has launched major initiatives, including LEAD FROM BEHIND and Project Cure CRC, aiming to raise $100 million for innovative colorectal cancer research. Sapienza’s mission-driven approach has significantly expanded screening efforts and enhanced patient support across communities.

Sapienza highlighted the urgency of colorectal cancer, which ranks as the second leading cause of cancer-related deaths in the U.S. and is particularly lethal for men under 50. He stressed the need for early screening and awareness, citing barriers like rural access and socioeconomic challenges that hinder screening rates. Sapienza emphasized underfunding in colorectal cancer research compared to breast cancer and discussed initiatives like Project Cure CRC and the LEAD FROM BEHIND campaign with Ryan Reynolds, which boosted screening rates. He noted Dr. Dammie Brown’s contributions and initiatives like BlueHQ for patient support and education.

Scott Douglas Jacobsen: Of the types of cancer that exist, how prevalent is colorectal cancer? How high is it on the priority list?

Michael Sapienza: Colorectal cancer is the second leading cause of cancer-related deaths for both men and women combined in the United States. Globally, it is also among the most common cancer killers.

Unfortunately, for individuals under the age of 50, it is the leading cancer killer for men and the second-leading cancer killer for women. While it is highly prevalent, it is also one of the most preventable cancers, especially for those eligible for screening.

Jacobsen: What are the factors that contribute to a higher risk of developing colorectal cancer?

Sapienza:. First, if you are 45 or older and have no family history of colon cancer, that is when you should start getting screened. Screening methods include colonoscopy, a fecal immunochemical test (FIT), or a Cologuard test. However, if you have a family history, screening should begin 10 years before the age at which your relative was diagnosed or at age 40, whichever comes first. For example, if my mother had been diagnosed at age 40, I would have started screening at age 30.

Regarding risk factors, signs to watch out for include blood in the stool, changes in bowel habits, unexpected weight loss, and similar symptoms. However, it is important to undergo screening before symptoms appear, as symptoms can indicate an advanced stage of the disease. Screening is essential for individuals age 45 andover.

Jacobsen: Now, why is it the leading cancer killer for men and only the second for women? What is the distinction?

Sapienza: At this time, we do not fully understand the reasons. This statistic refers to young-onset colorectal cancer, defined as cancer occurring in individuals under the age of 50. While it is increasing more rapidly in men under 50 compared to women, the exact reason is unknown. However, if you were born after 1990, you are twice as likely to develop colorectal cancer before the age of 50 compared to those born before 1990. This represents a significant increase in young-onset colorectal cancer, and the reasons for this rise remain unclear.

Potential factors include increased use of antibacterial products, overuse of antibiotics, and a higher intake of sugary drinks than vitamin-rich beverages common in previous generations. Although these are hypotheses, the trend is likely multifactorial. The increase is not confined to the United States; it is observed in many Western countries. We suspect it may be related to environmental factors, diet, and other contributing elements.

One aspect that may be contributing is the change in the human microbiome. Our microbiome evolves as we grow, influenced by exposure to different environments and substances. When altered, the microbiome can weaken our natural defenses, allowing polyps to develop in the colon. These polyps can become cancerous over time.

Jacobsen: Who is more likely to go in for screenings, men or women?

Sapienza: That is a good question. Generally, women are more likely to undergo screenings, but this varies depending on demographics.

So, unfortunately, Black men are much less likely to get screened than their white male counterparts. But Black females do get screened. It depends. However, the most underserved population is the Alaskan Natives.

Jacobsen: Why?

Sapienza: It is likely due to the distance in terms of access to endoscopy suites, where one can get a colonoscopy and education. But mainly, the rural aspect makes it difficult. There are still tribes in places without running water and other basic amenities, which contributes to the inability to have a colonoscopy or even another type of test.

Jacobsen: What about the economic differences and geographic differences? How do those factor into this as well?

Sapienza: It’s interesting to consider whether you live in a city in rural America or another country. There are different risk factors. In a rural area, it may require driving 100 miles to reach an endoscopy center for a colonoscopy. This means taking time off work, paying for gas, and other costs associated with the trip, which deters people from following through with screenings.

In the city, there are other reasons. Are you a single mom or dad who needs that income? You might not be able to do the prep the night before and get screened the next day, or you may need someone to give you a ride home or face a co-pay with your insurance. There are numerous barriers related to payment and insurance.

This is not just an issue for underserved Black Americans or Hispanic Americans. Many white rural Americans face similar challenges and barriers. Additionally, affluent, insured middle-class individuals aged 45 to 58 may be less likely to get screened. They are often busy, with children approaching college age or already in college, and may be in the prime of their careers. The Alliance works extensively to increase screening across these different populations.

Jacobsen: Why is there a target of $100 million through initiatives like Project CURE CRC?

Sapienza: Colon cancer is one of the most underfunded cancers. Suppose you compare the federal spending in the United States. In that case, breast cancer receives about $1.1 to $1.3 billion, whereas colorectal cancer receives $353 million. More people die of colorectal cancer than breast cancer, which highlights a significant funding discrepancy.

Jacobsen: And is the ecosystem of research in the colon cancer space comparable to that of breast cancer?

Sapienza: No, not at all. The entire ecosystem of research for colon cancer is nowhere near where breast cancer research is. For example, the Estee Lauder family donated $100 million in 1994, generating approximately $4 billion in various treatments and leading to 300 new FDA approvals. Meanwhile, colon cancer patients diagnosed with metastatic cancer are still receiving the same frontline treatment they did 20 years ago.

Our board decided to create an initiative to raise significant money and make a substantial impact. This led to the announcement of our $100 million commitment. In December, we gathered top scientists in Miami Beach to plan our proposal request (RFP). We launched the first RFP in March, announced our first grant in June, and funded about $10 million, with more applications and projects in progress. We are reconvening experts in Miami to explore innovative approaches and draw insights from other diseases.

Jacobsen: What is the “Lead From Behind” initiative?

Sapienza: Lead From Behind is a celebrity-driven initiative to break the stigma surrounding colorectal cancer and encourage people to get screened. We partnered with Ryan Reynolds’ agency, Maximum Effortand collaborated with Ryan Reynolds, a Canadian, on the initial campaign. He’s really helped us to bring awareness to screening and prevention.

Jacobsen: Ah, yes, he came straight out of our highest end Canadian famous Ryan manufacturing facility. 

Sapienza: He, along with Rob McElhenney from It’s Always Sunny in Philadelphia, participated by filming their colonoscopies. The campaign generated about 16 million video views and 3.8 billion media impressions.

We have continued with several related campaigns to spread awareness and keep the conversation going. This cultural outreach has proven effective; a study conducted by Axios and Zocdoc showed a 36% increase in colonoscopy appointments during the 100 days following the launch in 2022 compared to the previous year. We refer to this as the “Ryan Reynolds effect.” We were thrilled with the success and continued collaborating with him to raise awareness.

Jacobsen: Dr. Dammie Brown, Senior Vice President of Mission Delivery—what has she contributed?

Sapienza: Dr. Brown has been essential in overseeing our mission delivery programs, including screening navigation initiatives. She has extensive experience launching multiple screening programs in Africa and working on similar programs in Los Angeles. She also brings a wealth of expertise from her time at pharmaceutical companies worldwide, focusing on pipeline development and patient engagement.

Dr. Brown contributes significantly to the research component of Project Cure CRC and has deep knowledge of patient support. Her business experience has also enabled us to develop various products and improve our mission programs.

Jacobsen: What is BlueHQ, and what is Dr. Brown’s role with it?

Sapienza: BlueHQ is a portal for all our patients to access resources and support. Dr. Brown is collaborating closely with our Senior Vice President of Data Intelligence and IT to develop this platform, ensuring it is approached with a business-minded perspective. You may already know this from speaking with other organizations, but many nonprofits are run differently from businesses. They are often managed as traditional nonprofits but must operate more like businesses to be effective. We are focused on creating products that help people rather than on making a profit from them.

Dr. Brown’s experience managing profit and loss (P&L) in large companies like Genentech, Roche, and Novartis has been invaluable. This expertise is crucial for developing practical tools such as an app that can be integrated into a healthcare system. As you may know, the U.S. healthcare system, unlike Canada’s, is neither the most efficient nor the highest quality, and it certainly does not provide universal access.

Jacobsen: What should people understand about the reasons to support colorectal cancer research, and how can they get involved? Are there other types of cancer they should be mindful of for their screenings?

Sapienza: Yes, cancer is a major cause of premature death. First, if anyone has questions about screenings, they should visit quiz.getscreened.org. We have a quiz that helps people determine if they are at high risk. Second, if you have a family member who has been diagnosed with colorectal cancer, visit colorectalcancer.orgg for support resources, including treatment navigators, financial assistance, and psychosocial support. If you are interested in learnign more about Project Cure CRC, to donate or submit a proposal, visit colorectalcancer.org/cure.

It is essential to be aware of when you should be screened for various cancers, such as breast, colorectal, lung, and prostate cancer. The HPV vaccine is also crucial. Knowing when to be screened for these major cancers is vital, as each has specific age guidelines and screening recommendations.

Jacobsen: Any final thoughts or feelings after today’s discussion?

Sapienza: No, I talked fast enough. Didn’t I?

Jacobsen: Your coffee kicked in. You’re in D.C., where people need to be verbally fluent. I love D.C. I visited for the first time when I came to the United States earlier this year. I traveled from Montreal to New York, Boston, D.C., Atlanta, New Orleans, Chicago, Los Angeles, San Diego, Irvine, and Seattle, among other cities. I have to say, D.C. has the best landscapers. I did landscaping at a horse farm and other places for several years–and I can tell you–they do mulching right.

Sapienza: That is so funny. That’s what you noticed? Where exactly?

Jacobsen: Downtown. I believe the Smithsonian Museum is there as well. I walked by there. There were some protests about the ongoing book bans—essentially another period of literary repression happening in the United States. I don’t panic too much because this tends to happen periodically in the U.S. I remember walking around and seeing that. 

Thank you so much for your time today.

Sapienza: Of course, Scott.

Jacobsen: It was good to meet you.

Sapienza: Good to meet you too. If you ever need anything or are in D.C., let me know.

Jacobsen: Absolutely. That would be fun.

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